Over the past three years, it has become clear that, for many people, the effects of SARS-CoV-2 infection persist long after an initial case of COVID-19 wanes.
Like primary COVID-19, the affliction, known as post-acute sequelae of SARS-CoV-2 (PASC) or long COVID, has highly variable duration, symptoms and severity.
And as data accumulates, it appears that long COVID is a serious public health problem that will not go away any time soon.
In a study from Jackson Laboratory, scientists were able to analyze clinical data of more than 20,000 patients diagnosed with long COVID to better define its characteristics.
They also sought to determine whether it was possible to identify and define subtypes.
The researchers defined long COVID as presenting 28 days after the earliest COVID-19 date noted for outpatients and 28 days after the end of hospitalization for inpatients.
The team found that long COVID does indeed manifest in distinct subtypes that can help stratify patients and inform treatment strategies.
The subtypes are defined by the predominant clinical manifestations:
- Multi-system + lab (associated with severe initial infection and a high frequency of multiple symptoms: neuropsychiatric, pulmonary, constitutional (e.g., general fatigue), cardiovascular, and vertigo as well as lab test abnormalities);
- Hypoxemia and cough;
- Neuropsychiatric (headache, insomnia, depression, movement abnormalities);
- Cardiovascular;
- Pain/fatigue; and
- Multi-system-pain (similar to 1 without the lab results).
Each cluster has different age, gender and race frequencies associated with it, as well as different prior comorbidities and conditions.
The findings underscore the possibility that the mechanisms of long COVID may vary among individuals based on a collection of risk factors.
The team says clinical research studies are needed to identify possible treatments.
If you care about COVID, please read studies about antibodies that block all the COVID-19 variants, and vitamin D level could determine severity of COVID-19 infection.
For more information about COVID, please see recent studies about new antiviral drug that may block COVID-19 transmission, and results showing when you should get the new COVID-19 booster and the flu shot.
The study was conducted by Professor Peter Robinson et al and published in eBioMedicine.
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