The effect of SARS-CoV-2 vaccination on post-acute COVID-19 syndrome (PASC): A prospective cohort study 8 243 physical measurements (respiratory rate [RR], heart rate [HR] and oxygen saturation [SpO2]), collected biological specimens (nasopharyngeal swab for PCR, blood samples, saliva) and recorded participants’ past medical history and socio-demographic characteristics. Symptoms were based a validated questionnaire[7] and included: fatigue, cough, fever, rhinorrhoea, sore throat, dyspnoea, loss of smell and/or taste, chest pain, headache, abdominal pain, confusion, arthralgia, myalgia, loss of appetite, wheeze, skin rash, nausea and/or vomiting, diarrhoea, ear ache, spontaneous bleeding. Between months 3 to 12 of follow-up, quarterly biological sampling took place and participants completed monthly online questionnaires on the presence of the same 20 COVID-19 symptoms within the past month (yes/no). Finally, participants with PASC at first vaccination were asked at one month following first COVID-19 vaccination whether they had experienced an overall subjective change in their PASC symptoms. From 6 January 2021, study participants were invited for SARS-CoV-2 vaccination through the national Dutch SARS-CoV-2 vaccination campaign[8]. Study participants who had not yet been vaccinated by 4 April 2021 were invited to receive two doses as part of our study, administered 28 days apart, of the BNT162b2 mRNA (Pfizer/BioNTech) vaccine[9], which were made available to RECoVERED by the Dutch Ministry of Health, Wellbeing and Sport (RIVM). Definitions Illness onset was defined as the earliest date upon which COVID-19 symptoms were experienced for symptomatic patients, or the date of SARS-CoV-2 diagnosis for asymptomatic patients. The definition of PASC was based on the WHO criteria as reporting at least one COVID-19 symptom that started within one month of overall illness onset and lasted beyond 3 months after illness onset. We thus considered any symptom occurring one month after the onset of COVID-19 illness unlikely to be due to COVID-19 and hence these symptoms were not deemed to be PACS symptoms. [3]. Full recovery took place when all PASC symptoms had resolved (i.e., were reported as being absent). COVID-19 clinical severity was categorised according to WHO COVID-19 disease severity criteria [10]: mild disease as having a RR <20/min and SpO2>94% on room air at both day 0 (D0) and day 7 (D7) study visits; moderate disease as having a RR 20-30/min and/or SpO2 90-94% or receiving oxygen therapy at D0 or D7; severe disease as having a RR>30/ min and/or SpO2<90% or receiving oxygen therapy at D0 or D7; critical disease as ICU admission due to COVID-19 at any point. BMI was defined in kg/m2 as: <25, underweight or normal weight; 25-29, overweight; ≥30, obese.
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