Most of the people who buy the infection for him coronavirus feel better within a few days or weeks of the first symptom and fully recover in 12 weeks. But some people can suffer different sequelae for months and up to more than a year, a syndrome known as Prolonged COVID
A study led by researchers at Weill Cornell Medicine in the United States identified that there are four main subtypes defined by different groups of symptoms of Protracted or long-standing COVID.
The study was published in the journal nature medicineand has been the oldest in his class to examine Prolonged COVID.
The researchers, which include clinicians and computer scientists, used a machine learning algorithm to detect symptom patterns in the medical records of nearly 35,000 US patients who tested positive and later developed persistent symptoms. of long-term COVID.
The research was funded by the Researching COVID to Enhance Recovery (RECOVER) initiative of the National Institutes of Health. It is part of a one-year, $9.8 million grant focused on cohort studies of medical records.
The principal investigator was Rainu Kaushal, MD, associate dean for clinical research and chair of the Department of Population Health Sciences at Weill Cornell Medicine.
“The goal of the RECOVER study is to rapidly elucidate what happens in long-term COVID,” said Kaushal, co-senior author of the study. “Looking at how cases cluster can profoundly influence patient care and prognosis,” she added.
Of the four main patterns detected, one involved heart and kidney problems, and included a relatively high proportion of patients infected in the early months of the pandemic in the United States.
Another pattern included breathing problems, anxiety, sleep disturbances, and other symptoms such as headache and chest pain; nearly two-thirds of patients with this pattern were women.
“These results should serve as the foundation for ongoing investigations into the potential mechanisms of long-term COVID and possible treatments,” said Dr. Fei Wang, associate professor of Population Health Sciences, who led the study.
Viral infections sometimes leave patients with a persistent, often nonspecific, set of symptoms. The number of Americans who have had long-term COVID is estimated to be 40% of the adult population.
“Understanding the epidemiology of long-term COVID allows clinicians to help patients understand their symptoms and prognoses and facilitates multispecialty treatment of patients,” Kaushal said. “Electronic medical records offer a window into this condition, allowing us to better characterize the symptoms of long-term COVID.”
The medical records analyzed for the study came from two large data sets assembled by the Patient-Centered Clinical Research National Network (PCORnet), which comprises eight consortia of health institutions from across the country.
One of the data sets, from the INSIGHT clinical research network led by Kaushal, included data from patients in New York, while the other came from the OneFlorida+ network, which includes patients from Florida, Georgia and Alabama.
In total, the analysis covered the medical records of 34,605 different patients from March 2020 to November 2021 (up to, but not including, the first wave of the Omicron variant).
Initially analyzing the New York patient dataset, the machine learning algorithm detected four main patterns of symptoms. The former, which accounted for about 34% of patients, was dominated by symptoms related to the heart, kidneys, and circulation.
Patients in this group, compared with those in other groups, had a higher mean age (median 65 years), more likely to be male (49%), a relatively high rate of COVID hospitalization (61%), and a relatively higher number of pre-existing conditions.
This group also had the highest proportion (37%) of patients who fell ill with the SARS-CoV-2 coronavirus during the first large wave that occurred from March to June 2020.
The second symptom pattern, comparable in frequency (33% of patients) to the first, was dominated by respiratory and sleep problems, anxiety, headache, and chest pain. Patients with this pattern were mostly women (63%), with a median age of 51 years and a much lower rate (31%) of hospitalization for COVID.
Nearly two-thirds of patients in this group tested positive for SARS-CoV-2 during subsequent waves, from November 2020 to November 2021. Pre-existing conditions in this group focused on respiratory problems such as chronic obstructive pulmonary disorder and asthma.
The other two symptom patterns were dominated, respectively, by musculoskeletal and nervous system symptoms, including arthritis (23% of patients), and by a combination of digestive and respiratory symptoms (10%).
Only in the first symptomatic pattern was the sex ratio approximately 1:1; in the other three, women constituted a significant majority (more than 60%).
“This sex difference in the risk of Long-Term COVID is consistent with previous research, but until now very few studies have attempted to uncover the underlying mechanisms,” Wang said. To validate their findings, the researchers applied their algorithm to the dataset that included patients from the three southern states, and found very similar results.
The analysis also supported the overall validity of COVID Prolonged by demonstrating that, for patients who tested negative for SARS-CoV-2, symptoms that occurred in the same time interval of 30 to 180 days after the test did not show such clear patterns.
Currently, researchers continue to investigate several lines, such as the definition of symptom patterns of long-term COVID so that they can be easily identified from electronic medical records, and the identification of risk factors for different symptom patterns. They are also looking to identify existing treatments that can be repurposed to help patients with long-term COVID.
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