Clinical phenotypes and features of the post-COVID syndrome course

Close metadata

OBJECTIVE

To develop a methodology for describing post-acute sequelae of COVID-19 (PASC) phenotypes and determine their role in outpatient practice; to study the most common clinical variants (phenotypes) of PASC, depending on the comorbidities and features of the course of the new coronavirus infection (COVID-19).

MATERIALS AND METHODS

A cross-sectional study involved 665 respondents aged 18 years and older with a history of COVID-19 in 2020—2022. The subjects filled out an online questionnaire with questions about the features of their acute COVID-19 course, the presence of chronic diseases, the signs and symptoms of PACS, and their quality of life. Statistical processing was performed using MS Excel 2021 and Jamovi software.

RESULTS

The mean age of subjects (88.1% females, 11.9% males) was 38 (30; 46) years. Viral pneumonia was diagnosed in 25.3% of patients. Hypertension (24%), obesity (18.6%), and coronary heart disease (6.1%) were the most common comorbidities. In total, 7 main PASC phenotypes were identified. The predominance of a particular phenotype was not statistically significantly associated with gender, hospital admission status, and the presence of a positive PCR test for SARS-CoV-2. Patients with a longer course of COVID-19 (more than 15 days) and those with a history of COVID-associated pneumonia more often had phenotypes with cardiovascular (p=0.009 and p=0.015), neurological (p=0.036 and p=0.039), and gastrointestinal (p=0.05 and p=0.022) disorders. Patients with comorbidities were more likely to have phenotypes with respiratory (p=0.004), cardiovascular (p=0.001), neurological (p=0.0043), and gastrointestinal (p=0.001) disorders.

CONCLUSION

The new coronavirus infection causes damage to many organs and systems, manifested in various symptoms of the post-acute sequelae of COVID-19. The main factors associated with the phenotype of the post-acute sequelae of COVID-19 were concomitant chronic diseases, a history of COVID-associated pneumonia, and the duration of the new coronavirus infection. Identifying post-acute sequelae of COVID-19 phenotypes will optimize patient management and improve their quality of life.

Keywords:

new coronavirus infection

post-acute sequelae of COVID-19

clinical phenotypes

quality of life

Authors:

Isaeva A.V.

Federal State Budgetary Educational Institution of Higher Education «Ural State Medical University» of the Ministry of Health of Russia

ORCID: 0000-0003-0634-9759

Vetluzhskaya M.V.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0001-9733-4813

Korobeynikova A.N.

Center for Cardiology and Neurology

ORCID: 0000-0002-4357-1757

Vlasova A.V.

Sechenov First Moscow State Medical University (Sechenov University)

ORCID: 0000-0002-7677-1544

Received:

17.05.2023

Accepted:

29.05.2023

List of references:

