Post-COVID-19 condition is not only a question of persistent symptoms: structured screening including health-related quality of life reveals two separate clusters of post-COVID

Abstract

Purpose Some patients experience long-term sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, despite a present post-COVID condition, defined as “any symptom lasting longer than 12 weeks,” only a subset of patients search for medical help and therapy. Method We invited all adults with a positive real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 between March 2020 and September 2021 (n = 4091) in the city of Jena to answer a standardized questionnaire including demographic information, the course of the acute infection and current health status. K-means-clustering of quality of life (QoL) was used to explore post-COVID subgroups. Results A total of 909 participants at a median interval of 367 (IQR 291/403) days after acute infection were included in the analysis. Of those, 643 (70.7%) complained of having experienced persistent symptoms at the time of the survey. Cluster analysis based on QoL revealed two subgroups of people with persistent post-COVID symptoms. Whereas 189/643 participants (29.4%) showed markedly diminished QoL, normal QoL was detected in 454/643 individuals (70.6%). Conclusion Despite persistent symptoms being reported by nearly three quarters of participants, only one-third of these described a significant reduction in QoL (cluster 1), whereas the other two-thirds reported a near-normal QoL (cluster 2), thus indicating a differentiation between “post-COVID disease” and “post-COVID condition”. The prevalence of clinically relevant post-COVID disease was at least 20.7%. Health policies should focus on this subset.

The therapeutic potential of non-invasive brain stimulation for the treatment of Long-COVID-related cognitive fatigue

“…Thus, in a study by Giszas et al. ( 24 ), 70.7% of the participants reported persistent symptoms, while only one-third of those also reported that these symptoms significantly reduced their quality of life. Giszas et al.…”

“…Giszas et al. ( 24 ) therefore proposed to distinguish between Long-COVID “disease”, in which quality of life is significantly diminished and Long-COVID “condition”, in which quality of life is near-normal. In summary, while not entirely conclusive, these rates indicate that a significant amount of individuals who have had COVID-19 may develop Long-COVID.…”

A scoping review of regulatory T cell dynamics in convalescent COVID-19 patients – indications for their potential involvement in the development of Long COVID?

“…The World Health Organization (WHO) defines these sequelae, by common usage now also referred to as “Long COVID”, as a post-COVID-19 condition that usually occurs three months after a confirmed or probable SARS-CoV-2 infection with a set of new-onset, persistent or fluctuating symptoms that last for at least two months ( 11 ). The most common symptoms in this context are fatigue, exercise intolerance, post-exertional malaise, difficulty breathing, headache, muscle pain, tachycardia, concentration deficits and diminished quality of life ( 12 – 15 ). In this context, it bears noting that the overall prevalence and types of symptoms can vary depending on the COVID-19 disease severity.…”

A scoping review of regulatory T cell dynamics in convalescent COVID-19 patients – Implications for Long COVID?

“…The World Health Organization (WHO) defines these sequelae, by common usage now also referred to as "Long COVID", as a post-COVID-19 condition that usually occurs three months after a confirmed or probable SARS-CoV-2 infection with a set of new-onset, persistent or fluctuating symptoms that last for at least two months (11). The most common symptoms in this context are fatigue, exercise intolerance, post-exertional malaise, difficulty breathing, headache, muscle pain, tachycardia, concentration deficits and diminished quality of life (12)(13)(14)(15). The pathophysiological mechanisms involved in the devolvement of Long COVID remain to be elucidated, with a range of theories currently under discussion.…”