Refinement of post-COVID condition core symptoms, subtypes, determinants, and health impacts: a cohort study integrating real-world data and patient-reported outcomes

Wang, Y; Alcalde-Herraiz, M; Güell, KL; Chen, L; Mateu, L; Li, C; Ali, R; Wareham, N; Paredes, R; Prieto-Alhambra, D; Xie, J

Journal article

Refinement of post-COVID condition core symptoms, subtypes, determinants, and health impacts: a cohort study integrating real-world data and patient-reported outcomes

Abstract:: Background: Post-COVID-19 condition (PCC) affects millions of people, and is an essential component of the long-term impact of COVID-19 during the post-pandemic era. Yet, consensus on clinical case definition and core components of PCC remains lacking, affecting our ability to inform research and evidence-based management. Our study aims 1) to identify the most specific symptoms for PCC, and identify clinical subtypes; 2) to evaluate both virus- and host-related determinants of PCC, and 3) assess the impact of PCC on physical and mental health.

Methods: We studied participants from UK Biobank who completed a health and wellbeing survey between June and September 2022. We identified individuals with PCC and characterised PCC symptoms and subtypes. We investigated virus- and host-related determinants of PCC and assessed the impact of PCC on physical and mental health.

Findings: We identified 10 most specific symptoms and classified four PCC subtypes: ENT subtype (30.1%), characterized by alterations in smell, taste, and hearing loss; cardiopulmonary subtype (10.4%), characterized by shortness of breath, postural tachycardia, chest tightness, and chest pressure; neurological subtype (23.5%), characterized by brain fog and difficulty speaking; and general fatigue subtype (38.0%), characterized by mild fatigue. A higher PCC risk was observed for patients with Wild-type variant, multiple infections, and severe acute COVID-19 illness, consistently across the four PCC subtypes. In addition, a range of factors, including socioeconomic deprivation, higher BMI, unhealthy lifestyle, and multiple chronic health conditions, were associated with increased PCC risk, except for age and sex. Conversely, vaccination was associated with a largely reduced PCC risk, particularly for the cardiopulmonary subtypes. Individuals with PCC experienced a much worse physical and mental health. Specifically, the cardiopulmonary subtype had the most pronounced adverse impact on function impairments, followed by neurological, mild fatigue, and ENT subtype.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Wang, Y., Alcalde-Herraiz, M., Güell, K. L., Chen, L., Mateu, L., Li, C., Ali, R., Wareham, N., Paredes, R., Prieto-Alhambra, D., & Xie, J. (2024). Refinement of post-COVID condition core symptoms, subtypes, determinants, and health impacts: a cohort study integrating real-world data and patient-reported outcomes. EBioMedicine, 111.

MLA Style

Wang, Y, et al. “Refinement of Post-COVID Condition Core Symptoms, Subtypes, Determinants, and Health Impacts: a Cohort Study Integrating Real-World Data and Patient-Reported Outcomes.” EBioMedicine, vol. 111, 2024.

Chicago Style

Wang, Y, M Alcalde-Herraiz, KL Güell, et al. 2024. “Refinement of Post-COVID Condition Core Symptoms, Subtypes, Determinants, and Health Impacts: a Cohort Study Integrating Real-World Data and Patient-Reported Outcomes.” EBioMedicine 111.
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