Identification of Distinct Long COVID Clinical Phenotypes Through Cluster Analysis of Self-Reported Symptoms
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...
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| Veröffentlicht in: | Open forum infectious diseases Jg. 9; H. 4; S. ofac060 |
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| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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Oxford University Press
01.04.2022
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| ISSN: | 2328-8957, 2328-8957 |
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| Abstract | 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. |
|---|---|
| AbstractList | 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. 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. We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID. 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. 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; < .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. 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. We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID.BackgroundWe aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID.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.MethodsThis 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.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.ResultsTwo 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.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.ConclusionsClusters of symptoms are evident in long COVID patients that are associated with functional impairments and may point to distinct underlying pathophysiologic mechanisms of disease. |
| Author | Kenny, Grace McCann, Kathleen Mallon, Patrick W G Yousif, Obada Savinelli, Stefano Doran, Peter Lambert, John S O’Broin, Cathal O’Brien, Conor Tinago, Willard Feeney, Eoin R De Barra, Eoghan |
| AuthorAffiliation | 5 Department of Infectious Diseases, Mater Misericordiae University Hospital , Dublin , Ireland 4 Endocrinology Department, Wexford General Hospital , Carricklawn, Wexford , Ireland 7 Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland , Dublin , Ireland 3 School of Medicine, University College Dublin , Belfield, Dublin , Ireland 6 Department of Infectious Diseases, Beaumont Hospital , Beaumont, Dublin , Ireland 1 Centre for Experimental Pathogen Host Research, University College Dublin , Dublin , Ireland 2 Department of Infectious Diseases, St Vincent’s University Hospital , Elm Park, Dublin , Ireland |
| AuthorAffiliation_xml | – name: 1 Centre for Experimental Pathogen Host Research, University College Dublin , Dublin , Ireland – name: 2 Department of Infectious Diseases, St Vincent’s University Hospital , Elm Park, Dublin , Ireland – name: 6 Department of Infectious Diseases, Beaumont Hospital , Beaumont, Dublin , Ireland – name: 7 Department of International Health and Tropical Medicine, Royal College of Surgeons in Ireland , Dublin , Ireland – name: 4 Endocrinology Department, Wexford General Hospital , Carricklawn, Wexford , Ireland – name: 3 School of Medicine, University College Dublin , Belfield, Dublin , Ireland – name: 5 Department of Infectious Diseases, Mater Misericordiae University Hospital , Dublin , Ireland |
| Author_xml | – sequence: 1 givenname: Grace surname: Kenny fullname: Kenny, Grace email: grace.kenny1@ucd.ie organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland – sequence: 2 givenname: Kathleen surname: McCann fullname: McCann, Kathleen organization: Department of Infectious Diseases, St Vincent’s University Hospital, Elm Park, Dublin, Ireland – sequence: 3 givenname: Conor surname: O’Brien fullname: O’Brien, Conor organization: School of Medicine, University College Dublin, Belfield, Dublin, Ireland – sequence: 4 givenname: Stefano surname: Savinelli fullname: Savinelli, Stefano organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland – sequence: 5 givenname: Willard surname: Tinago fullname: Tinago, Willard organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland – sequence: 6 givenname: Obada surname: Yousif fullname: Yousif, Obada organization: Endocrinology Department, Wexford General Hospital, Carricklawn, Wexford, Ireland – sequence: 7 givenname: John S surname: Lambert fullname: Lambert, John S organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland – sequence: 8 givenname: Cathal surname: O’Broin fullname: O’Broin, Cathal organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland – sequence: 9 givenname: Eoin R surname: Feeney fullname: Feeney, Eoin R organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland – sequence: 10 givenname: Eoghan surname: De Barra fullname: De Barra, Eoghan organization: Department of Infectious Diseases, Beaumont Hospital, Beaumont, Dublin, Ireland – sequence: 11 givenname: Peter surname: Doran fullname: Doran, Peter organization: School of Medicine, University College Dublin, Belfield, Dublin, Ireland – sequence: 12 givenname: Patrick W G surname: Mallon fullname: Mallon, Patrick W G organization: Centre for Experimental Pathogen Host Research, University College Dublin, Dublin, Ireland |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35265728$$D View this record in MEDLINE/PubMed |
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| ContentType | Journal Article |
| Contributor | Horgan, M Bracken, T Mallon, P W G Muldoon, E Green, S McConkey, S Lambert, J S Feeney, E de Barra, E Whelan, B Yousif, O McCann, K Garcia Leon, A Sulaiman, I Courtney, G Eustace, J McCann, R Hurley, K Gavin, P Savinelli, S Negi, R Cotter, A Low, J Waqas, S Sadlier, C O'Broin, C McNicholas, B Leamy, K Kelly, C Alalwan, D Sheehan, G Miles, S McGinty, T Kenny, G |
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| Copyright | The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. 2022 The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. The Author(s) 2022. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This work is published under https://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| DOI | 10.1093/ofid/ofac060 |
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| Keywords | SARS 2 long COVID CoV post–acute sequelae of SARS 2 infection |
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We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19),... We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long COVID.... Background We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as... We aimed to describe the clinical presentation of individuals presenting with prolonged recovery from coronavirus disease 2019 (COVID-19), known as long... |
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| Title | Identification of Distinct Long COVID Clinical Phenotypes Through Cluster Analysis of Self-Reported Symptoms |
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