Nationally representative prevalence and determinants of post-acute sequelae of SARS-CoV-2 infection (Long COVID) amongst Mexican adults in 2022

OBJECTIVE To characterize the epidemiology of post-acute sequelae after SARS-CoV-2 infection (PASC) in Mexico during 2022 and identify potential predictors of PASC prevalence using nationally representative data. METHODS We analyzed data from the 2022 Mexican National Health and Nutrition Survey (ENSANUT) totaling 24,434 participants, representing 85,521,661 adults ≥20 years. PASC was defined using both the World Health Organization definition and a PASC score ≥12. Estimates of PASC prevalence were stratified by age, sex, rural vs. urban setting, social lag quartiles, number of reinfections, vaccination status and by periods of predominance of SARS-CoV-2 circulating variants. Predictors of PASC were assessed using logistic regression models adjusted by survey weights. RESULTS Persistent symptoms after SARS-CoV-2 infection were reported by 12.44% (95%CI 11.89-12.99) of adults ≥20 years in Mexico during 2022. The most common persistent symptoms were musculoskeletal pain, headache, cough, loss of smell or taste, fever, post-exertional malaise, brain fog, anxiety, chest pain, and sleep disorders. PASC was present in 21.21% (95%CI 7.71-9.65) subjects with previously diagnosed COVID-19. Over 28.6% patients with PASC reported symptoms persistence ≥6 months and 14.05% reported incapacitating symptoms. Higher PASC prevalence was associated with SARS-CoV-2 reinfections, depressive symptoms and living in states with high social lag. PASC prevalence, particularly its more severe forms, decreased with COVID-19 vaccination and for infections during periods of Omicron variant predominance. CONCLUSIONS PASC implies a significant public health burden in Mexico as the COVID-19 pandemic transitions into endemicity. Promoting reinfection prevention and booster vaccination may be useful to reduce PASC burden. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement FUNDING: This research was supported by Instituto Nacional de Geriatria in Mexico. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: ENSANUT 2022 data is openly available at: https://ensanut.insp.mx/encuestas/ensanutcontinua2022/descargas.php I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All code, datasets and materials are available for reproducibility of results at http://github.com/oyaxbell/pasc_ensanut/. ENSANUT 2022 data is openly available at: https://ensanut.insp.mx/encuestas/ensanutcontinua2022/descargas.php