tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2022 Mar 7;9(4)
fac060.
doi: 10.1093/ofid/ofac060. eCollection 2022 Apr.
Identification of Distinct Long COVID Clinical Phenotypes Through Cluster Analysis of Self-Reported Symptoms
Grace Kenny[SUP] 1 2 [/SUP], Kathleen McCann[SUP] 2 [/SUP], Conor O'Brien[SUP] 3 [/SUP], Stefano Savinelli[SUP] 1 2 [/SUP], Willard Tinago[SUP] 1 [/SUP], Obada Yousif[SUP] 4 [/SUP], John S Lambert[SUP] 1 3 5 [/SUP], Cathal O'Broin[SUP] 1 2 [/SUP], Eoin R Feeney[SUP] 1 2 [/SUP], Eoghan De Barra[SUP] 6 7 [/SUP], Peter Doran[SUP] 3 [/SUP], Patrick W G Mallon[SUP] 1 2 [/SUP], All-Ireland Infectious Diseases (AIID) Cohort Study Group
Collaborators, Affiliations
Abstract
Background: We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID.
Methods: This was an analysis within a multicenter, prospective cohort study of individuals with a confirmed diagnosis of COVID-19 and persistent symptoms >4 weeks from onset of acute symptoms. We performed a multiple correspondence analysis (MCA) on the most common self-reported symptoms and hierarchical clustering on the results of the MCA to identify symptom clusters.
Results: Two hundred thirty-three individuals were included in the analysis; the median age of the cohort was 43 (interquartile range [IQR], 36-54) years, 74% were women, and 77.3% reported a mild initial illness. MCA and hierarchical clustering revealed 3 clusters. Cluster 1 had predominantly pain symptoms with a higher proportion of joint pain, myalgia, and headache; cluster 2 had a preponderance of cardiovascular symptoms with prominent chest pain, shortness of breath, and palpitations; and cluster 3 had significantly fewer symptoms than the other clusters (2 [IQR, 2-3] symptoms per individual in cluster 3 vs 6 [IQR, 5-7] and 4 [IQR, 3-5] in clusters 1 and 2, respectively; P < .001). Clusters 1 and 2 had greater functional impairment, demonstrated by significantly longer work absence, higher dyspnea scores, and lower scores in SF-36 domains of general health, physical functioning, and role limitation due to physical functioning and social functioning.
Conclusions: Clusters of symptoms are evident in long COVID patients that are associated with functional impairments and may point to distinct underlying pathophysiologic mechanisms of disease.
Keywords: 2; 2 infection; CoV; SARS; long COVID; post–acute sequelae of SARS.
. 2022 Mar 7;9(4)
fac060.doi: 10.1093/ofid/ofac060. eCollection 2022 Apr.
Identification of Distinct Long COVID Clinical Phenotypes Through Cluster Analysis of Self-Reported Symptoms
Grace Kenny[SUP] 1 2 [/SUP], Kathleen McCann[SUP] 2 [/SUP], Conor O'Brien[SUP] 3 [/SUP], Stefano Savinelli[SUP] 1 2 [/SUP], Willard Tinago[SUP] 1 [/SUP], Obada Yousif[SUP] 4 [/SUP], John S Lambert[SUP] 1 3 5 [/SUP], Cathal O'Broin[SUP] 1 2 [/SUP], Eoin R Feeney[SUP] 1 2 [/SUP], Eoghan De Barra[SUP] 6 7 [/SUP], Peter Doran[SUP] 3 [/SUP], Patrick W G Mallon[SUP] 1 2 [/SUP], All-Ireland Infectious Diseases (AIID) Cohort Study Group
Collaborators, Affiliations
- PMID: 35265728
- PMCID: PMC8900926
- DOI: 10.1093/ofid/ofac060
Abstract
Background: We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID.
Methods: This was an analysis within a multicenter, prospective cohort study of individuals with a confirmed diagnosis of COVID-19 and persistent symptoms >4 weeks from onset of acute symptoms. We performed a multiple correspondence analysis (MCA) on the most common self-reported symptoms and hierarchical clustering on the results of the MCA to identify symptom clusters.
Results: Two hundred thirty-three individuals were included in the analysis; the median age of the cohort was 43 (interquartile range [IQR], 36-54) years, 74% were women, and 77.3% reported a mild initial illness. MCA and hierarchical clustering revealed 3 clusters. Cluster 1 had predominantly pain symptoms with a higher proportion of joint pain, myalgia, and headache; cluster 2 had a preponderance of cardiovascular symptoms with prominent chest pain, shortness of breath, and palpitations; and cluster 3 had significantly fewer symptoms than the other clusters (2 [IQR, 2-3] symptoms per individual in cluster 3 vs 6 [IQR, 5-7] and 4 [IQR, 3-5] in clusters 1 and 2, respectively; P < .001). Clusters 1 and 2 had greater functional impairment, demonstrated by significantly longer work absence, higher dyspnea scores, and lower scores in SF-36 domains of general health, physical functioning, and role limitation due to physical functioning and social functioning.
Conclusions: Clusters of symptoms are evident in long COVID patients that are associated with functional impairments and may point to distinct underlying pathophysiologic mechanisms of disease.
Keywords: 2; 2 infection; CoV; SARS; long COVID; post–acute sequelae of SARS.