Document Type
Article
Publication Date
7-7-2023
Abstract
BACKGROUND: The prevalence, incidence, and interrelationships of persistent symptoms after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection vary. There are limited data on specific phenotypes of persistent symptoms. Using latent class analysis (LCA) modeling, we sought to identify whether specific phenotypes of COVID-19 were present 3 months and 6 months post-infection.
METHODS: This was a multicenter study of symptomatic adults tested for SARS-CoV-2 with prospectively collected data on general symptoms and fatigue-related symptoms up to 6 months postdiagnosis. Using LCA, we identified symptomatically homogenous groups among COVID-positive and COVID-negative participants at each time period for both general and fatigue-related symptoms.
RESULTS: Among 5963 baseline participants (4504 COVID-positive and 1459 COVID-negative), 4056 had 3-month and 2856 had 6-month data at the time of analysis. We identified 4 distinct phenotypes of post-COVID conditions (PCCs) at 3 and 6 months for both general and fatigue-related symptoms; minimal-symptom groups represented 70% of participants at 3 and 6 months. When compared with the COVID-negative cohort, COVID-positive participants had higher occurrence of loss of taste/smell and cognition problems. There was substantial class-switching over time; those in 1 symptom class at 3 months were equally likely to remain or enter a new phenotype at 6 months.
CONCLUSIONS: We identified distinct classes of PCC phenotypes for general and fatigue-related symptoms. Most participants had minimal or no symptoms at 3 and 6 months of follow-up. Significant proportions of participants changed symptom groups over time, suggesting that symptoms present during the acute illness may differ from prolonged symptoms and that PCCs may have a more dynamic nature than previously recognized.
Recommended Citation
Gottlieb, Michael; Spatz, Erica S.; Yu, Huihui; Wisk, Lauren E; Elmore, Joann G.; Gentile, Nicole L.; Hill, Mandy; Huebinger, Ryan M.; Idris, Ahamed H.; Kean, Efrat M.; Koo, Katherine; Li, Shu-Xia; McDonald, Samuel; Montoy, Juan Carlos C; Nichol, Graham; O'Laughlin, Kelli N.; Plumb, Ian D.; Rising, Kristin L.; Santangelo, Michelle; Saydah, Sharon; Wang, Ralph C.; Venkatesh, Arjun; Stephens, Kari A.; and Weinstein, Robert A., "Long COVID Clinical Phenotypes up to 6 Months After Infection Identified by Latent Class Analysis of Self-Reported Symptoms" (2023). Department of Emergency Medicine Faculty Papers. Paper 229.
https://jdc.jefferson.edu/emfp/229
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
PubMed ID
37426952
Language
English
Comments
This article is the author’s final published version in Open Forum Infectious Diseases, Volume 10, Issue 7, July 2023, Article number ofad277.
The published version is available at https://doi.org/10.1093/ofid/ofad277. © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.