Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection
Tanayott Thaweethai(Harvard University), Sarah E. Jolley(University of Colorado Anschutz Medical Campus), Elizabeth W. Karlson(Brigham and Women's Hospital), Emily B. Levitan(University of Alabama at Birmingham), Bruce D. Levy(Brigham and Women's Hospital), Grace A. McComsey(Case Western Reserve University), Lisa McCorkell(Patient-Led Research Collaborative), Girish N. Nadkarni(Icahn School of Medicine at Mount Sinai), Sairam Parthasarathy(University of Arizona), Upinder Singh(Stanford University), Tiffany Walker(Emory University), Caitlin Selvaggi(Massachusetts General Hospital), Daniel J. Shinnick(Massachusetts General Hospital), Carolin C. M. Schulte(Massachusetts General Hospital), Rachel Atchley-Challenner(Mass General Brigham), Leora I. Horwitz(New York University), Andrea S. Foulkes(Harvard University), Judith A. Aberg, Natalie L. Adolphi, Shreya Ahirwar, Shifa Ahmed, Neera Ahuja, Masanori Aikawa, Almary Akerlundh, Teresa Akintonwa, Aseel Al‐Jadiri, Natalya Alekhina, Heather A. Algren, Akram N. Alshawabkeh, Nariman Ammar, Adit Anand, Brett R. Anderson, Lisa Aponte‐Soto, Judy L. Aschner, Mary Atha, Andrew M. Atz, Robin L. Aupperle, Mirna Ayache, Eduardo Azziz‐Baumgartner, L. Charles Bailey, Fiona C. Baker, Venkataraman Balaraman, Jennifer A. Bandy, Dithi Banerjee, Deanna M. Barch, James M. Bardes, Jackson Barlocker, R. Graham Barr, Arielle Baskin–Sommers, Sanjib Basu, Tracy A. Battaglia, Leah Castro Baucom, Carmen Beamon, Casey L. Beaty, Noam D. Beckmann, Jasmine A. Berry, Nahid Bhadelia, Daksh Bhargava, Sultana Bhuiyan, Jiang Bian, Christian Bime, James M. Bjork, Lora Black, Catherine A. Blish, Jason P. Block, Amanda Bogie, Dawn Bolliger, William J. Bonaventura, Seuli Bose‐Brill, Mary Bower, Andrew D. Boyd, Jerusha Boyineni, Steven B. Bradfute, Carolyn T. Bramante, M. Daniel Brannock, J. Douglas Bremner, Shari B. Brosnahan, Natalie C. Buchbinder, Elliott Bueler, Irina A. Buhimschi, Hülya Bükülmez, H. Timothy Bunnell, John B. Buse, Elizabeth A. Calhoun, Tingyi Cao, Michael D. Carrithers, Thomas W. Carton, Abigail Case, B.J. Casey, Faye Victoria C. Casimero, Lauren Castro, Teresa C. Cato, Patricia Ceger, Connie L. Cerullo, Linda Chang, A. Ann Chang, Praneeth Chebrolu, Yong Chen, Long‐Qing Chen, Benjamin K. Chen, David Chestek, Robert Chew, Deena J. Chisolm, Dominic C. Chow, Maryanne Chrisant, Dimitri Christakis, Christopher G. Chute, Mine S. Cicek, Cheryl R. Clark, Duncan B. Clark, Geoffrey D. Clarke, Katharine N. Clouser, Thomas J. Connors, Judith Α. Cook, Krista Coombs, Carlos Cordon‐Cardo, Julie L. Costello, Lesley Cottrell, Kelly Cowan, Lindsay G. Cowell, Savannah Cranford, J. Cronin, Mollie Cummins, Hannah L. Curry, Viren D’Sa, S Dabney, Casey L. Daniel, Mirella Dapretto, Dawood Darbar, Paul M. Darden, Raktima Dasgupta, Soham Dasgupta, Felicia Davis Blakley, Katherine Dea, Sara J. Deakyne Davies, Lauren A. Decker, Ralph A. DeFronzo, Walter Dehority, Amelia N. Deitchman, James Del Alcazar, Phoebe Del Boccio, Carlos del Rı́o, Marina Del Rios, Julie A. DeLisa, Sean Deoni, Maya Z. Diaz, John D. Dickinson, Audrey Dionne, Kathleen