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. 2021 Jul 26:14:3941-3949.
doi: 10.2147/IJGM.S313486. eCollection 2021.

Identification of a Vulnerable Group for Post-Acute Sequelae of SARS-CoV-2 (PASC): People with Autoimmune Diseases Recover More Slowly from COVID-19

Nancy Dreyer  1 , Natalia Petruski-Ivleva  1 , Lisa Albert  1 , Damir Mohamed  2 , Emma Brinkley  1 , Matthew Reynolds  1 , Stephen Toovey  3
Affiliations

Identification of a Vulnerable Group for Post-Acute Sequelae of SARS-CoV-2 (PASC): People with Autoimmune Diseases Recover More Slowly from COVID-19

Nancy Dreyer et al. Int J Gen Med. .

Abstract

Purpose: Evidence is emerging that a significant percentage of COVID-19 cases experience symptom persistence beyond 30 days and go on to develop post-acute sequelae. Our objective was to compare the risk for COVID-19 symptom persistence by self-reported use of medications for autoimmune disease among participants of an on-line COVID-19 registry.

Patients and methods: A community-based online survey collected weekly data on COVID-19 symptom presentation. Participants who completed informed consent online, reported a positive COVID-19 test result within 14 days prior to enrollment and also reported demographics, underlying illnesses, and medication use were included. Symptom presence and severity were evaluated weekly after enrollment and compared between participants reporting use of medications for autoimmune conditions and all others. Logistic regression was used to evaluate the odds of more severe acute illness and symptom persistence approximately 30 days after enrollment.

Results: A total of 1,518 COVID-19-positive participants were included. Participants reporting use of medications for autoimmune disease (n=70) were more likely to have experienced symptoms at all time points over a 30-day time period and were more likely to report more severe presentation of COVID-19 during acute illness (adjusted OR (95% CI)=1.32 (0.76-2.29)) compared to those reporting not taking medications for autoimmune disease. At about 30 days after enrollment, users of medications for autoimmune disease were more than twice as likely to report three or more symptoms (adjusted OR (95% CI)=2.53 (1.21-5.29)). In particular, their risk of persistent shortness of breath and fatigue was elevated (adjusted OR (95% CI)=2.66 (1.15-6.18) and 4.73 (2.17-10.34), respectively).

Conclusion: Individuals with underlying autoimmune conditions appear to be particularly vulnerable to post-acute sequelae from COVID-19; early intervention might be considered.

Keywords: COVID-19; PASC; autoimmune; direct-to-patient; fatigue; shortness of breath.

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Conflict of interest statement

The authors have no competing interests to disclose.

Figures

Figure 1
Figure 1
Symptom prevalence (%) for COVID-19-positive participants by self-reported use of medication for autoimmune disease.
See this image and copyright information in PMC

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