Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination

Khaled Rjoob; Michela Antonelli; Benjamin Murray; Erika Molteni; Nathan Cheetham; Liane S Canas; Marc Modat; Joan Capdevila Pujol; Christina Hu; Vicky Bowyer; Jonathan Wolf; Tim D Spector; Sebastien Ourselin; Alexander Hammers; Emma L Duncan; Claire J Steves; Carole H Sudre

doi:10.1016/j.jinf.2024.106406

Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination

Khaled Rjoob, Michela Antonelli, Benjamin Murray, Erika Molteni, Nathan Cheetham, Liane S Canas, Marc Modat, Joan Capdevila Pujol, Christina Hu, Vicky Bowyer, Jonathan Wolf, Tim D Spector, Sebastien Ourselin, Alexander Hammers, Emma L Duncan, Claire J Steves, Carole H Sudre

Research output: Contribution to journal › Article › peer-review

Abstract

Background: COVID-19 symptoms may persist beyond acute SARS-CoV-2 infection, as ongoing symptomatic COVID-19 [OSC] (symptom duration 4–12 weeks) and post-COVID syndrome [PCS] (symptom duration ≥12 weeks). Vaccination against SARS-CoV-2 decreases OSC/PCS in individuals subsequently infected with SARS-CoV-2 post-vaccination. Whether vaccination against SARS-CoV-2, or any other vaccinations (such as against influenza) affects symptoms in individuals already experiencing OSC/PCS, more than natural symptom evolution, is unknown. Method: Using data from the ZOE COVID Symptom Study app, two comparative analyses were carried out, both in prospectively-reporting individuals with OSC/PCS: A) symptoms in individuals receiving first vaccination against SARS-CoV-2, compared with unvaccinated individuals, matched for age, sex, BMI and week of test (n=1679 in each group); B) symptoms in individuals receiving vaccination against influenza, compared with unvaccinated individuals, matched for age, sex, BMI, week of test and number of SARS-CoV-2 vaccinations (n=692 in each group). In both analyses, vaccination date (or equivalent time from start of symptoms in the unvaccinated group) was considered as the index time, and symptom evolution was measured by comparing symptoms during the second week before and second week after vaccination. Symptoms were considered by prevalence and burden over the considered periods; all results were adjusted for multiple comparisons. Results: After first vaccination against SARS-CoV-2, many symptoms in individuals with OSC/PCS improved more rapidly than natural history resolution, including the commonly reported symptoms of fatigue (p<0.0001, β=-−0.9 [95% CI: −1.86; −0.67]) and myalgia (p<0.001, β=−0.3 [95% CI: −0.50; −0.12]). No symptom worsened after vaccination. In contrast, there was no improvement in OSC/PCS symptoms beyond natural history resolution after vaccination against influenza. Conclusion: In individuals with OSC/PCS, symptom resolution improved after vaccination against SARS-CoV-2; this was not observed, however, after other vaccinations.

Original language	English
Article number	106406
Pages (from-to)	106406
Journal	The Journal of infection
Volume	90
Issue number	2
DOIs	https://doi.org/10.1016/j.jinf.2024.106406
Publication status	E-pub ahead of print - 10 Jan 2025

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Rjoob, K., Antonelli, M., Murray, B., Molteni, E., Cheetham, N., Canas, L. S., Modat, M., Pujol, J. C., Hu, C., Bowyer, V., Wolf, J., Spector, T. D., Ourselin, S., Hammers, A., Duncan, E. L., Steves, C. J., & Sudre, C. H. (2025). Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination. The Journal of infection, 90(2), 106406. Article 106406. Advance online publication. https://doi.org/10.1016/j.jinf.2024.106406

