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Open Forum Infect Dis . Long COVID Clinical Phenotypes up to 6 Months After Infection Identified by Latent Class Analysis of Self-Reported Symptoms

tetano

Editor, Senior Moderator
Open Forum Infect Dis


. 2023 May 31;10(7):ofad277.
doi: 10.1093/ofid/ofad277. eCollection 2023 Jul. Long COVID Clinical Phenotypes up to 6 Months After Infection Identified by Latent Class Analysis of Self-Reported Symptoms

Michael Gottlieb[SUP] 1 [/SUP], Erica S Spatz[SUP] 2 3 4 [/SUP], Huihui Yu[SUP] 2 4 [/SUP], Lauren E Wisk[SUP] 5 [/SUP], Joann G Elmore[SUP] 5 [/SUP], Nicole L Gentile[SUP] 6 [/SUP], Mandy Hill[SUP] 7 [/SUP], Ryan M Huebinger[SUP] 7 [/SUP], Ahamed H Idris[SUP] 8 [/SUP], Efrat R Kean[SUP] 9 [/SUP], Katherine Koo[SUP] 10 [/SUP], Shu-Xia Li[SUP] 4 [/SUP], Samuel McDonald[SUP] 8 11 [/SUP], Juan Carlos C Montoy[SUP] 12 [/SUP], Graham Nichol[SUP] 13 [/SUP], Kelli N O'Laughlin[SUP] 14 [/SUP], Ian D Plumb[SUP] 15 [/SUP], Kristin L Rising[SUP] 9 16 [/SUP], Michelle Santangelo[SUP] 10 [/SUP], Sharon Saydah[SUP] 15 [/SUP], Ralph C Wang[SUP] 12 [/SUP], Arjun Venkatesh[SUP] 4 17 [/SUP], Kari A Stephens[SUP] 18 [/SUP], Robert A Weinstein[SUP] 19 20 21 [/SUP]; INSPIRE Group



Collaborators, Affiliations
Abstract

Background: The prevalence, incidence, and interrelationships of persistent symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection vary. There are limited data on specific phenotypes of persistent symptoms. Using latent class analysis (LCA) modeling, we sought to identify whether specific phenotypes of COVID-19 were present 3 months and 6 months post-infection.
Methods: This was a multicenter study of symptomatic adults tested for SARS-CoV-2 with prospectively collected data on general symptoms and fatigue-related symptoms up to 6 months postdiagnosis. Using LCA, we identified symptomatically homogenous groups among COVID-positive and COVID-negative participants at each time period for both general and fatigue-related symptoms.
Results: Among 5963 baseline participants (4504 COVID-positive and 1459 COVID-negative), 4056 had 3-month and 2856 had 6-month data at the time of analysis. We identified 4 distinct phenotypes of post-COVID conditions (PCCs) at 3 and 6 months for both general and fatigue-related symptoms; minimal-symptom groups represented 70% of participants at 3 and 6 months. When compared with the COVID-negative cohort, COVID-positive participants had higher occurrence of loss of taste/smell and cognition problems. There was substantial class-switching over time; those in 1 symptom class at 3 months were equally likely to remain or enter a new phenotype at 6 months.
Conclusions: We identified distinct classes of PCC phenotypes for general and fatigue-related symptoms. Most participants had minimal or no symptoms at 3 and 6 months of follow-up. Significant proportions of participants changed symptom groups over time, suggesting that symptoms present during the acute illness may differ from prolonged symptoms and that PCCs may have a more dynamic nature than previously recognized. Clinical Trials Registration. NCT04610515.

Keywords: COVID-19; Long COVID; SARS-CoV-2; cluster; phenotype.

 
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