Identification of Distinct Long COVID Clinical Phenotypes Through Cluster Analysis of Self-Reported Symptoms.
Authors
Kenny, GraceMcCann, 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
Issue Date
2022-03-07Keywords
22 infection
CoV
SARS
long COVID
post–acute sequelae of SARS
Metadata
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Open forum infectious diseasesDOI
10.1093/ofid/ofac060PubMed ID
35265728Abstract
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.Item Type
ArticleLanguage
enISSN
2328-8957ae974a485f413a2113503eed53cd6c53
10.1093/ofid/ofac060
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