BACKGROUND: Growing evidence suggests that severe acute COVID-19 illness increases the risk of long COVID (also known as post-COVID-19 condition). However, few studies have examined associations between acute symptoms and long COVID onset. OBJECTIVE: This study aimed to examine associations between acute COVID-19 symptom profiles and long COVID prevalence using a population-based sample. METHODS: We used a dual mode (phone and web-based) population-based probability survey of adults with polymerase chain reaction-confirmed SARS-CoV-2 between June 2020 and May 2022 in the Michigan Disease Surveillance System to examine (1) how acute COVID-19 symptoms cluster together using latent class analysis, (2) sociodemographic and clinical predictors of symptom clusters using multinomial logistic regression accounting for classification uncertainties, and (3) associations between symptom clusters and long COVID prevalence using modified Poisson regression. RESULTS: In our sample (n=4169), 15.9% (n=693) had long COVID, defined as new or worsening symptoms at least 90 days post SARS-CoV-2 infection. We identified 6 acute COVID-19 symptom clusters resulting from the latent class analysis, with flu-like symptoms (24.7%) and fever (23.6%) being the most prevalent in our sample, followed by nasal congestion (16.4%), multi-symptomatic (14.5%), predominance of fatigue (10.8%), and predominance of shortness of breath (10%) clusters. Long COVID prevalence was highest in the multi-symptomatic (39.7%) and predominance of shortness of breath (22.4%) clusters, followed by the flu-like symptom (15.8%), predominance of fatigue (14.5%), fever (6.4%), and nasal congestion (5.6%) clusters. After adjustment, females (vs males) had greater odds of membership in the multi-symptomatic, flu-like symptom, and predominance of fatigue clusters, while adults who were Hispanic or another race or ethnicity (vs non-Hispanic White) had greater odds of membership in the multi-symptomatic cluster. Compared with the nasal congestion cluster, the multi-symptomatic cluster had the highest prevalence of long COVID (adjusted prevalence ratio [aPR] 6.1, 95% CI 4.3-8.7), followed by the predominance of shortness of breath (aPR 3.7, 95% CI 2.5-5.5), flu-like symptom (aPR 2.8, 95% CI 1.9-4.0), and predominance of fatigue (aPR 2.2, 95% CI 1.5-3.3) clusters. CONCLUSIONS: Researchers and clinicians should consider acute COVID-19 symptom profiles when evaluating subsequent risk of long COVID, including potential mechanistic pathways in a research context, and proactively screen high-risk patients during the provision of clinical care.

BACKGROUND: Climate change has contributed to increasing temperatures, earlier snowmelts and thinning ice packs in the Arctic, where crossing frozen bodies of water is essential for transportation and subsistence living. In some Arctic communities, anecdotal reports indicate a growing belief that falling-through-the-ice (FTI) are increasing. The objective of this study was to describe the morbidity and mortality associated with unintentional FTIs in Alaska. METHODS: We searched newspaper reports to identify FTI events from 1990 to 2010. We also used data from a trauma registry, occupational health and law enforcement registries and vital statistics to supplement the newspaper reports. Morbidity and mortality rates were calculated for Alaska Native (AN) people and all Alaskans. RESULTS: During the 21-year period, we identified 307 events, affecting at least 449 people. Events ranged from no morbidity to fatalities of five people. More than half of the events involved transportation by snow machine. Mortality rates were markedly higher for AN people than that for all Alaskans. CONCLUSIONS: We provide a numeric estimate of the importance of FTI events in Alaska. FTIs may represent an adverse health outcome related to climate changes in the Arctic, and may be particularly critical for vulnerable populations such as AN people.

BACKGROUND: Migrant farmworkers are at risk for heat-related illness (HRI) at work. PURPOSE: The purpose of this study was to determine which risk factors could potentially reduce the prevalence of HRI symptoms among migrant farmworkers in Georgia. METHODS: Trained interviewers conducted in-person interviews of adults who attended the South Georgia Farmworker Health Project clinics in June 2011. The analysis was conducted in 2011-2012. Population intervention models were used to assess where the greatest potential impact could be made to reduce the prevalence of HRI symptoms. RESULTS: In total, 405 farmworkers participated. One third of participants had experienced three or more HRI symptoms in the preceding week. Migrant farmworkers faced barriers to preventing HRI at work, including lack of prevention training (77%) and no access to regular breaks (34%); shade (27%); or medical attention (26%). The models showed that the prevalence of three or more HRI symptoms (n=361, 34.3%) potentially could be reduced by increasing breaks in the shade (-9.2%); increasing access to medical attention (-7.3%); reducing soda intake (-6.7%); or increasing access to regular breaks (-6.0%). CONCLUSIONS: Migrant farmworkers experienced high levels of HRI symptoms and faced substantial barriers to preventing these symptoms. Although data are cross-sectional, results suggest that heat-related illness may be reduced through appropriate training of workers on HRI prevention, as well as regular breaks in shaded areas.