P325 Post-COVID general health symptoms in patients with Immune Mediated Inflammatory Diseases

Abstract

Abstract Background Post-COVID entails persistent symptoms following a presumed or confirmed SARS-CoV-2 infection and has a prevalence of 12.5% in the general population in The Netherlands. The aim of this study is to evaluate post-COVID general health symptoms reported by patients with Immune Mediated Inflammatory Diseases (IMIDs), given the unclear prevalence. Methods An online questionnaire was distributed to IMID patients at dermatology, rheumatology and gastroenterology departments in an academic and teaching hospital in Rotterdam, the Netherlands. Only patients on systemic therapy were included. General health symptoms were compared between patients with and without prior SARS-CoV-2 infection. Multivariable logistic regression, adjusted for disease-related factors and known post-COVID risk factors, was performed to assess the association between SARS-CoV-2 infection and symptom occurrence. Additionally, the self-reported prevalence of post-COVID symptoms was assessed by asking patients if they linked their symptoms to the previous SARS-CoV-2 infection. Results The final study population comprised 1,518 patients, of whom 58% (n=877) reported ≥ 1 SARS-CoV-2 infections (table 1). More patients with a prior SARS-CoV-2 infection reported general health symptoms compared to those without (56% vs 44%; P<0.001) (figure 1). After adjusting for potential risk factors, including age, sex, smoking, diagnosis, SARS-CoV-2 vaccination status, and immunosuppressive therapy, a consistent significant association was found between SARS-CoV-2 infection and symptoms (OR 1.53; 95%CI 1.23-1.91; P<0.001). Sub-analysis showed a significant association between self-reported COVID-19 severity and symptoms, while presumed SARS-CoV-2 variant (based on date of reported infection) and number of infections were not associated. Fatigue was the most common symptom in both patients with and without a previous SARS-CoV-2 infection, with significantly higher prevalence among patients with previous SARS-CoV-2 infection (42% vs 32%; P<0.001). After adjusting for the potential risk factors, a previous SARS-CoV-2 infection remained significantly associated with fatigue (OR 1.31; 95%CI 1.04-1.64; P=0.021). Of the patients with a prior SARS-CoV-2 infection, 14% (122 out of 877) reported post-COVID symptoms, with fatigue as the most common complaint (78%). Conclusion The self-reported prevalence of post-COVID general health symptoms among IMID patients on systemic therapy (14%) aligns with that of the general population. The prevalence of symptoms, particularly fatigue, is elevated in patients with a history of a SARS-CoV-2 infection. Our findings emphasize the importance of incorporating SARS-CoV-2 infection history when evaluating fatigue in IMID patients during outpatient visits.