• Mayo Clinic proceedings · Mar 2022

    The Female-Predominant Persistent Immune Dysregulation of the Post-COVID Syndrome.

    • Ravindra Ganesh, Stephanie L Grach, Aditya K Ghosh, Dennis M Bierle, Bradley R Salonen, Nerissa M Collins, Avni Y Joshi, Neal D Boeder, Christopher V Anstine, Michael R Mueller, Elizabeth C Wight, Ivana T Croghan, Andrew D Badley, Rickey E Carter, and Ryan T Hurt.
    • Division of General Internal Medicine. Electronic address: ganesh.ravindra@mayo.edu.
    • Mayo Clin. Proc. 2022 Mar 1; 97 (3): 454464454-464.

    ObjectiveTo describe the clinical data from the first 108 patients seen in the Mayo Clinic post-COVID-19 care clinic (PCOCC).MethodsAfter Institutional Review Board approval, we reviewed the charts of the first 108 patients seen between January 19, 2021, and April 29, 2021, in the PCOCC and abstracted from the electronic medical record into a standardized database to facilitate analysis. Patients were grouped into phenotypes by expert review.ResultsMost of the patients seen in our clinic were female (75%; 81/108), and the median age at presentation was 46 years (interquartile range, 37 to 55 years). All had post-acute sequelae of SARS-CoV-2 infection, with 6 clinical phenotypes being identified: fatigue predominant (n=69), dyspnea predominant (n=23), myalgia predominant (n=6), orthostasis predominant (n=6), chest pain predominant (n=3), and headache predominant (n=1). The fatigue-predominant phenotype was more common in women, and the dyspnea-predominant phenotype was more common in men. Interleukin 6 (IL-6) was elevated in 61% of patients (69% of women; P=.0046), which was more common than elevation in C-reactive protein and erythrocyte sedimentation rate, identified in 17% and 20% of cases, respectively.ConclusionIn our PCOCC, we observed several distinct clinical phenotypes. Fatigue predominance was the most common presentation and was associated with elevated IL-6 levels and female sex. Dyspnea predominance was more common in men and was not associated with elevated IL-6 levels. IL-6 levels were more likely than erythrocyte sedimentation rate and C-reactive protein to be elevated in patients with post-acute sequelae of SARS-CoV-2 infection.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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