{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T22:15:31Z","timestamp":1764713731234,"version":"3.40.5"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Woodruff Health Sciences Center"},{"name":"Woodruff Health Sciences Center"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The impact of COVID-19 severity on development of long-term sequelae remains unclear, and symptom courses are not well defined.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>This ambidirectional cohort study recruited adults with new or worsening symptoms lasting \u22653 weeks from confirmed SARS-CoV-2 infection between August 2020\u2013December 2021. COVID-19 severity was defined as severe for those requiring hospitalization and mild for those not. Symptoms were collected using standardized questionnaires. Multivariable logistical regression estimated odds ratios (OR) and 95% confidence intervals (CI) for associations between clinical variables and symptoms.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Of 332 participants enrolled, median age was 52 years (IQR 42\u201362), 233 (70%) were female, and 172 (52%) were African American. Antecedent COVID-19 was mild in 171 (52%) and severe in 161 (48%). In adjusted models relative to severe cases, mild COVID-19 was associated with greater odds of fatigue (OR:1.83, CI:1.01\u20133.31), subjective cognitive impairment (OR:2.76, CI:1.53\u20135.00), headaches (OR:2.15, CI:1.05\u20134.44), and dizziness (OR:2.41, CI:1.18\u20134.92). Remdesivir treatment was associated with less fatigue (OR:0.47, CI:0.26\u20130.86) and fewer participants scoring &gt;1.5 SD on PROMIS Cognitive scales (OR:0.43, CI:0.20\u20130.92). Fatigue and subjective cognitive impairment prevalence was higher 3\u20136 months after COVID-19 and persisted (fatigue OR:3.29, CI:2.08\u20135.20; cognitive OR:2.62, CI:1.67\u20134.11). Headache was highest at 9\u201312 months (OR:5.80, CI:1.94\u201317.3).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Mild antecedent COVID-19 was associated with highly prevalent symptoms, and those treated with remdesivir developed less fatigue and cognitive impairment. Sequelae had a delayed peak, ranging 3\u201312 months post infection, and many did not improve over time, underscoring the importance of targeted preventative measures.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0288391","type":"journal-article","created":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T17:31:12Z","timestamp":1689010272000},"page":"e0288391","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Mild antecedent COVID-19 associated with symptom-specific post-acute sequelae"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9602-3754","authenticated-orcid":true,"given":"Tiffany A.","family":"Walker","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex D.","family":"Truong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aerica","family":"Summers","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adviteeya N.","family":"Dixit","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicia C.","family":"Goldstein","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ihab","family":"Hajjar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6630-5761","authenticated-orcid":true,"given":"Melvin R.","family":"Echols","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew C.","family":"Woodruff","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erica D.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Tekwani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelley","family":"Carroll","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ignacio","family":"Sanz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F. 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