Development of a Definition of Postacute Sequelae of SARS-CoV-2 Infection

作者：Tanayott Thaweethai, Sarah E. Jolley, Elizabeth W. Karlson, Emily B. Levitan, Bruce D. Levy, Grace A. McComsey, Lisa McCorkell, Girish N. Nadkarni, Sairam Parthasarathy, Upinder Singh, Tiffany Walker, Caitlin Selvaggi, Daniel J. Shinnick, Carolin C. M. Schulte, Rachel Atchley-Challenner, Leora I. Horwitz, Andrea S. Foulkes, 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, 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, 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, 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, Elyce B. Sheehan, Alisha N. Parada, Kiirk Knowlton, J. L. Ross Anderson, Marjorie McIntyre, Sean McCandless, Sarah Montoya, Debra Davis, Eric Spanier, Thomas Wodushek, Ron J. Sokol, Yvonne Maldonado, Karen B. Jacobson, 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, Donna M. Campbell, Donna Armstrong, Madison Mann, Nicole P. Burrell, Anna Bartholomew, William A. Grobman, Barbara Cackovic, Baylee Klopfenstein, Samantha Weigand, Esther K. Snow, Kathleen Fennig, M. Sean Esplin, Denise Lamb, Amanda L. Nelsen, Jocelyn E. Phipers, Lauren Fischer, Olivia Docter, Jeanette P. Brown, Angelica M. DeMartino, Donna Allard, Emily Miller, Sabine Bousleiman, Megan M. Loffredo, Ashley Q. Vanneman, Imene Beche, Rosalyn Chan-Akeley, Luis D. Pacheco, Jennfier D. DeVolder, Ashley H. Salazar, Lisa Thibodeaux, Jennifer Cornwell, 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, Michelle A. Kominiarek, Dequana Jones, Tim Reynolds, Katherine M Kearns, Eleanor Saffian, Mariana Karasti, Chrsitinia Pizzi, Anna Filipczak, Emily Long, Megan Mitchell, Katia J. Barrett, Celia M. Mullowney, George A. Macones, George A. Alba, Radica Z. Alicic, Natasha Altman, Khamal Anglin, Urania Argueta, Hassan Ashktorab, Gaston Baslet, Ingrid V. Bassett, Lucinda Bateman, Brahmchetna Bedi, Shamik Bhattacharyya, Marie‐Abèle Bind, Andra L. Blomkalns, Hector Bonilla, Hassan Brim, Patricia A. Bush, Mario Castro, James Chan, Alexander W. Charney, Peter Chen, Lori B. Chibnik, Helen Y. Chu, Rebecca G. Clifton, Maged M Costantine, Sushma K. Cribbs, Sylvia I. Davila Nieves, Steven G. Deeks, Alexandria M. Duven, Ivette F. Emery, Nathan Erdmann, Kristine M. Erlandson, Kacey C. Ernst, Rachael Farah-Abraham, Cheryl E. Farner, Elen Feuerriegel, Judes Fleurimont, Vivian Fonseca, Nicholas Franko, Vivian S. Gainer, Jennifer C. Gander, Edward M. Gardner, Linda N. Geng, Kelly S. Gibson, Minjoung Go, Jason D. Goldman, Halle Grebe, Frank L. Greenway, Mounira Habli, John W. Hafner, Jenny E. Han, Keith A. Hanson, James R. Heath, Carla Hernandez, Rachel Hess, Sally Hodder, Matthew Hoffman, Susan E. Hoover, Beatrice Huang, Brenna L. Hughes, Prasanna Jagannathan, Janice John, Michael R. Jordan, Stuart D. Katz, Elizabeth S. Kaufman, J. Daniel Kelly, Sara Warfield Kelly, Megan Kemp, John P. Kirwan, Jonathan D. Klein, Kenneth S. Knox, Jerry A. Krishnan, Andre Kumar, Adeyinka O. Laiyemo, Allison Lambert, Margaret Lanca, Joyce Lee‐Iannotti, Brian P. Logarbo, Michele Longo, Carlos A. Luciano, Karen Lutrick, Jason H. Maley, G. Mallett, Jai Marathe, Vincent C. Marconi, Gailen D. Marshall, Christopher F. Martin, Yuri Matusov, Alem Mehari, Hector Mendez‐Figueroa, Robin J. Mermelstein, Torri D. Metz, Richard P. Morse, Jarrod Mosier, Christian Mouchati, Janet Mullington, Shawn N. Murphy, Robert B. Neuman, Janko Ž. Nikolich, Ighovwerha Ofotokun, Elizabeth I. Ojemakinde, Anna Palatnik, Kristy Palomares, Tanyalak Parimon, Samuel Parry, Jan E. Patterson, Thomas F. Patterson, Rachel E. Patzer, Michael J. Peluso, Priscilla Pemu, Christian M. Pettker, Beth A. Plunkett, Kristen Pogreba-Brown, Athena Poppas, John G. Quigley, Uma M. Reddy, Rebecca Reece, Harrison T. Reeder, William Reeves, Eric M. Reiman, Franz Rischard, Jonathan Rosand, Dwight J. Rouse, Adam M. Ruff, George R. Saade, Grecio J. Sandoval, Jorge Santana, Shannon M. Schlater, Frank C. Sciurba, Fitzgerald M. Shepherd, Zaki A. Sherif, Hyagriv N. Simhan, Nora G. Singer, Daniel W. Skupski, Amber Sowles, Jeffrey A. Sparks, Fatima I. Sukhera, Barbara S. Taylor, Larissa Teunis, Robert J. Thomas, John M. Thorp, Paul J. Thuluvath, Amberly Ticotsky, Alan Tita, Katherine R. Tuttle, Alfredo E. Urdaneta, Daisy Valdivieso, Timothy M. VanWagoner, Andrew Vasey, Monica Verduzco‐Gutierrez, Zachary S. Wallace, Honorine Ward, David E. Warren, Steven J. Weiner, Shelley Welch, Sidney W. Whiteheart, Zanthia Wiley, Juan P. Wisnivesky, Lynn M. Yee, Sokratis N. Zisis · 发表于：JAMA · 年份：2023 · DOI：10.1001/jama.2023.8823 · 被引用次数：867 · 研究领域：Long-Term Effects of COVID-19、Fibromyalgia and Chronic Fatigue Syndrome Research、Respiratory and Cough-Related Research

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,...