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
Hauptverfasser: Kenny, Grace, McCann, Kathleen, O’Brien, Conor, Savinelli, Stefano, Tinago, Willard, Yousif, Obada, Lambert, John S, O’Broin, Cathal, Feeney, Eoin R, De Barra, Eoghan, Doran, Peter, Mallon, Patrick W G
Format: Journal Article
Sprache:Englisch
Veröffentlicht: US Oxford University Press 01.04.2022
Schlagworte:
Cluster analysis
Coronaviruses
Long COVID
Major
SARS
2
long COVID
CoV
post–acute sequelae of SARS
2 infection
ISSN:2328-8957, 2328-8957
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Zusammenfassung: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.
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ISSN:2328-8957
2328-8957
DOI:10.1093/ofid/ofac060