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Subphenotypes of self-reported symptoms and outcomes in long COVID: a prospective cohort study with latent class analysis

Por: Kitsios · G. D. · Blacka · S. · Jacobs · J. J. · Mirza · T. · Naqvi · A. · Gentry · H. · Murray · C. · Wang · X. · Golubykh · K. · Qurashi · H. · Dodia · A. · Risbano · M. · Benigno · M. · Emir · B. · Weinstein · E. · Bramson · C. · Jiang · L. · Dai · F. · Szigethy · E. · Mellors · J. W. · Met
Objective

To characterise subphenotypes of self-reported symptoms and outcomes (SRSOs) in postacute sequelae of COVID-19 (PASC).

Design

Prospective, observational cohort study of subjects with PASC.

Setting

Academic tertiary centre from five clinical referral sources.

Participants

Adults with COVID-19 ≥20 days before enrolment and presence of any new self-reported symptoms following COVID-19.

Exposures

We collected data on clinical variables and SRSOs via structured telephone interviews and performed standardised assessments with validated clinical numerical scales to capture psychological symptoms, neurocognitive functioning and cardiopulmonary function. We collected saliva and stool samples for quantification of SARS-CoV-2 RNA via quantitative PCR.

Outcomes measures

Description of PASC SRSOs burden and duration, derivation of distinct PASC subphenotypes via latent class analysis (LCA) and relationship with viral load.

Results

We analysed baseline data for 214 individuals with a study visit at a median of 197.5 days after COVID-19 diagnosis. Participants reported ever having a median of 9/16 symptoms (IQR 6–11) after acute COVID-19, with muscle-aches, dyspnoea and headache being the most common. Fatigue, cognitive impairment and dyspnoea were experienced for a longer time. Participants had a lower burden of active symptoms (median 3 (1–6)) than those ever experienced (p

Conclusions

We identified three distinct PASC subphenotypes. We highlight that although most symptoms progressively resolve, specific PASC subpopulations are impacted by either high burden of constitutional symptoms or persistent olfactory/gustatory dysfunction, requiring prospective identification and targeted preventive or therapeutic interventions.

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