Background Little is known about how symptoms or symptom clusters of Post-COVID Conditions (PCC) impact an individual’s return to pre-COVID health. Methods We used four state-level COVID-19 case reporting systems and patient-reported survey data to identify patients with PCC and associations with an individual’s return to pre-COVID health after laboratory-confirmed SARS-CoV-2 infection. Participants had a positive SARS-CoV-2 test between March–December 2020. Weighted regression models were used to 1) estimate prevalence of PCC; 2) identify risk factors associated with developing PCC; and 3) examine associations between PCC symptom clusters and return to pre-COVID health. Factor analysis was used to statistically identify post-COVID symptom clusters. Findings Prevalence of PCC in this population-based sample was 29·9% for persons with SARS-CoV-2 infection, during the pre-delta variant period (March–December 2020); 77·2% of persons experiencing PCC had not returned to pre-COVID health within 8–60 weeks after infection. Female sex, acute COVID-19 illness severity, and number of pre-existing comorbidities were significant risk factors associated with PCC. Myalgic encephalomyelitis/chronic fatigue syndrome-like symptoms, upper-respiratory symptoms, and gastrointestinal symptoms were significantly associated with not returning to pre-COVID health. Interpretation Understanding PCC symptom clustering may provide insight into pathophysiology, severity of PCC, and management for patients who have not returned to their usual state of health after SARS-CoV-2 infection. Tracking PCC can help measure the impact of COVID-19 vaccination and acute COVID-19-specific treatments on reducing PCC in the US.

中文翻译：

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COVID 后疾病风险因素和症状群以及与恢复到 COVID 前健康的关联——2021 年多州调查结果


背景 关于 COVID 后疾病 （PCC） 的症状或症状群如何影响个人恢复到 COVID 之前的健康知之甚少。方法 我们使用四个州级 COVID-19 病例报告系统和患者报告调查数据来确定 PCC 患者以及与个人在实验室确诊的 SARS-CoV-2 感染后恢复到 COVID 前健康状况的关联。参与者在 2020 年 3 月至 12 月期间的 SARS-CoV-2 检测呈阳性。加权回归模型用于 1） 估计 PCC 的患病率;2） 确定与发生 PCC 相关的风险因素;3） 检查 PCC 症状集群与恢复到 COVID 前健康状况之间的关联。因子分析用于统计识别 COVID 后症状集群。调查结果 在 delta 变种前时期（2020 年 3 月至 12 月），SARS-CoV-2 感染者的 PCC 患病率为 29·9%;77·2% 的 PCC 患者在感染后 8-60 周内未恢复到 COVID 之前的健康状况。女性、急性 COVID-19 疾病严重程度和预先存在的合并症数量是与 PCC 相关的重要危险因素。肌痛性脑脊髓炎/慢性疲劳综合征样症状、上呼吸道症状和胃肠道症状与未恢复到 COVID 前的健康显著相关。解释 了解 PCC 症状聚集可能有助于深入了解 SARS-CoV-2 感染后未恢复正常健康状况的患者的病理生理学、PCC 严重程度和管理。追踪 PCC 有助于衡量 COVID-19 疫苗接种和急性 COVID-19 特异性治疗对降低美国 PCC 的影响。