R. Diviak, Sarah E. Donohue, Michael J. Downey, Allen J. Dozor, Benard P. Dreyer, Kirsten Dummer, Matthew S. Durstenfeld, Mark S. Dworkin, Sherrie Edmonds, Matthew D. Elias, Jamie Elifritz, Evan Ellingworth, Amy Elliott, Angela M. Ellison, Mike Enger, Joaquı́n M. Espinosa, Shari Esquenazi‐Karonika, Michael D. Evans, Danielle N. Evans, Julio C. Facelli, Camila S. Fang, E. Vincent S. Faustino, Maria E. Fayad Lara, Candace H. Feldman, Alexander G. Fiks, Rebecca Fineman, Aloke V. Finn, M Fischer, Megan L. Fitzgerald, Valerie J. Flaherman, Thomas J. Flotte, Daniel Forsha, Meghan R. Fortune, John J. Foxe, Nicole Franks, Michael B. Freedman, Catherine Freeland, Naomi P. Friedman, Greta Fry, Margot Gage Witvliet, Emily J. Gallagher, Richard Gallagher, Hugh Garavan, Sunanda M. Gaur, Dylan G. Gee, Maria Laura Gennaro, Lynn B. Gerald, Saikat B. Ghosh, Joseph T. Giacino, Andrew T. Girvin, Stephanie L. Godfrey, Mark P. Goldberg, Steven N. Goodman, Howard S. Gordon, Ramkiran Gouripeddi, Paige Graham, Joey P. Granger, Kevin M. Gray, Tina Greimes, Rachel S. Gross, Nicholas Güthe, Evan Gutter, Stephanie Haasnoot, Emily Hadley, Melissa Haendel, Stephanie Hafner, Katia C. Halabi, Patrick C. Hanley, Ashraf S. Harahsheh, Michelle Harkins, Kimberly Hartwig, Keren Hasbani, Sharon Hasek, Kristine Hauser, Andrew C. Heath, Camden L. Hebson, Mary M. Heitzeg, Monica Hendrickson, Timothy J. Henrich, Alfonso C. Hernandez‐Romieu, Christina M. Hester, Miranda Higginbotham, Sophia Hill, Kathryn Hirabayashi, On Ho, Laura Hobart‐Porter, M. Camille Hoffman(Christiana Care Health System), Maryann Holtcamp, Travis K.F. Hong, Benjamin D. Horne, Carol R. Horowitz, Daniel S. Hsia, Harvey Hsu, Priscilla Y. Hsue, Matthew J. Huentelman, Bryan E. Huerta, Jared D. Huling, Kathy D. Hummel, William G. Iacono, Alejandra L. Ibanez, Carmel Ibeawuchi, Katherine Irby, Nahed Ismail, Joanna Jacobus, Vanessa L. Jacoby, Leonard A. Jason, Vidhi Javia, Kyle J. Jennette, Terry L. Jernigan, Sihang Jiang, Naimin Jing, Jace D. Johnny, Nadia Johnson, Brandi Johnson, Brandon M. Johnson, Pei‐Ni Jone, Suzanne E. Judd, Joy Juskowich, Edmond K. Kabagambe, David C. Kaelber, Diane G. Kanjilal, Mayank Kansal, Tyler Kasmarcak, Daniel Kaufman, Rika Kawakami, Dean L. Kellogg, Denise A. Kent, Deepshikha Kewlani, Dhruv Khullar, Keri S. Kim, Arthur Y. Kim, Patricia A. Kinser, Lawrence C. Kleinman, Elizabeth B. Klerman, Matthew J. Kluko, Stacey Knight, Misaki Kobayashi, Karla Kopp, Michael Koropsak, Jessica S. Kosut, Ellen Kraig, Amanda Krausert, Ana C. Krieger, Hema Krishna, Aparna Krishnamoorthy, Sankaran Krishnan, James P. Lahs, Angela R. Laird, Victoria Laleau, Michelle F. Lamendola-Essel, Jeremy Landeo‐Gutierrez, Sean M. Lang, Christine L. Larson, James P. Lash, Jessica Lasky‐Su, Gregory Laynor, Simon Lee, Grace M. Lee, F. E. Lee, Matthew A. Lee, Peter Leese, R. C. Lefebvre, Angelica J. Levreault, Kennedy C. Lewis, Li Lu, Peter Paul Lim, Janet Lin, Krista M. Lisdahl, Matthew B. Litvack, Xiaokang Liu, Jennifer E. V. Lloyd, Jennifer K. Logue, Johanna Loomba, Vitaly Lorman, Yiwen Lu, Katelyn R. Ludwig, Allison M. Lutz, Jeri Mack, Abeer M. Mahmoud, Cheryl L. Maier, Shahdi