Abstract
Background: Long COVID has become a burden on healthcare systems worldwide. Research into the etiology and risk factors has been impeded by observing all diverse manifestations as part of a single entity. We aimed to determine patterns of symptoms in convalescing COVID-19 patients. Methods: Symptomatic patients were recruited from four countries. Data were collected regarding demographics, comorbidities, acute disease and persistent symptoms. Factor analysis was performed to elucidate symptom patterns. Associations of the patterns with patients’ characteristics, features of acute disease and effect on daily life were sought. Results: We included 1027 symptomatic post-COVID individuals in the analysis. The majority of participants were graded as having a non-severe acute COVID-19 (N = 763, 74.3%). We identified six patterns of symptoms: cognitive, pain-syndrome, pulmonary, cardiac, anosmia-dysgeusia and headache. The cognitive pattern was the major symptoms pattern, explaining 26.2% of the variance; the other patterns each explained 6.5–9.5% of the variance. The cognitive pattern was higher in patients who were outpatients during the acute disease. The pain-syndrome pattern was associated with acute disease severity, higher in women and increased with age. The pulmonary pattern was associated with prior lung disease and severe acute disease. Only two of the patterns (cognitive and cardiac) were associated with failure to return to pre-COVID occupational and physical activity status. Conclusion: Long COVID diverse symptoms can be grouped into six unique patterns. Using these patterns in future research may improve our understanding of pathophysiology and risk factors of persistent COVID, provide homogenous terminology for clinical research, and direct therapeutic interventions.
Highlights
Long COVID has become a burden on healthcare systems worldwide
Similar to the acute disease, which manifests in multiple ways, post-COVID individuals report a multitude of symptoms, involving different organ systems [6]
Three hundred twenty six individuals (31.7%) reported worse physical activity status compared to pre-infection state, and 131 were unable to return to their former work because of ongoing symptoms at the time of the clinic visit
Summary
Long COVID has become a burden on healthcare systems worldwide. Research into the etiology and risk factors has been impeded by observing all diverse manifestations as part of a single entity. Similar to the acute disease, which manifests in multiple ways, post-COVID individuals report a multitude of symptoms, involving different organ systems [6]. In the acute disease, several pathophysiological mechanisms have already been identified (i.e., direct viral induced damage, microthrombi and immune mediated damage), the underlying mechanisms behind long COVID are still unknown and are likely to be multifactorial. Aggregating all individuals with long COVID under a single entity might be misleading for our understanding of the pathophysiology, risk factors and potential interventions for these individuals. Assigning these symptoms to unique patterns might advance future research and a personalized treatment approach [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
