학술논문
Long COVID Clinical Phenotypes up to 6 Months After Infection Identified by Latent Class Analysis of Self-Reported Symptoms.
Document Type
article
Author
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 R; 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; Weinstein, Robert A; INSPIRE Group
Source
Open forum infectious diseases. 10(7)
Subject
Language
Abstract
BackgroundThe 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.MethodsThis 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.ResultsAmong 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.ConclusionsWe 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. Clinical Trials Registration. NCT04610515.