K. Malakooti, Sergey Malchenko, Gail Mallett(Northwestern University), Gabrielle Maranga, Megan W. Martel, Susanne P. Martin‐Herz, Maria Martinez‐Lage, Christine Maughan, Cammeo Mauntel‐Medici, Heidi T. May, Kenneth H. Mayer, Diego R. Mazzotti, Caitryn McCallum, Brian W. McCrindle, Russell J. McCulloh, Dylan McDonald, Stephanie McInnis, Julie A. McMurry, Asunción Mejías, Jonathan Melamed, Martha Menchaca, Alan L. Mendelsohn, Lucio Miele, Mitchell G. Miglis, Cris Milne, Joshua D. Milner, Roger A. Mitchell, Murray A. Mittleman, Sindhu Mohandas, Jonathan G. Monteiro, Vanessa Monzon, David J. Moreno, Lerraughn Morgan, Dmitry Morozyuk, Keith Morse, Érick Moyneur, Praveen C. Mudumbi, Eva M. Müller‐Oehring, Naoko Muramatsu, Hugh Musick, Kshema Nagavedu, Erica R. Nahin, Anoop M. Nambiar, Benjamin H. Natelson, Michael C. Neale, Manette Ness-Cochinwala, Jane W. Newburger, Lisa T. Newman, Amber N. Nguyen, Lauren P. Nichols, Sheila M. Nolan, Seth Noland, Richard Novák, George O'connor, John J. O’Keefe, Princess U. Ogbogu, Carlos R. Oliveira, Matthew E. Oster, Robert F. Padera, Henry Paik, Nathan M. Pajor, Huaqin Pan, Deepti Pant, Andrew Partridge, Payal Patel, Saaya Patel, Khushboo Patel, Martin P. Paulus, R. Mark Payne, Ann Pearman, Myriam Peralta-Carcelén, Nicolas L. Perez, Emily Pfaff, De‐Ann M. Pillers, Chloe E. Pitsch, Neil H. Pliskin, Michael A. Portman, Radu Postelnicu, Jennifer Sharpe Potter, Bellur S. Prabhakar, Priya Prahalad, Bharati Prasad, Barbara Predki, Alexander Preiss, Heather M. Prendergast, Davin K. Quinn, Yuri Quintana, Dustin J. Rabideau, Jonathan Radosta, Jeffrey Radwell, Hengameh Raissy, Ramaswamy Ramchandran, Isabelle Randall, Suchitra Rao, Amy Rapkiewicz, Sonja A. Rasmussen, Hanieh Razzaghi, Candida J. Rebello, Paulina A. Rebolledo, Neha V Reddy, U.M. Reddy(Columbia University Irving Medical Center), Cara Reedy, Jalees Rehman, R. Ross Reichard, Kayleigh M. Reid, Jane E.B. Reusch, Kyung E. Rhee, Mary B. Rice, John-Ross R. Rizzo, Nadia R. Roan, Polly Robarts, Timothy Roberts, Nitza Rochez, Kathleen E. Rodgers, Colin Rogerson, Maria Romero, Johana Rosas, Erika B. Rosenzweig, Russell L. Rothman, Nadine Rouphael, Mark W. Russell, Melissa Rutherfoord, Arash Sabati, Samer B. Sader, Marzieh Salehi, Amy L. Salisbury, Barbara A. Sampson, Yamuna Sanil, Alice I. Sato, Sharon Saydah, Michael S. Schechter, Edward J. Schenck, Katherine Schlepphorst, Julia Schuchard, Tina Schuh, Jennifer A. Sculley, Alan C. Seifert, Anisha K. Sekar, Rangaraj Selvarangan, Sudha Seshadri, Howard D. Sesso, Dimpy P. Shah, Divya Shakti, Nancy L. Shapiro, Suchetha Sharma, Kumar Sharma, Shubhi Sharma, Kavita Sharma, Gwendolyn DuBois Shaw, Eyal Shemesh, Yishan Shen, Elizabeth Shenkman, Stephanie Shiau, Michelle Siciliano, Aylin Simsir, Veronica E. Smith, Jessica Snowden, Isaac H. Solomon, Leslie Spikes, Lindsay M. Squeglia, Shubhika Srivastava, Mary L. St. Jean, Kenneth A. Stapleford, Cheryl R. Stein, Michelle D. Stevenson, Sarah A. Stewart de Ramirez, Lauren E. Stiles, Aryeh Stock, Melissa S. Stockwell, James R. Stone, Jeran K. Stratford, Til Stürmer, Vignesh Subbian, Jun Sun, Mehul S. Suthar, Ashley Sylvera, David M. Systrom, Jacqueline