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Use of latent class analysis and patient reported outcome measures to identify distinct long COVID phenotypes: A longitudinal cohort study.
Wong, Alyson W; Tran, Karen C; Binka, Mawuena; Janjua, Naveed Z; Sbihi, Hind; Russell, James A; Carlsten, Christopher; Levin, Adeera; Ryerson, Christopher J.
  • Wong AW; Department of Medicine, University of British Columbia, Vancouver, Canada.
  • Tran KC; Centre for Heart Lung Innovation, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.
  • Binka M; Division of General Internal Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
  • Janjua NZ; Data and Analytic Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
  • Sbihi H; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
  • Russell JA; Data and Analytic Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
  • Carlsten C; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
  • Levin A; Data and Analytic Services, BC Centre for Disease Control, Vancouver, British Columbia, Canada.
  • Ryerson CJ; School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One ; 18(6): e0286588, 2023.
Article in English | MEDLINE | ID: covidwho-20244773
ABSTRACT

OBJECTIVES:

We sought to 1) identify long COVID phenotypes based on patient reported outcome measures (PROMs) and 2) determine whether the phenotypes were associated with quality of life (QoL) and/or lung function.

METHODS:

This was a longitudinal cohort study of hospitalized and non-hospitalized patients from March 2020 to January 2022 that was conducted across 4 Post-COVID Recovery Clinics in British Columbia, Canada. Latent class analysis was used to identify long COVID phenotypes using baseline PROMs (fatigue, dyspnea, cough, anxiety, depression, and post-traumatic stress disorder). We then explored the association between the phenotypes and QoL (using the EuroQoL 5 dimensions visual analogue scale [EQ5D VAS]) and lung function (using the diffusing capacity of the lung for carbon monoxide [DLCO]).

RESULTS:

There were 1,344 patients enrolled in the study (mean age 51 ±15 years; 780 [58%] were females; 769 (57%) were of a non-White race). Three distinct long COVID phenotypes were identified Class 1) fatigue and dyspnea, Class 2) anxiety and depression, and Class 3) fatigue, dyspnea, anxiety, and depression. Class 3 had a significantly lower EQ5D VAS at 3 (50±19) and 6 months (54 ± 22) compared to Classes 1 and 2 (p<0.001). The EQ5D VAS significantly improved between 3 and 6 months for Class 1 (median difference of 6.0 [95% CI, 4.0 to 8.0]) and Class 3 (median difference of 5.0 [95% CI, 0 to 8.5]). There were no differences in DLCO between the classes.

CONCLUSIONS:

There were 3 distinct long COVID phenotypes with different outcomes in QoL between 3 and 6 months after symptom onset. These phenotypes suggest that long COVID is a heterogeneous condition with distinct subpopulations who may have different outcomes and warrant tailored therapeutic approaches.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0286588

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Quality of Life / COVID-19 Type of study: Cohort study / Observational study / Prognostic study Topics: Long Covid Limits: Female / Humans / Male Country/Region as subject: North America Language: English Journal: PLoS One Journal subject: Science / Medicine Year: 2023 Document Type: Article Affiliation country: Journal.pone.0286588