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Identification of Distinct Long COVID Clinical Phenotypes Through Cluster Analysis of Self-Reported Symptoms

2022; Oxford University Press; Volume: 9; Issue: 4 Linguagem: Inglês

10.1093/ofid/ofac060

2328-8957

Grace Kenny, Kathleen McCann, Conor O’Brien, Stefano Savinelli, Willard Tinago, Obada Yousif, John S. Lambert, Cathal O’Broin, Eoin R. Feeney, Eoghan de Barra, Peter Doran, Patrick Mallon, Aoife G. Cotter, Eavan G. Muldoon, G Sheehan, Tara McGinty, John S. Lambert, S Green, Kelly Leamy, Grace Kenny, Kathleen McCann, Rebecca McCann, Cathal O’Broin, Sarmad Waqas, Stefano Savinelli, Eoin R. Feeney, Patrick Mallon, A. Léon, Sarah Miles, Dana Alalwan, Renu Negi, Eoghan de Barra, Samuel McConkey, Killian Hurley, Imran Sulaiman, Mary Horgan, Corinna Sadlier, John C. Eustace, Christine Kelly, T Bracken, Bryan Whelan, Jenny G. Low, Obada Yousif, Bairbre McNicholas, G. Courtney, Patrick J. Gavin,

Neuroinflammation and Neurodegeneration Mechanisms

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; 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.