Szmuszkovicz, Maria M. Talavera‐Barber, Kelan G. Tantisira, Nancy Tartt, Tracy Terlinde, Ronald J. Teufel, Deepika Thacker, M. Thakrar, Stephen N. Thibodeau, Gelise L. Thomas, Moriah E. Thomason, Jiayi Tong, Robert Carreras‐Torres, Jessica Traenkner, Robin Tragus, Joel D. Trinity, Jena Shaw Tronieri, Andrea B. Troxel, Jennifer Truong, Dongngan T. Truong, Joel Tsevat, Mmekom Udosen, Kristen Unterberger, Paul J. Utz, Viola Vaccarino, Brittany B. Vallejos, Terry L. Vanden Hoek, Nita Vangeepuram, Jay K. Varma, Suzanne D. Vernon, Crystal M. Vidal, Sara Vivensi, Adam Vohra, Laura Wagner, Fei Wang, David Warburton, Megan Warner, Rebecca L. Watkins, Sara Watson, Ryan Webb, Ryan M. Weeks, Mark G. Weiner, Alan Werzberger, Shelby C. West, Jordan C. Weyer, Jennifer L. Wheeler, Kenneth J. Wilkins, Natasha Williams, Charles T. Williams, Erika Wimberly, Terra J. Winter, Scott C. Woller, Rachel Wong, Jeremy P. Wood, John C. Wood, Marion J. Wood, Qiong Wu, Yinglin Xia, Jie Xu, Samuel Yang, Hong-Xia Yin, H. Shonna Yin, Yun Jae Yoo, Chloe E. Young, N. Young, Chengxi Zang, William T. Zempsky, Bingyu Zhang, Yongkang Zhang, Dazheng Zhang, Emily Zimmerman, John Andrefsky, Jeanne Marrazzo, Jennifer Dixon, Lisa Gale, Phoebe Maholovich, Praveen Sudhindra, Tiffany Thompson(Emory University), Elyce B. Sheehan, Alisha N. Parada, Kiirk Knowlton, J. L. Ross Anderson, Marjorie McIntyre, Sean McCandless, Sarah Montoya, Debra Davis, Eric Spanier(Alzheimer's Association), Thomas Wodushek, Ron J. Sokol, Yvonne Maldonado, Karen B. Jacobson(University of Arizona), Xiaolin Jia, Jake Scott, Orlando Quintero, François Haddad, Hannah Valantine, Roham T. Zamanian, Divya Pathak, Jeanette Boyce, Francesca Facco, Sarah C. Hankle, John A. Vargo(University of Illinois Chicago), Donna M. Campbell, Donna Armstrong, Madison Mann(University of Alabama at Birmingham), Nicole P. Burrell, Anna Bartholomew(Stanford University), William A. Grobman, Barbara Cackovic(The University of Texas at San Antonio Health Science Center), Baylee Klopfenstein, Samantha Weigand, Esther K. Snow, Kathleen Fennig, M. Sean Esplin, Denise Lamb(University of Washington), Amanda L. Nelsen, Jocelyn E. Phipers, Lauren Fischer, Olivia Docter, Jeanette P. Brown(University of Arizona), Angelica M. DeMartino, Donna Allard, Emily Miller, Sabine Bousleiman, Megan M. Loffredo(University of Washington), Ashley Q. Vanneman, Imene Beche, Rosalyn Chan-Akeley, Luis D. Pacheco, Jennfier D. DeVolder, Ashley H. Salazar, Lisa Thibodeaux, Jennifer Cornwell(Kaiser Permanente), Amelia A. Nounes, Eugenia S. Sweet, Abigail Pierse, Brittany DeSantis, Parmjit Gill-Jones, David N. Hackney, Suneet P. Chauhan, Felecia Ortiz, Jenifer Treadway, Juanita Rugerio, Kelly James Clark, Molly A. Leatherland, S. Timlin, Chelsea A. Grinnan, Jennifer Ferrara(Kaiser Permanente), Michelle A. Kominiarek, Dequana Jones, Tim Reynolds, Katherine M Kearns, Eleanor Saffian, Mariana Karasti, Chrsitinia Pizzi, Anna Filipczak(Medical College of Wisconsin), Emily Long(Tulane University), Megan Mitchell, Katia J. Barrett, Celia M. Mullowney, George A. Macones(Eastern Virginia Medical School), George A. Alba(Massachusetts