400. Predictors of Post-COVID Conditions after SARS-CoV-2 Infection in Adults Enrolled in a Multistate Household Transmission Study

Abstract Background Severe COVID-19 predicts increased risk of Post-COVID conditions (PCC). However, the impact of mild COVID-19 in non-hospitalized patients on development of PCC is less clear. Methods We recruited individuals with mild SARS-CoV-2 (SCV2) infection from 7 US sites into a household transmission study, Sep. 2021–Dec. 2022. Index cases and their household contacts (HHC) were enrolled ≤6 days after the index case tested positive for SCV2. At baseline, participants provided sociodemographic, clinical and vaccine history, and dried blood spot for antibody detection. Participants completed daily symptom and medication diaries and collected nasal swabs for quantitative PCR (qPCR) for 10 days as well as a 90-day survey including the PROMIS® Global Health measure of physical, mental, and social health. We defined PCC as presence of ≥1 symptom (Table 1) most or almost all of the time 90 days post enrollment (Fig. 1). We calculated the proportion of PCC among adults with SCV2 infection and evaluated factors associated with PCC using Chi-squared, Student’s t-test, or binary logistic regression, as applicableTable 1:Individual symptoms and symptom clusters occurring most of the time or almost all the time at 90-day follow-up among adults who had Post-COVID (PCC) conditions At 90-days after enrollment, participants were asked how often they experience a list of 17 symptoms with response options of never, sometimes, most of the time, almost all the time. Those who responded most or almost all the time to at least one of the listed symptoms and tested positive for SARS-CoV-2 during enrollment or daily swabbing were defined as having PCC. Constitutional symptoms include fever, fatigue, and dizziness/lightheadedness; Neuropsychiatric symptoms include brain fog, change in mood, problems sleeping, tingling/numbness, and dizziness/lightheadedness; Respiratory symptoms include cough and dyspnea; Cardiovascular symptoms include chest pain and dizziness/lightheadedness; Gastrointestinal symptoms include change in taste/smell, vomiting, constipation, and diarrhea.Figure 1.Flow chart of participants who tested positive for SARS-CoV-2 and completed a 90-day survey for Post-COVID conditions (PCC) Results Among 532 adults with SCV2 who completed a 90-day survey, 326 (61.3%) were female, mean age was 47.4 years (SD 16.8), and 89 (17%) met PCC definition. Among people with PCC, the most common symptoms were neuropsychiatric (60%), fatigue (35%), respiratory (34%), and sl