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Persistent Symptoms of Lyme: Determinants after Treatment
eBioMedicine (Vrijmoeth, H.D., et al.) 11.27.2023 published “Determinants of persistent symptoms after treatment for Lyme borreliosis: a prospective observational cohort study.” In this study, researchers assessed 1135 physician-confirmed Lyme disease patients from the time of initiation of treatment with antibiotics to a one year follow-up. Patients were assessed for a range of potential determinants of persistent symptoms, including microbiological, immunological, genetic, clinical, functional, epidemiological, psychosocial and cognitive behavioral variables.
Findings showed that the determinants of persistent symptoms after Lyme disease infections and initial treatment were considered “mainly generic.” Determinants of 295 patients with persistent symptoms included a baseline of physical and social functioning that was poorer, depression and anxiety scores that were higher, illness perceptions that were more negative, as well as having baseline comorbidities, fatigue, cognitive impairment, and pain.
Persistent symptoms were correctly indicated in 71.0% of predictions in the primary prediction model. For patients that exhibited symptoms at baseline, the cognitive-behavioral responses to symptoms predicted the symptom persistence. Lower IL-10 concentrations in ex vivo stimulation experiments were also associated with persistent symptoms, but the potential role of the host immune response requires further investigation.
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