- Jia, Xiaolin;
- Cao, Shu;
- Lee, Alexandra S;
- Manohar, Monali;
- Sindher, Sayantani B;
- Ahuja, Neera;
- Artandi, Maja;
- Blish, Catherine A;
- Blomkalns, Andra L;
- Chang, Iris;
- Collins, William J;
- Desai, Manisha;
- Din, Hena Naz;
- Do, Evan;
- Fernandes, Andrea;
- Geng, Linda N;
- Rosenberg-Hasson, Yael;
- Mahoney, Megan Ruth;
- Glascock, Abigail L;
- Chan, Lienna Y;
- Fong, Sharon Y;
- Consortium, CLIAHUB;
- Biohub, Chan Zuckerberg;
- Phelps, Maira;
- Raeber, Olivia;
- Group, Stanford COVID-19 Biobank Study;
- Purington, Natasha;
- Röltgen, Katharina;
- Rogers, Angela J;
- Snow, Theo;
- Wang, Taia T;
- Solis, Daniel;
- Vaughan, Laura;
- Verghese, Michelle;
- Maecker, Holden;
- Wittman, Richard;
- Puri, Rajan;
- Kistler, Amy;
- Yang, Samuel;
- Boyd, Scott D;
- Pinsky, Benjamin A;
- Chinthrajah, Sharon;
- Nadeau, Kari C
BACKGROUNDProlonged symptoms after SARS-CoV-2 infection are well documented. However, which factors influence development of long-term symptoms, how symptoms vary across ethnic groups, and whether long-term symptoms correlate with biomarkers are points that remain elusive.METHODSAdult SARS-CoV-2 reverse transcription PCR-positive (RT-PCR-positive) patients were recruited at Stanford from March 2020 to February 2021. Study participants were seen for in-person visits at diagnosis and every 1-3 months for up to 1 year after diagnosis; they completed symptom surveys and underwent blood draws and nasal swab collections at each visit.RESULTSOur cohort (n = 617) ranged from asymptomatic to critical COVID-19 infections. In total, 40% of participants reported at least 1 symptom associated with COVID-19 six months after diagnosis. Median time from diagnosis to first resolution of all symptoms was 44 days; median time from diagnosis to sustained symptom resolution with no recurring symptoms for 1 month or longer was 214 days. Anti-nucleocapsid IgG level in the first week after positive RT-PCR test and history of lung disease were associated with time to sustained symptom resolution. COVID-19 disease severity, ethnicity, age, sex, and remdesivir use did not affect time to sustained symptom resolution.CONCLUSIONWe found that all disease severities had a similar risk of developing post-COVID-19 syndrome in an ethnically diverse population. Comorbid lung disease and lower levels of initial IgG response to SARS-CoV-2 nucleocapsid antigen were associated with longer symptom duration.TRIAL REGISTRATIONClinicalTrials.gov, NCT04373148.FUNDINGNIH UL1TR003142 CTSA grant, NIH U54CA260517 grant, NIEHS R21 ES03304901, Sean N Parker Center for Allergy and Asthma Research at Stanford University, Chan Zuckerberg Biohub, Chan Zuckerberg Initiative, Sunshine Foundation, Crown Foundation, and Parker Foundation.