ArticlePLoS medicine2025
Comparative risk of post-acute sequelae following SARS-CoV-2 or influenza virus infection: A retrospective cohort study among United States adults.
Article in PLoS medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Differential Factors Associated With the Presence of Persistent Symptoms in Individuals Diagnosed With Long COVID: Protocol for a Longitudinal Matched Case-Control Study.JMIR research protocols · 2026Observational
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11 authors.
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Abstract
backgroundPost-acute sequelae (PAS) of SARS-CoV-2 infection are well documented. However, it remains unclear whether such long-term health effects are unique to COVID-19, or also occur following other viral respiratory infections. METHODS AND
findingsWe undertook a retrospective cohort study of 74,738 COVID-19 cases and 18,790 influenza cases within the Kaiser Permanente Southern California healthcare system diagnosed between 1 September, 2022 and 31 December, 2023. Cases received care for index infections across a spectrum of clinical settings, spanning virtual (n = 35,835; 38.3%), ambulatory (n = 26,579; 28.4%), emergency department (n = 23,388; 25.0%) and inpatient (n = 7,726; 8.3%) facilities. We compared 180-day risk of PAS-related healthcare utilization among COVID-19 cases and influenza via adjusted hazard ratios (aHRs) weighted to account for cases' index infection type and follow-up retention. Adjustment models addressed patients' demographic characteristics, comorbidity profiles, prior healthcare utilization patterns, and index episode severity. Risk of PAS diagnoses in any clinical setting was only modestly higher among COVID-19 cases in comparison to influenza cases within 31-90 days after cases' initial illness (aHR = 1.04 [95% confidence interval: 0.99, 1.09]; risk difference = 0.6 [-0.1, 1.2] cases per 100 person-months). This difference was attenuated by 91-180 days (aHR = 1.01 [0.97, 1.06]; risk difference = 0.4 [-0.1, 0.9] cases per 100 person-months). However, COVID-19 cases faced higher risk of severe PAS conditions requiring hospitalization (aHR = 1.31 [1.07, 1.59] and 1.24 [1.03, 1.49] within 31-90 and 91-180 days, respectively). This excess risk of severe PAS was concentrated among COVID-19 cases hospitalized during acute-phase illness, and was attenuated among cases who received antiviral treatment, who had up-to-date vaccination status prior to infection, or who did not require inpatient admission for acute-phase illness. As a limitation, analyses included only PAS resulting in healthcare utilization; patient-reported symptoms and quality-of-life measures were not captured.
conclusionsIn this large, real-world cohort, individuals with non-severe acute respiratory illness caused by SARS-CoV-2 experienced only modestly greater risk of PAS in comparison to those whose illness was caused by influenza. However, COVID-19 cases hospitalized for their initial illness experienced greater risk of severe PAS necessitating inpatient care, and this difference persisted through 180 days of follow-up. Our findings challenge assumptions about the uniqueness of post-acute COVID-19 morbidity and suggest the long-term burden of influenza may be underrecognized.
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