General Hospital), Radica Z. Alicic(University of Washington), Natasha Altman(University of Colorado Anschutz Medical Campus), Khamal Anglin(University of California, San Francisco), Urania Argueta(University of California, San Francisco), Hassan Ashktorab(Howard University), Gaston Baslet(Brigham and Women's Hospital), Ingrid V. Bassett(Massachusetts General Hospital), Lucinda Bateman(Bateman Horne Center), Brahmchetna Bedi(Emory University), Shamik Bhattacharyya(Brigham and Women's Hospital), Marie‐Abèle Bind(Massachusetts General Hospital), Andra L. Blomkalns(Stanford University), Hector Bonilla(Stanford University), Hassan Brim(Howard University), Patricia A. Bush, Mario Castro(University of Kansas Medical Center), James Chan(Massachusetts General Hospital), Alexander W. Charney(Icahn School of Medicine at Mount Sinai), Peter Chen(Cedars-Sinai Medical Center), Lori B. Chibnik(Massachusetts General Hospital), Helen Y. Chu(University of Washington), Rebecca G. Clifton(George Washington University), Maged M Costantine(The Ohio State University), Sushma K. Cribbs(Emory University), Sylvia I. Davila Nieves(University of Puerto Rico, Medical Sciences Campus), Steven G. Deeks(University of California, San Francisco), Alexandria M. Duven(Swedish Medical Center), Ivette F. Emery(MaineHealth), Nathan Erdmann(University of Alabama at Birmingham), Kristine M. Erlandson(University of Colorado Anschutz Medical Campus), Kacey C. Ernst(University of Arizona), Rachael Farah-Abraham(Emory University), Cheryl E. Farner(The University of Texas at San Antonio Health Science Center), Elen Feuerriegel(University of Colorado Anschutz Medical Campus), Judes Fleurimont(University of Illinois Chicago), Vivian Fonseca(Tulane University), Nicholas Franko(University of Washington), Vivian S. Gainer(Mass General Brigham), Jennifer C. Gander(Kaiser Permanente), Edward M. Gardner(Denver Health Medical Center), Linda N. Geng(Stanford University), Kelly S. Gibson(MetroHealth), Minjoung Go(Stanford University), Jason D. Goldman(Swedish Medical Center), Halle Grebe(University of California, San Francisco), Frank L. Greenway(Pennington Biomedical Research Center), Mounira Habli(TriHealth), John W. Hafner(University of Illinois Chicago), Jenny E. Han(Emory University), Keith A. Hanson(Illinois College), James R. Heath(Institute for Systems Biology), Carla Hernandez, Rachel Hess(University of Utah), Sally Hodder, Matthew Hoffman(Christiana Care Health System), Susan E. Hoover(Sanford Health), Beatrice Huang(University of California, San Francisco), Brenna L. Hughes(Duke University), Prasanna Jagannathan(Stanford University), Janice John(Cambridge Health Alliance), Michael R. Jordan(Tufts Medical Center), Stuart D. Katz(New York University), Elizabeth S. Kaufman(MetroHealth Medical Center), J. Daniel Kelly(University of California, San Francisco), Sara Warfield Kelly(Illinois College), Megan Kemp(University of Washington), John P. Kirwan(Pennington Biomedical Research Center), Jonathan D. Klein(University of Illinois Chicago), Kenneth S. Knox(University of Arizona), Jerry A. Krishnan(University of Illinois Chicago), Andre Kumar(Stanford