@article{5183b22874e94a8abc25fd9169a2ddac,

title = "Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination",

abstract = "Background: COVID-19 symptoms may persist beyond acute SARS-CoV-2 infection, as ongoing symptomatic COVID-19 [OSC] (symptom duration 4–12 weeks) and post-COVID syndrome [PCS] (symptom duration ≥12 weeks). Vaccination against SARS-CoV-2 decreases OSC/PCS in individuals subsequently infected with SARS-CoV-2 post-vaccination. Whether vaccination against SARS-CoV-2, or any other vaccinations (such as against influenza) affects symptoms in individuals already experiencing OSC/PCS, more than natural symptom evolution, is unknown. Method: Using data from the ZOE COVID Symptom Study app, two comparative analyses were carried out, both in prospectively-reporting individuals with OSC/PCS: A) symptoms in individuals receiving first vaccination against SARS-CoV-2, compared with unvaccinated individuals, matched for age, sex, BMI and week of test (n=1679 in each group); B) symptoms in individuals receiving vaccination against influenza, compared with unvaccinated individuals, matched for age, sex, BMI, week of test and number of SARS-CoV-2 vaccinations (n=692 in each group). In both analyses, vaccination date (or equivalent time from start of symptoms in the unvaccinated group) was considered as the index time, and symptom evolution was measured by comparing symptoms during the second week before and second week after vaccination. Symptoms were considered by prevalence and burden over the considered periods; all results were adjusted for multiple comparisons. Results: After first vaccination against SARS-CoV-2, many symptoms in individuals with OSC/PCS improved more rapidly than natural history resolution, including the commonly reported symptoms of fatigue (p<0.0001, β=-−0.9 [95% CI: −1.86; −0.67]) and myalgia (p<0.001, β=−0.3 [95% CI: −0.50; −0.12]). No symptom worsened after vaccination. In contrast, there was no improvement in OSC/PCS symptoms beyond natural history resolution after vaccination against influenza. Conclusion: In individuals with OSC/PCS, symptom resolution improved after vaccination against SARS-CoV-2; this was not observed, however, after other vaccinations.",

author = "Khaled Rjoob and Michela Antonelli and Benjamin Murray and Erika Molteni and Nathan Cheetham and Canas, {Liane S} and Marc Modat and Pujol, {Joan Capdevila} and Christina Hu and Vicky Bowyer and Jonathan Wolf and Spector, {Tim D} and Sebastien Ourselin and Alexander Hammers and Duncan, {Emma L} and Steves, {Claire J} and Sudre, {Carole H}",

note = "Publisher Copyright: {\textcopyright} 2025 The Authors",

year = "2025",

month = jan,

day = "10",

doi = "10.1016/j.jinf.2024.106406",

language = "English",

volume = "90",

pages = "106406",

journal = "The Journal of infection",

issn = "0163-4453",

publisher = "British Infection Society",

number = "2",

}

Rjoob, K, Antonelli, M , Murray, B , Molteni, E , Cheetham, N, Canas, LS, Modat, M, Pujol, JC, Hu, C, Bowyer, V, Wolf, J, Spector, TD , Ourselin, S , Hammers, A , Duncan, EL , Steves, CJ & Sudre, CH 2025, 'Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination', The Journal of infection, vol. 90, no. 2, 106406, pp. 106406. https://doi.org/10.1016/j.jinf.2024.106406

