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

OBJECTIVETo 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. METHODSWe 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. RESULTSPersistent 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. CONCLUSIONSPASC 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.