University), Adeyinka O. Laiyemo(Howard University), Allison Lambert(University of Washington), Margaret Lanca(Harvard University), Joyce Lee‐Iannotti(University of Arizona), Brian P. Logarbo(Tulane University), Michele Longo(Tulane University), Carlos A. Luciano(University of Puerto Rico System), Karen Lutrick(University of Arizona), Jason H. Maley(Beth Israel Deaconess Medical Center), G. Mallett(Northwestern University), Jai Marathe, Vincent C. Marconi(Emory University), Gailen D. Marshall(University of Mississippi), Christopher F. Martin(Emory University), Yuri Matusov(Cedars-Sinai Medical Center), Alem Mehari(Howard University), Hector Mendez‐Figueroa(The University of Texas Health Science Center at Houston), Robin J. Mermelstein(University of Illinois Chicago), Torri D. Metz(University of Utah), Richard P. Morse(Massachusetts General Hospital), Jarrod Mosier(University of Arizona), Christian Mouchati(University School), Janet Mullington(Harvard University), Shawn N. Murphy(Massachusetts General Hospital), Robert B. Neuman, Janko Ž. Nikolich(University of Arizona), Ighovwerha Ofotokun(Emory University), Elizabeth I. Ojemakinde(Morehouse School of Medicine), Anna Palatnik(Medical College of Wisconsin), Kristy Palomares(Saint Peter's University Hospital), Tanyalak Parimon(Sinai Health System), Samuel Parry(University of Pennsylvania), Jan E. Patterson(The University of Texas at San Antonio Health Science Center), Thomas F. Patterson(The University of Texas at San Antonio Health Science Center), Rachel E. Patzer(Emory University), Michael J. Peluso(University of California, San Francisco), Priscilla Pemu(Morehouse School of Medicine), Christian M. Pettker(Yale University), Beth A. Plunkett(NorthShore University HealthSystem), Kristen Pogreba-Brown(University of Arizona), Athena Poppas(Brown University), John G. Quigley(University of Illinois Chicago), Uma M. Reddy(Columbia University Irving Medical Center), Rebecca Reece(West Virginia University), Harrison T. Reeder(Massachusetts General Hospital), William Reeves(The University of Texas at San Antonio Health Science Center), Eric M. Reiman(Alzheimer's Association), Franz Rischard(Banner - University Medical Center Tucson), Jonathan Rosand(Massachusetts General Hospital), Dwight J. Rouse(Brown University), Adam M. Ruff(University of Kansas Medical Center), George R. Saade(Eastern Virginia Medical School), Grecio J. Sandoval(Milken Institute), Jorge Santana(University of Puerto Rico System), Shannon M. Schlater(University of Utah), Frank C. Sciurba(University of Pittsburgh), Fitzgerald M. Shepherd(Boston University), Zaki A. Sherif(Howard University), Hyagriv N. Simhan(University of Pittsburgh), Nora G. Singer(MetroHealth), Daniel W. Skupski(Cornell University), Amber Sowles(University of Utah), Jeffrey A. Sparks(Brigham and Women's Hospital), Fatima I. Sukhera(University of Oklahoma), Barbara S. Taylor(The University of Texas at San Antonio Health Science Center), Larissa Teunis(Emory University), Robert J. Thomas(Beth Israel Deaconess Medical Center), John M. Thorp(University of North Carolina at Chapel Hill), Paul J. Thuluvath(Mercy Medical