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 David Levy, Grace A. McComsey, Lisa McCorkell, Girish N. Nadkarni, Sairam Parthasarathy, Upinder Singh, Tiffany A. Walker, Caitlin Ann Selvaggi, Daniel James Shinnick, Carolin C. M. Schulte, Rachel Atchley-Challenner, Leora Idit Horwitz, Andrea S. Foulkes, Judith A. Aberg, Natalie L. Adolphi, Shreya Ahirwar, Shifa Ahmed, Neera K. 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 Lynn Aschner, Mary M. Atha, Andrew M. Atz, Robin L. Aupperle, Mirna B. 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 R Baskin-Sommers, Sanjib Basu, Tracy Ann 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 Matthew Bjork, Lora Jane Black, Catherine A. Blish, Jason P. Block, Amanda Lynn Bogie, Dawn Bolliger, William John Bonaventura, Seuli Bose‐Brill, Mary Bower, Andrew Dallas Boyd, Jerusha Boyineni, Steven B. Bradfute, Carolyn T. Bramante, M. Daniel Brannock, J. Douglas Bremner, Shari B. Brosnahan, Natalie C. Buchbinder, Elliott Bueler, Irina Alexandra 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 C. Ceger, Connie L. Cerullo, Linda L. Chang, A. Ann Chang, Praneeth Chebrolu, Yong Chen, Long‐Qing Chen, Benjamin K. Chen, David W. Chestek, Robert Chew, Deena J. Chisolm, Dominic Cheung 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 Grey Cowell, Savannah Cranford, Jamie Cronin, Mollie Rebecca Cummins, Hannah L. Curry, Viren A. 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 Anthony DeFronzo, Walter N. 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 David Elias, Jamie M. Elifritz, Evan Ellingworth, Amy J. Elliott, Angela M. Ellison, Mike Enger, Joaquin Maximiliano Espinosa, Shari Esquenazi‐Karonika, Michael D. Evans, Danielle N. Evans, Julio Cesar Facelli, Camila S. Fang, Edward Vincent S. Faustino, Maria E. Fayad Lara, Candace H. Feldman, Alexander G. Fiks, Rebecca Fineman, Aloke V. Finn, Melinda S. Fischer, Megan L. Fitzgerald, Valerie J. Flaherman, Thomas James Flotte, Daniel E Forsha, Meghan R. Fortune, John J. Foxe, Nicole M. Franks, Michael B. Freedman, Catherine Freeland, Naomi P. Friedman, Greta Fry, Margot Gage Witvliet, Emily J. Gallagher, Richard Gallagher, Hugh P 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 Michael Gray, Tina Greimes, Rachel S. Gross, Nicholas Güthe, Evan Gutter, Stephanie Haasnoot, Emily Hadley, Melissa Anne Haendel, Stephanie Hafner, Katia Camille Halabi, Patrick C. Hanley, Ashraf S. Harahsheh, Michelle S. Harkins, Kimberly Hartwig, Keren Hasbani, Sharon Hasek, Kristine Hauser, Andrew C. Heath, Camden L. Hebson, Mary M. Heitzeg, Monica Hendrickson, Timothy J. Henrich, Alfonso Claudio Hernández-Romieu, Christina M. Hester, Miranda Higginbotham, Sophia Hill, Kathryn Hirabayashi, On Ho, Laura J. Hobart‐Porter, Maria 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 N. Javia, Kyle J. Jennette, Terry L. Jernigan, Sihang Jiang, Naimin Jing, Jace D. Johnny, Nadia L. Johnson, Brandi E. Johnson, Brandon M. Johnson, Pei‐Ni Jone, Suzanne E. Judd, Joy J. Juskowich, Edmond Kato Kabagambe, David C. Kaelber, Diane G. Kanjilal, Mayank Mohan Kansal, Tyler J. Kasmarcak, Daniel Kaufman, Rika Kawakami, Dean L. Kellogg, Denise A. Kent, Deepshikha Kewlani, Dhruv Khullar, Keri S. Kim, Arthur Y. Kim, Patricia Anne Kinser, Lawrence C. Kleinman, Elizabeth B. Klerman, Matthew J. Kluko, Stacey Knight, Misaki Kobayashi, Karla J. 