Oronsky B, Larson C, Hammond TS, Oronsky A, Kesari S, Lybeck M, Reid TR. A Review of Persistent Post-COVID Syndrome (PPCS). Clinical Reviews in Allergy and Immunology. 2023;64(1):66-74. https://doi.org/10.1007/s12016-021-08848-3
Tirelli U, Taibi R, Chirumbolo S. Post COVID syndrome: a new challenge for medicine. European Review for Medical and Pharmacological Sciences. 2021;25(12):4422-4425. https://doi.org/10.26355/eurrev_202106_26154
Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, Redfield S, Austin JP, Akrami A. Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. eClinicalMedicine. 2021;38:101019. https://doi.org/10.1016/j.eclinm.2021.101019
Ejaz H, Alsrhani A, Zafar A, Javed H, Junaid K, Abdalla AE, Khalid O. A.Abosalif, Ahmed Z, Younas S. COVID-19 and comorbidities: Deleterious impact on infected patients. Journal of Infection and Public Health. 2020;13(12):1833-1839. https://doi.org/10.1016/j.jiph.2020.07.014
Michelen M, Cheng V, Manoharan L, Elkheir N, Dagens D, Hastie C, O’Hara M, Suett JC, Dahmash DT, Bugaeva P, Rigby I, Munblit D, Harriss E, Burls A, Foote C, Scott JT, Carson G, Olliaro P, Sigfrid L, Stavropoulou C. Characterising long term Covid-19: a living systematic review. BMJ Global Health. 2021;6(9):e005427. https://doi.org/10.1136/bmjgh-2021-005427
Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute Covid-19 in primary care. BMJ. 2020;370:m3026. https://doi.org/10.1136/bmj.m3026
Bell ML, Catalfamo JC, Farland LV, Ernst KC, Jacobs ET, Klimentidis YC, Jehn M, Pogreba-Brown K. Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT. PLoS One. 2021;16(8):e0254347. https://doi.org/10.1371/journal.pone.0254347
Chopra V, Flanders SA, O’Malley M, Malani AN, Prescott HC.Sixty-day outcomes among patients hospitalized with COVID-19. Annals of Internal Medicine. 2021;174(4):576-578. https://doi.org/10.7326/M20-5661
Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, Cook JR, Nordvig AS, Shalev D, SehrawatTS, Ahluwalia N, Bikdeli B, Dietz D, Der-Nigoghossian C, Liyanage-Don N, Rosner GF, Bernstein EJ, Mohan S, Beckley AA, Seres DS, Choueiri TK, Uriel N, Ausiello JC, Accili D, Freedberg DE, Baldwin M, Schwartz A, Brodie D, Garcia CK, Elkind MSV, Connors JM, Bilezikian JP, Landry DW, Wan EY. Post-acute COVID-19 syndrome. Nature Medicine. 2021;27(4):601-615. https://doi.org/10.1038/s41591-021-01283-z
Yoo SM, Liu TC, Motwani Y, Sim MS, Viswanathan N, Samras N, Hsu F, Wenger NS. Factors Associated with Post-Acute Sequelae of SARS-CoV-2 (PASC) After Diagnosis of Symptomatic COVID-19 in the Inpatient and Outpatient Setting in a Diverse Cohort. Journal of General Internal Medicine. 2022;37(8):1988-1995. https://doi.org/10.1007/s11606-022-07523-3
Chen X, Li Y, Shao TR, Yang LL, Li SJ, Wang XJ, Li A, Wu YY, Liu XF, Liu CM, Liu YH, Zeng F, Cen Y. Some characteristics of clinical sequelae of COVID-19survivors from Wuhan, China: A multi-center longitudinalstudy. Influenza and Other Respiratory Viruses. 2022;16(3):395-401. https://doi.org/10.1111/irv.12943
Logue JK, Franko NM, McCulloch DJ, McDonald D, Magedson A, Wolf CR, Chu HY. Sequelae in Adults at 6 Months After COVID-19 Infection. JAMA Network Open. 2021;4(2):e210830. https://doi.org/10.1001/jamanetworkopen.2021.0830
Salmon-Ceron D, Slama D, De Broucker T, Pichard E, Canoui-Poitrine F; APHP COVID-19 research collaboration. Clinical, virological and imaging profile in patients with prolonged forms of COVID-19: a cross-sectional study. The Journal of Infection. 2021;82(2):1-4. https://doi.org/10.1016/j.jinf.2020.12.002
Arutyunov GP, Tarlovskaya EI, Arutyunov AG, Belenkov YuN, Konradi OA. The results of the international registry «Analysis of the dynamics of comorbidy in patients with post-acute sequelae of SARS-CoV2 infection (ACTIVSARS-CoV2). Preliminary data (6 months of observation). Rossijskij kardiologicheskij zhurnal. 2021;26(10):4708. (In Russ.). https://doi.org/10.15829/1560-4071-2021-4708
Vorob’ev PA, Vorob’ev AP, Krasnova LS. Post-acute sequelae of COVID-19: the image of the disease, the concept of pathogenesis and classification. Problemy standartizacii v zdravoohranenii. 2021;(5-6) 3-10. (In Russ.).

Close metadata