TY - JOUR

T1 - Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination

AU - Rjoob, Khaled

AU - Antonelli, Michela

AU - Murray, Benjamin

AU - Molteni, Erika

AU - Cheetham, Nathan

AU - Canas, Liane S

AU - Modat, Marc

AU - Pujol, Joan Capdevila

AU - Hu, Christina

AU - Bowyer, Vicky

AU - Wolf, Jonathan

AU - Spector, Tim D

AU - Ourselin, Sebastien

AU - Hammers, Alexander

AU - Duncan, Emma L

AU - Steves, Claire J

AU - Sudre, Carole H

PY - 2025/1/10

Y1 - 2025/1/10

N2 - Background: COVID-19 symptoms may persist beyond acute SARS-CoV-2 infection, as ongoing symptomatic COVID-19 [OSC] (symptom duration 4–12 weeks) and post-COVID syndrome [PCS] (symptom duration ≥12 weeks). Vaccination against SARS-CoV-2 decreases OSC/PCS in individuals subsequently infected with SARS-CoV-2 post-vaccination. Whether vaccination against SARS-CoV-2, or any other vaccinations (such as against influenza) affects symptoms in individuals already experiencing OSC/PCS, more than natural symptom evolution, is unknown. Method: Using data from the ZOE COVID Symptom Study app, two comparative analyses were carried out, both in prospectively-reporting individuals with OSC/PCS: A) symptoms in individuals receiving first vaccination against SARS-CoV-2, compared with unvaccinated individuals, matched for age, sex, BMI and week of test (n=1679 in each group); B) symptoms in individuals receiving vaccination against influenza, compared with unvaccinated individuals, matched for age, sex, BMI, week of test and number of SARS-CoV-2 vaccinations (n=692 in each group). In both analyses, vaccination date (or equivalent time from start of symptoms in the unvaccinated group) was considered as the index time, and symptom evolution was measured by comparing symptoms during the second week before and second week after vaccination. Symptoms were considered by prevalence and burden over the considered periods; all results were adjusted for multiple comparisons. Results: After first vaccination against SARS-CoV-2, many symptoms in individuals with OSC/PCS improved more rapidly than natural history resolution, including the commonly reported symptoms of fatigue (p<0.0001, β=-−0.9 [95% CI: −1.86; −0.67]) and myalgia (p<0.001, β=−0.3 [95% CI: −0.50; −0.12]). No symptom worsened after vaccination. In contrast, there was no improvement in OSC/PCS symptoms beyond natural history resolution after vaccination against influenza. Conclusion: In individuals with OSC/PCS, symptom resolution improved after vaccination against SARS-CoV-2; this was not observed, however, after other vaccinations.

AB - Background: COVID-19 symptoms may persist beyond acute SARS-CoV-2 infection, as ongoing symptomatic COVID-19 [OSC] (symptom duration 4–12 weeks) and post-COVID syndrome [PCS] (symptom duration ≥12 weeks). Vaccination against SARS-CoV-2 decreases OSC/PCS in individuals subsequently infected with SARS-CoV-2 post-vaccination. Whether vaccination against SARS-CoV-2, or any other vaccinations (such as against influenza) affects symptoms in individuals already experiencing OSC/PCS, more than natural symptom evolution, is unknown. Method: Using data from the ZOE COVID Symptom Study app, two comparative analyses were carried out, both in prospectively-reporting individuals with OSC/PCS: A) symptoms in individuals receiving first vaccination against SARS-CoV-2, compared with unvaccinated individuals, matched for age, sex, BMI and week of test (n=1679 in each group); B) symptoms in individuals receiving vaccination against influenza, compared with unvaccinated individuals, matched for age, sex, BMI, week of test and number of SARS-CoV-2 vaccinations (n=692 in each group). In both analyses, vaccination date (or equivalent time from start of symptoms in the unvaccinated group) was considered as the index time, and symptom evolution was measured by comparing symptoms during the second week before and second week after vaccination. Symptoms were considered by prevalence and burden over the considered periods; all results were adjusted for multiple comparisons. Results: After first vaccination against SARS-CoV-2, many symptoms in individuals with OSC/PCS improved more rapidly than natural history resolution, including the commonly reported symptoms of fatigue (p<0.0001, β=-−0.9 [95% CI: −1.86; −0.67]) and myalgia (p<0.001, β=−0.3 [95% CI: −0.50; −0.12]). No symptom worsened after vaccination. In contrast, there was no improvement in OSC/PCS symptoms beyond natural history resolution after vaccination against influenza. Conclusion: In individuals with OSC/PCS, symptom resolution improved after vaccination against SARS-CoV-2; this was not observed, however, after other vaccinations.

UR - http://www.scopus.com/inward/record.url?scp=85215424886&partnerID=8YFLogxK

U2 - 10.1016/j.jinf.2024.106406

DO - 10.1016/j.jinf.2024.106406

M3 - Article

C2 - 39800064

SN - 0163-4453

VL - 90

SP - 106406

JO - The Journal of infection

JF - The Journal of infection

IS - 2

M1 - 106406

ER -

Symptom Evolution in Individuals with Ongoing Symptomatic COVID-19 and Post COVID-19 Syndrome After SARS-CoV-2 Vaccination Versus Influenza Vaccination

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