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. 2024 Nov 26;12(12):2694.
doi: 10.3390/biomedicines12122694.

Pharmacotherapy from Pre-COVID to Post-COVID: Longitudinal Trends and Predictive Indicators for Long COVID Symptoms

Nadia Baalbaki  1   2   3 , Sien T Verbeek  1 , Harm Jan Bogaard  1   4 , Jelle M Blankestijn  1   2   3 , Vera C van den Brink  1 , Merel E B Cornelissen  1   2   3 , Jos W R Twisk  5 , Korneliusz Golebski  1   2   3 , Anke H Maitland-van der Zee  1   2   3 ; P4O2 consortium
Affiliations

Pharmacotherapy from Pre-COVID to Post-COVID: Longitudinal Trends and Predictive Indicators for Long COVID Symptoms

Nadia Baalbaki et al. Biomedicines. .

Abstract

Background/objectives: A significant number of COVID-19 cases experience persistent symptoms after the acute infection phase, a condition known as long COVID or post-acute sequelae of COVID-19. Approved prevention and treatment options for long COVID are currently lacking. Given the heterogeneous nature of long COVID, a personalized medicine approach is essential for effective disease management. This study aimed to describe trends in pharmacotherapy from pre-COVID to post-COVID phases to gain insights into COVID-19 treatment strategies and assess whether pre-COVID pharmacotherapy can predict long COVID symptoms as a health status indicator.

Methods: In the Precision Medicine for more Oxygen (P4O2) COVID-19 study, 95 long COVID patients were comprehensively evaluated through post-COVID outpatient clinics and study visits. This study focused on descriptive analysis of the pharmacotherapy patterns across different phases: pre-COVID-19, acute COVID, and post-COVID. Furthermore, associations between pre-COVID medication and long COVID outcomes were analyzed with regression analyses.

Results: We observed peaks in the use of certain medications during the acute infection phase, including corticosteroids and antithrombotic agents, with a decrease in the use of renin-angiotensin system inhibitors. Consistently high use of alimentary tract medications was found across all phases. Pre-COVID respiratory medications were associated with fatigue symptoms, while antiinfectives and cardiovascular drugs were linked to fewer persisting long COVID symptom categories.

Conclusion: Our findings provide longitudinal, descriptive pharmacotherapy insights and suggest that medication history can be a valuable health status indicator in characterizing patients for personalized disease management strategies, considering the heterogeneous nature of long COVID.

Keywords: COVID-19; long COVID; longitudinal trends; pharmacotherapy; precision medicine.

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Conflict of interest statement

K.G.: received funding from STIMAG, GSK ISS, and ZonMw. Payments made to institution by GSK and ALK. A.H.M.-v.d.Z.: She is the PI of a public–private consortium (P4O2 (Precision Medicine for More Oxygen)) sponsored by Health Holland involving many private partners that contribute in cash and/or in kind (AbbVie, Boehringer Ingelheim, Breathomix, Clear, Fluidda, Ortec Logiqcare, Olive, Philips, Quantib-U, Smartfish, Clear, SODAQ, Thirona, Roche, TopMD, Novartis, and RespiQ). Received an unrestricted research grant from GSK and Boehringer Ingelheim. Received a Vertex Innovation Award Grant. Honoraria paid to institution from Boehringer Ingelheim, Astra Zeneca, and GSK. She is Chair of DSMB of a study on BPD in neonates. N.B., M.E.B.C., and J.M.B.: received salary from the PPP Allowance made available by Health Holland, Top Sector Life Sciences & Health (LSHM20104; LSHM20068), to stimulate public–private partnerships. J.M.B.: honorarium paid to institution from Vitakruid. S.T.V., H.J.B., V.C.v.d.B., and J.T.: nothing to declare.

Figures

Figure 1
Figure 1
Methods visualization. Data were collected from 95 P4O2 COVID-19 study participants at 3–6 months post-infection. Pharmacotherapy was reported at four time points (pre-COVID-19, during COVID-19, post-COVID, and at 3–6 months post-infection or long COVID). Self-reported symptom data at 3–6 months were categorized into fatigue, respiratory, neurological, cardiovascular, gastrointestinal, and other complaints.
Figure 2
Figure 2
Pharmacotherapy from pre-COVID to LC. A longitudinal visualization of the percentages of pharmacotherapy use among P4O2 COVID-19 study participants, categorized according to the first-level ATC medication groups.
See this image and copyright information in PMC

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