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 Phillip Lash, Jessica Ann 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 Jean Loomba, Vitaly Lorman, Yiwen Lu, Katelyn R. Ludwig, Allison M. Lutz, Jeri Mack, Abeer Mostafa Mahmoud, Cheryl L. Maier, Shahdi K. Malakooti, Sergey Malchenko, Gail L. Mallett, Gabrielle Maranga, Megan Wilson Martel, Susanne Pelley Martin-Herz, Maria Martinez‐Lage, Christine Maughan, Cammeo Mauntel‐Medici, Heidi Thomas May, Kenneth Hugh Mayer, Diego Robles Mazzotti, Caitryn M. McCallum, Brian W. McCrindle, Russell J. McCulloh, Dylan McDonald, Stephanie McInnis, Julie A. McMurry, Asunción Mejías, Jonathan Melamed, Martha G. Menchaca, Alan L. Mendelsohn, Lucio Miele, Mitchell G. Miglis, Cris I.P. Milne, Joshua D. Milner, Roger A. Mitchell, Murray A. Mittleman, Sindhu Mohandas, Jonathan G. Monteiro, Vanessa Monzon, David J. Moreno, Lerraughn M. 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 Nghi Nguyen, Lauren P. Nichols, Sheila M. Nolan, Seth Noland, Richard Novák, George T. O’Connor, John J. O’Keefe, Princess U. Ogbogu, Carlos R. Oliveira, Matthew E. Oster, Robert F. Padera, Henry Hyun-Il Paik, Nathan M. Pajor, Huaqin Helen Pan, Deepti B. Pant, Andrew Partridge, Payal B. Patel, Saaya Patel, Khushboo Patel, Martin P. Paulus, Ronald Mark Payne, Ann M. 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 John Rabideau, Jonathan M. Radosta, Jeffrey Radwell, Hengameh Raissy, Ramaswamy Ramchandran, Isabelle G. Randall, Suchitra Rao, Amy Rapkiewicz, Sonja A. Rasmussen, Hanieh Razzaghi, Candida Joan Rebello, Paulina A. Rebolledo, Neha V Reddy, U.M. Reddy, Cara Reedy, Jalees Rehman, Robert Ross Reichard, Kayleigh M. Reid, Jane E.B. Reusch, Kyung E. Rhee, Mary Berlik Rice, John-Ross R. Rizzo, Nadia R. Roan, Polly Robarts, Timothy R. Roberts, Nitza Rochez, Kathleen E. Rodgers, Colin M. Rogerson, Maria Elisa Nalegach Romero, Johana M. Rosas, Erika B. Rosenzweig, Russell L. Rothman, Nadine Rouphael, Mark W. W. Russell, Melissa Rutherfoord, Arash Alen Sabati, Samer B. Sader, Marzieh Salehi, Amy L. Salisbury, Barbara A. Sampson, Yamuna Sanil, Alice I. Sato, Sharon Saydah, Michael S. Schechter, Edward James Schenck, Katherine Schlepphorst, Julia Schuchard, Tina L. Schuh, Jennifer A. Sculley, Alan C. Seifert, Anisha K. Sekar, Rangaraj Selvarangan, Sudha S. 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 A. Shenkman, Stephanie Shiau, Michelle A. Siciliano, Aylin Simsir, Veronica E. Smith, Jessica N. Snowden, Isaac H. Solomon, Leslie A. 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 R. Szmuszkovicz, Maria M. Talavera‐Barber, Kelan G. Tantisira, Nancy Tartt, Tracy Terlinde, Ronald J. Teufel, Deepika Thacker, Mansi Thakrar, Stephen N. Thibodeau, Gelise L. Thomas, Moriah E. Thomason, Jiayi Tong, Robert Carreras‐Torres, Jessica J. Traenkner, Robin E. Tragus, Joel Douglas Trinity, Jena Shaw Tronieri, Andrea B. Troxel, Jennifer Truong, Dongngan T. Truong, Joel Tsevat, Mmekom M. 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 S Vohra, Laura Wagner, Fei Wang, David Warburton, Megan R. Warner, Rebecca L. Watkins, Sara E. Watson, Ryan D. Webb, Ryan M. Weeks, Mark G. Weiner, Alan Werzberger, Shelby C. West, Jordan C. Weyer, Jennifer L. Wheeler, Kenneth J. Wilkins, Natasha J. 