Abstract

Introduction: Few data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, also called long-COVID or post-acute sequelae of COVID-19 (PASC). Patients and methods: We conducted a nationwide online study among adult patients with PASC as defined by symptoms persisting over 4 weeks following a confirmed or probable COVID-19, without any identified alternative diagnosis. Information concerning PASC symptoms, vaccine type and scheme and its effect on PASC symptoms were studied. Results: 620 questionnaires were completed and 567 satisfied the inclusion criteria and were analyzed. The respondents’ median age was 44 (IQR 25–75: 37–50) and 83.4% were women. The initial infection was proven in 365 patients (64%) and 5.1% had been hospitalized to receive oxygen. A total of 396 patients had received at least one injection of SARS-CoV-2 vaccine at the time of the survey, after a median of 357 (198–431) days following the initially-reported SARS-CoV-2 infection. Among the 380 patients who reported persistent symptoms at the time of SARS-CoV-2 vaccination, 201 (52.8%) reported a global effect on symptoms following the injection, corresponding to an improvement in 21.8% and a worsening in 31%. There were no differences based on the type of vaccine used. After a complete vaccination scheme, 93.3% (28/30) of initially seronegative patients reported a positive anti-SARS-CoV-2 IgG. A total of 170 PASC patients had not been vaccinated. The most common reasons for postponing the SARS-CoV-2 vaccine were fear of worsening PASC symptoms (55.9%) and the belief that vaccination was contraindicated because of PASC (15.6%). Conclusion: Our study suggests that SARS-CoV-2 vaccination is well tolerated in the majority of PASC patients and has good immunogenicity. Disseminating these reassuring data might prove crucial to increasing vaccine coverage in patients with PASC.

Highlights

  • Few data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, called long-COVID or post-acute sequelae of COVID-19 (PASC)

  • It is estimated that 10–50% of patients infected with SARS-CoV-2 will continue to experience debilitating symptoms 12 weeks after their initial infection [1,2], a condition called long-COVID or post-acute sequelae of COVID-19 (PASC)

  • Inclusion criteria were the definition of PASC by the French Haute Autorité de Santé [8]: a reported viral illness with a probable or confirmed COVID-19 diagnosis, persistent symptoms lasting >4 weeks and the lack of an alternative diagnosis to explain the presentation

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Summary

Introduction

Few data are available concerning the effect of SARS-CoV-2 vaccination on the persistent symptoms associated with COVID-19, called long-COVID or post-acute sequelae of COVID-19 (PASC). Viral persistence due to defective anti-viral immunity has been hypothesized to account for PASC [6], suggesting that SARS-CoV-2 vaccination could potentially help restore viral immunity, improve symptoms burden and the potential impact of vaccination on other pathogenic mechanisms such as organ sequelae of previous infection or dysautonomia. These hypotheses support the importance of studying the impact of vaccination on PASC symptoms. Preliminary data suggest that SARS-CoV-2 vaccination could improve

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