Association of mRNA SARS-CoV-2 vaccination with fatigue and functional recovery in patients with post-acute sequelae of COVID-19 (PASC).

چکیده اصلی

BACKGROUND: Patients with post-acute sequelae of SARS-CoV-2 (PASC) fear SARS-CoV-2 vaccine-linked symptom aggravation. Data on objective functional outcomes are limited. METHODS: We performed a retrospective analysis of an observational cohort at a post-COVID outpatient clinic at Hannover Medical School with standardized assessments at baseline and follow-up visit (3-6 months) in adults with confirmed SARS-CoV-2 infection and PASC. Participants were classified as vaccination (receipt of an additional SARS-CoV-2 vaccine dose between visits) or no vaccination. Primary outcomes were fatigue (Fatigue Assessment Scale) and exercise capacity (6-minute walk distance). Propensity scores matching (1:1 nearest-neighbor, ATT; caliper 0.2 SD) was performed using logistic regression. Group differences were assessed using t-tests/χ2 tests with Benjamini-Hochberg adjustment. Longitudinal changes were analyzed using linear mixed-effects models. RESULTS: Of 193 eligible patients, 174 were analyzed, 148 remained after matching (74 per group). No significant differences between the groups were observed at baseline or follow-up after adjustment for multiple comparisons. Both groups improved over time, with no statistically significant difference in fatigue or exercise capacity. CONCLUSIONS: Fatigue and functional performance improved over time regardless of vaccination status. We found no statistically significant association between mRNA SARS-CoV-2 vaccination and worsening symptoms or impaired recovery, although smaller effects cannot be excluded.

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