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Volume 31, Supplement—October 2025
SUPPLEMENT ISSUE
Supplement
Persistence of Symptoms among Commercially Insured Patients with Coccidioidomycosis, United States, 2017–2023
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.
1Current affiliation: The Carter Center, Atlanta, Georgia, USA