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Volume 31, Supplement—December 2025

SUPPLEMENT ISSUE
Supplement

Persistence of Symptoms among Commercially Insured Patients with Coccidioidomycosis, United States, 2017–2023

Ian Hennessee1Comments to Author , Samantha L. Williams, Kaitlin Benedict, Dallas J. Smith, George R. Thompson, and Mitsuru Toda
Author affiliation: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I. Hennessee, S.L. Williams, K. Benedict, D.J. Smith, M. Toda); University of California, Davis, Sacramento, California, USA (G.R. Thompson III)

Main Article

Table 2

Prevalence ratios of symptoms among commercially insured patients with coccidioidomycosis during 4 follow-up periods after index date compared with baseline, United States, July 2017‒January 2023*

0–3 months
 3–6 months
 6–9 months
 9–12 months
Characteristic PR (95% CI) p value PR (95% CI) p value PR (95% CI) p value PR (95% CI) p value
Coccidioidomycosis-associated symptoms
Abnormal weight loss 3.64 (2.08–6.82) <0.001 1.29 (0.64–2.63) 0.5 1.21 (0.60– 2.50) 0.6 1.29 (0.64– 2.63) 0.5
Chest pain 2.10 (1.71–2.60) <0.001 0.92 (0.71–1.18) 0.5 0.69 (0.53– 0.91) 0.009 0.83 (0.64– 1.07) 0.15
Cough 2.83 (2.48–3.24) <0.001 1.16 (0.99–1.37) 0.063 0.89 (0.75–1.06) 0.2 0.92 (0.77–1.09) 0.3
Dyspnea 3.05 (2.56–3.67) <0.001 1.29 (1.05–1.59) 0.018 1.10 (0.89–1.37) 0.4 0.90 (0.72–1.14) 0.4
Erythema nodosum or multiforme 28.6 (6.97–117) <0.001 5.50 (1.48–35.5) 0.026 2.50 (0.54–17.4) 0.3 1.50 (0.25–11.4) 0.7
Fatigue or malaise 2.48 (2.06–3.00) <0.001 1.31 (1.06–1.62) 0.012 1.33 (1.08–1.65) 0.008 1.29 (1.04–1.60) 0.019
Fever 3.28 (2.56–4.24) <0.001 0.88 (0.64–1.22) 0.4 0.67 (0.47–0.95) 0.026 0.76 (0.54– 1.07) 0.12
Generalized hyperhidrosis 4.43 (2.07–10.9) <0.001 1.57 (0.62– 4.26) 0.3 1.00 (0.34– 2.92) >0.9 1.00 (0.34– 2.92) >0.9
Headache 2.55 (1.58–4.24) <0.001 1.50 (0.88– 2.60) 0.14 1.14 (0.64– 2.03) 0.7 1.82 (1.09– 3.10) 0.024
Myalgia 2.42 (1.27–4.91) 0.010 1.25 (0.59– 2.72) 0.6 1.00 (0.45– 2.25) >0.9 0.50 (0.17– 1.29) 0.2
Pain in joint 1.28 (1.10–1.50) 0.001 1.19 (1.02– 1.40) 0.027 1.17 (1.00– 1.37) 0.050 1.25 (1.07– 1.46) 0.005
Weakness
 2.53 (1.85–3.51)
 <0.001
1.49 (1.05– 2.13)
 0.026
1.71 (1.22– 2.42)
 0.002
1.86 (1.34– 2.62)
 <0.001
IACCI symptoms
Depression 1.59 (1.22–2.07) <0.001 1.17 (0.89–1.56) 0.3 1.18 (0.90–1.57) 0.2 1.15 (0.87–1.53) 0.3
Dizziness 1.73 (1.23–2.47) 0.002 1.10 (0.75–1.62) 0.6 0.96 (0.64–1.43) 0.8 1.37 (0.95–1.98) 0.092
Generalized anxiety disorder 1.26 (0.93–1.74) 0.14 1.18 (0.86–1.62) 0.3 1.32 (0.97–1.81) 0.077 1.32 (0.97–1.81) 0.077
Insomnia 1.60 (1.12–2.30) 0.011 1.13 (0.76–1.67) 0.5 0.98 (0.65–1.47) >0.9 0.98 (0.65–1.47) >0.9
Irritable bowel syndrome 1.23 (0.77–1.98) 0.4 0.61 (0.34–1.07) 0.091 0.74 (0.43–1.26) 0.3 0.52 (0.28–0.93) 0.031
Palpitations 1.47 (1.02–2.13) 0.040 0.96 (0.64–1.44) 0.8 0.91 (0.61–1.38) 0.7 0.89 (0.59–1.35) 0.6
Sleep apnea 1.47 (1.23–1.77) <0.001 1.13 (0.93–1.38) 0.2 1.14 (0.94–1.38) 0.2 1.14 (0.94–1.38) 0.2
Tinnitus 2.56 (1.23–5.82) 0.017 1.33 (0.57–3.26) 0.5 1.33 (0.57–3.26) 0.5 0.89 (0.33–2.32) 0.8

*Baseline was 180–121 days before the index date. The 3-month follow-up periods were nonoverlapping periods after the index date: 0–89 days (0–3 months), 90–179 days (3–6 months), 180–269 days (6–9 months), and 270–365 days (9–12 months). Because of insufficient cell size, prevalence ratios were not calculated for chills, intracranial abscess, meningitis, irritability or anger, general paresis, or hypoactive sexual desire disorder. IACCI, infection-associated chronic conditions and illnesses; PR, prevalence ratio.

Main Article

1Current affiliation: The Carter Center, Atlanta, Georgia, USA

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