Epidemiology
Figure 3 Patient-reported outcomes among those with breakthrough and non-breakthrough COVID-19 infection. FSI, Fatigue Symptom Inventory; mHAQ, modified Health Assessment Questionnaire; MCS-12, Mental Component Summary-12; PCS-12, Physical Component Summary-12; SF-12, 12- item Short-Form Health Survey; SF-MPQ, SF McGill Pain Questionnaire.
periods characterised by the predominance of a single SARS- CoV-2 variant; future studies evaluating differences in PASC by vaccination status while a single variant is dominant may help to elucidate this. Other improvements during the pandemic, such as outpatient treatment, may also impact our findings, though our results remained consistent in sensitivity analyses excluding these patients. Importantly, PASC remained relatively common (41% with symptoms lasting ≥28 days) among those with breakthrough infection, highlighting the ongoing need to better understand the aetiology of PASC in patients with SARD and to identify
have suggested that severity of COVID-19 is not intrinsically lower with Omicron versus earlier variants and that differences in severity are likely due to rates of vaccination and immunity from prior infection. 36 However, other studies have shown that the Omicron variants lead to more mild infections with reduced risk of hospitalisation, mechanical ventilation and death, so it is possible that our findings may be due to intrinsic differ- ences in PASC risk from different SARS-CoV-2 variants. 37–39 Because of the high rates of early vaccination among patients with SARDs, we are unable to compare the rates of PASC among those with and without breakthrough infection during time
Table 4 Patient-reported outcomes in rheumatic disease patients following COVID-19 infection
Breakthrough COVID-19 infection (N=116)
Non-breakthrough COVID-19 infection (N=164)
All rheumatic disease patients (N=280)
P value
Pain (SF-MPQ) N
258
111
147
Median score (IQR)
4 (2–10)
4 (1–8)
5 (3–10)
0.04 0.20
Pain rating index ordinal category, n (%)
No pain
41 (15) 86 (31) 135 (48)
17 (15) 43 (37) 51 (44)
24 (15) 43 (26) 84 (51)
Mild pain
Discomforting, distressing, horrible, or excruciating pain
Fatigue (FSI) N
264
111
153
Median score (IQR)
54 (26–82)
48 (21–79)
55 (28–84)
0.08
Functional status (mHAQ) N
270
112
158
Median score (IQR)
0.1 (0.0–0.5)
0.1 (0.0–0.5)
0.1 (0.0–0.5)
0.88 0.61
Categorical score, n (%)
163 (58) 107 (38)
70 (60) 42 (36)
93 (57) 65 (40)
Normal (<0.3)
Mild, moderate, or severe (0.3 to >1.8)
Health status (SF-12) PCS-12 score, median (IQR) MCS-12 score, median (IQR)
42.1 (33.0–50.8) 46.8 (36.9–54.4)
43.6 (33.7–52.6) 49.3 (41.4–55.6)
41.0 (32.2–49.5) 50.2 (37.9–57.0)
0.11
0.86 FSI, Fatigue Symptom Inventory; MCS-12, Mental Component Summary score; mHAQ, modified Health Assessment Questionnaire; PCS-12, Physical Component Summary score; SF-12, 12-item Short-Form Health Survey; SF-MPQ, SF McGill Pain Questionnaire.
Patel NJ, et al . Ann Rheum Dis 2023; 82 :565–573. doi:10.1136/ard-2022-223439
571
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