Symptom trajectories of post-COVID sequelae in patients with acute Delta or Omicron infection in Bergen, Norway

Front Public Health. 2024 Mar 5:12:1320059. doi: 10.3389/fpubh.2024.1320059. eCollection 2024.

Abstract

Introduction: A substantial proportion of the over 700 million COVID-19 cases world-wide experience long-term symptoms. The objectives of this study were to compare symptom trajectories and risk factors for post-COVID-19 condition after Delta and Omicron infection.

Methods: This study consecutively recruited patients with SARS-CoV-2 infection from November 2021 to March 2022. We recorded demographics, comorbidities, vaccination status, sick leave, and 18 symptoms during acute infection and after 4 months. The primary outcome measures were symptoms during acute infection and after 4 months. Secondary outcome measures were work and school absenteeism.

Results: We followed a cohort of 1,374 non-hospitalized COVID-19 patients in Bergen, Norway, at three time points. The median age was 39.8 years and 11% were children <16 years. Common acute upper respiratory symptoms waned during follow-up. Fatigue remained common from acute infection (40%) until after 4 months (37%). Four months post-infection, patients reported increased frequencies of dyspnea (from 15% during acute illness to 25% at 4 months, p < 0.001), cognitive symptoms (from 9 to 32%, p < 0.001) and depression (from 1 to 17%, p < 0.001). Patients infected with Omicron reported less dyspnea (22% versus 27%, p = 0.046) and smell/taste problems (5% versus 19%, p < 0.001) at 4 months follow-up than those with Delta infection. Comorbidities and female sex were risk factors for persistent dyspnea and cognitive symptoms. Ten percent reported sick leave after acute illness, and vaccination reduced the risk of absenteeism (adjusted risk ratio: 0.36, 95% confidence interval: 0.15, 0.72, p = 0.008).

Conclusion: At 4 months, home-isolated patients infected with Omicron reported overall comparable symptom burden, but less dyspnea and smell/taste problems than Delta infected patients. Several acute symptoms waned during follow-up. It is worrying that dyspnea, neurocognitive symptoms, and particularly depression, increased significantly during the first 4 months after acute infection. Previous vaccination was protective against prolonged sick leave.

Keywords: COVID-19; SARS-CoV-2; delta variant; omicron variant; post-COVID-19 condition.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adult
  • COVID-19* / epidemiology
  • Child
  • Disease Progression
  • Dyspnea
  • Female
  • Humans
  • Norway / epidemiology
  • SARS-CoV-2

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Trond Mohn Stiftelse grant number TMS2020TMT05 (RC); the Ministry of Health and Care Services, Norway; Helse Vest grant number F-11628 (RC), F-12621 (NL); KLINBEFORSK (NL) grant number 34476, and the Faculty of Medicine, University of Bergen, Norway. The Influenza Center is funded by the Norwegian Research Council Globvac grant number 284930 (RC); the European Union grant numbers FLUCOP, H2020 874866 INCENTIVE (RC), H2020 101037867 Vaccelerate (RC) and IMI2 Inno4vac 101007799 (RC).