Center), Amberly Ticotsky(Cambridge Health Alliance), Alan Tita(University of Alabama at Birmingham), Katherine R. Tuttle(University of Washington), Alfredo E. Urdaneta(Stanford University), Daisy Valdivieso(University of California, San Francisco), Timothy M. VanWagoner(University of Oklahoma Health Sciences Center), Andrew Vasey(University of Nebraska Medical Center), Monica Verduzco‐Gutierrez(The University of Texas at San Antonio Health Science Center), Zachary S. Wallace(Massachusetts General Hospital), Honorine Ward(Tufts Medical Center), David E. Warren(University of Nebraska Medical Center), Steven J. Weiner(George Washington University), Shelley Welch(West Virginia University), Sidney W. Whiteheart(University of Kentucky), Zanthia Wiley(Emory University), Juan P. Wisnivesky(Icahn School of Medicine at Mount Sinai), Lynn M. Yee(Northwestern University), Sokratis N. Zisis(Case Western Reserve University)
Cited by 836Open Access
Abstract
Importance: SARS-CoV-2 infection is associated with persistent, relapsing, or new symptoms or other health effects occurring after acute infection, termed postacute sequelae of SARS-CoV-2 infection (PASC), also known as long COVID. Characterizing PASC requires analysis of prospectively and uniformly collected data from diverse uninfected and infected individuals. Objective: To develop a definition of PASC using self-reported symptoms and describe PASC frequencies across cohorts, vaccination status, and number of infections. Design, Setting, and Participants: Prospective observational cohort study of adults with and without SARS-CoV-2 infection at 85 enrolling sites (hospitals, health centers, community organizations) located in 33 states plus Washington, DC, and Puerto Rico. Participants who were enrolled in the RECOVER adult cohort before April 10, 2023, completed a symptom survey 6 months or more after acute symptom onset or test date. Selection included population-based, volunteer, and convenience sampling. Exposure: SARS-CoV-2 infection. Main Outcomes and Measures: PASC and 44 participant-reported symptoms (with severity thresholds). Results: A total of 9764 participants (89% SARS-CoV-2 infected; 71% female; 16% Hispanic/Latino; 15% non-Hispanic Black; median age, 47 years [IQR, 35-60]) met selection criteria. Adjusted odds ratios were 1.5 or greater (infected vs uninfected participants) for 37 symptoms. Symptoms contributing to PASC score included postexertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, changes in sexual desire or capacity, loss of or change in smell or taste, thirst, chronic cough, chest pain, and abnormal movements. Among 2231 participants first infected on or after December 1, 2021, and enrolled within 30 days of infection, 224 (10% [95% CI, 8.8%-11%]) were PASC positive at 6 months. Conclusions and Relevance: A definition of PASC was developed based on symptoms in a prospective cohort study. As a first step to providing a framework for other investigations, iterative refinement that further incorporates other clinical features is needed to support actionable definitions of PASC.
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