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 Marisa 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 A. McCandless, Sarah Montoya, Debra A. Davis, Eric Spanier, Thomas Wodushek, Ron J. Sokol, Yvonne Maldonado, Karen Blake Jacobson, Xiaolin Jia, Jake Scott, Orlando Quintero, François Haddad, Hannah Valantine, Roham T. Zamanian, Divya Pathak, Jeanette Boyce, Francesca Facco, Sarah C. Hankle, John Austin Vargo, Donna M. Campbell, Donna Armstrong, Madison Mann, Nicole P. Burrell, Anna B. C. Bartholomew, William A. Grobman, Barbara Cackovic, Baylee Klopfenstein, Samantha Weigand, Esther K. Snow, Kathleen Fennig, Michael Sean Esplin, Denise Lamb, Amanda L. Nelsen, Jocelyn E. Phipers, Lauren Fischer, Olivia Docter, Jeanette P. Brown, Angelica M. DeMartino, Donna M. Allard, Emily Miller, Sabine Bousleiman, Megan M. Loffredo, Ashley Q. Vanneman, Imene Beche, Rosalyn Chan-Akeley, Luis Diego 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 Nicholas Hackney, Suneet P. Chauhan, Felecia Ortiz, Jenifer Treadway, Juanita Rugerio, Kelly James Clark, Molly A. Leatherland, Sally A. 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 Lipson Altman, Khamal Anglin, Urania Argueta, Hassan Ashktorab, Gaston C. Baslet, Ingrid V. Bassett, Lucinda Bateman, Brahmchetna Bedi, Shamik Bhattacharyya, Marie‐Abèle Bind, Andra L. Blomkalns, Hector Fabio Bonilla, Hassan Brim, Patricia A. Bush, Mario Castro, James Gin Man Chan, Alexander W. Charney, Peter Chen, Lori Beth 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 B. Erdmann, Kristine Mace 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 Smith Gibson, Minjoung Go, Jason D. Goldman, Halle Grebe, Frank L. Greenway, Mounira A. Habli, John William 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 K. Jagannathan, Janice John, Michael R. Jordan, Stuart D. Katz, Elizabeth S. Kaufman, John Daniel Kelly, Sara Warfield Kelly, Megan Kemp, John Patrick Kirwan, Jonathan D. Klein, Kenneth S. Knox, Jerry A. Krishnan, Andre D. Kumar, Adeyinka O. Laiyemo, Allison Lambert, Margaret Lanca, Joyce K. Lee‐Iannotti, Brian P. Logarbo, Michele T. Longo, Carlos A. Luciano, Karen Lutrick, Jason H. Maley, Gail Mallett, Jai G. Marathe, Vincent C. Marconi, Gailen D. Marshall, Christopher F. Martin, Yuri P. Matusov, Alem Mehari, Hector Mendez‐Figueroa, Robin J. Mermelstein, Torri D. Metz, Richard P. Morse, Jarrod M Mosier, Christian Mouchati, Janet M. Mullington, Shawn N. Murphy, Robert B. Neuman, Janko Ž. Nikolich, Ighovwerha Ofotokun, Elizabeth I. Ojemakinde, Anna Palatnik, Kristy T. Salisbury Palomares, Tanyalak Parimon, Samuel I. Parry, JAN EVANS PATTERSON, Thomas F. Patterson, Rachel E. Patzer, Michael J. Peluso, Priscilla Igho Pemu, Christian Michael Pettker, Beth A. Plunkett, Kristen Pogreba-Brown, Athena Poppas, John G. Quigley, Uma Maheswara Reddy, Rebecca M. Reece, Harrison Thomas Reeder, William Brian Reeves, Eric M. Reiman, Franz P. Rischard, Jonathan M. Rosand, Dwight J. Rouse, Adam M. Ruff, George Robert 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 Sieck Taylor, Larissa J. Teunis, Robert James Thomas, John M. Thorp, Paul Joseph Thuluvath, Amberly Ticotsky, Alan Tita, Katherine R. Tuttle, Alfredo E. Urdaneta, Daisy Valdivieso, Timothy M. VanWagoner, Andrew J. Vasey, Monica Verduzco‐Gutierrez, Zachary S. Wallace, Honorine Ward, David E. Warren, Steven J. Weiner, Shelley Welch, Sidney W. Whiteheart, Zanthia Wiley, Juan Pablo 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：881 · 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,...