Phenotyping of acute and persistent COVID-19 features in the outpatient setting: exploratory analysis of an international cross-sectional online survey

Sahanic, Sabina; Tymoszuk, Piotr; Ausserhofer, Dietmar; Rass, Verena; Pizzini, Alex; Nordmeyer, Goetz; uumlfner, Katharina H; Kurz, Katharina; Weber, Paulina Maria; Sonnweber, Thomas; Boehm, Anna; Aichner, Magdalena; Cima, Katharina; Boeckle, Barbara; Holzner, Bernhard; Rumpold, Gerhard; Puelacher, Christoph; Kiechl, Stefan; Huber, Andreas; Wiedermann, Christian J.; Sperner‐Unterweger, Barbara; Tancevski, Ivan; Bellmann‐Weiler, Rosa; Bachler, Herbert; Piccoliori, Giuliano; Helbok, Raimund; Weiss, Guenter; Loeffler‐Ragg, Judith

doi:10.1101/2021.08.05.21261677

Cited by 5 publications

(5 citation statements)

References 21 publications

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“… Radar chart illustrating the prevalence of the specific long COVID symptoms in the cohort studies with study number indicated on the circle circumference [ 15 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , ...…”

Section: Resultsmentioning

confidence: 99%

Most Common Long COVID Physical Symptoms in Working Age Adults Who Experienced Mild COVID-19 Infection: A Scoping Review

et al. 2022

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Background: One-third of patients who recover from COVID-19 present with long COVID. Their symptoms are broad, affecting their physical functioning and, ultimately, their quality of life. Many of those individuals who develop long COVID, possibly from a mild COVID-19 infection, are in the 18–65 age group. This prolongation of malaise directly influences national workforce economies. Objectives: To summarise the commonly reported physical symptoms of long COVID in order to inform potential adjustments in healthcare for the employable population. Methods: The Embase, CINAHL, Medline, SCOPUS, and WHO COVID-19 databases were searched. The study selection process was based on the PRISMA guidelines. The extracted data were synthesised and presented narratively. Results: 7403 studies were accessed, comprising 60 cohort studies and 10 case series/studies, representing 289,213 patients who met our criteria. The most frequently reported physical symptoms were fatigue (92%), shortness of breath (SOB) (81.8%), muscle pain (43.6%), and joint pain (34.5%). Conclusions: The range of reported physical symptoms was broad and varied; the main ones being fatigue, breathlessness/SOB, and pain. Similarities observed between long COVID and other post-acute infection syndromes may help formulate protocols to manage and promote recovery for long COVID patients. Inconsistencies were evident, particularly with a lack of adherence to the standardised definitions of long COVID.

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Section: Resultsmentioning

confidence: 99%

Most Common Long COVID Physical Symptoms in Working Age Adults Who Experienced Mild COVID-19 Infection: A Scoping Review

et al. 2022

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“…COVID‐19 is characterized by a heterogeneous clinical manifestation and divergent courses of the disease [2]. This ranges from asymptomatic infection, to ambulatory disease with wide‐ranged flu‐like complaints, up to severe respiratory or multiorgan failure, requiring hospitalization and treatment at intensive care unit [2–4]. Especially in the latter cases, an excessive overstimulation of the immune system, likewise driven by an impaired immune control of viral replication leads to a “cytokine release syndrome” with subsequent organ damage [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Alterations of blood monocyte subset distribution and surface phenotype are linked to infection severity in COVID‐19 inpatients

et al. 2022

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Severe coronavirus disease 19 (COVID‐19) manifests with systemic immediate proinflammatory innate immune activation and altered iron turnover. Iron homeostasis, differentiation, and function of myeloid leukocytes are interconnected. Therefore, we characterized the cellularity, surface marker expression, and iron transporter phenotype of neutrophils and monocyte subsets in COVID‐19 patients within 72 h from hospital admission, and analyzed how these parameters relate to infection severity. Between March and November 2020, blood leukocyte samples from hospitalized COVID‐19 patients (n = 48) and healthy individuals (n = 7) were analyzed by flow cytometry enabling comparative analysis of 40 features. Inflammation‐driven neutrophil expansion, depletion of CD16 + nonclassical monocytes, and changes in surface expression of neutrophil and monocyte CD64 and CD86 were associated with COVID‐19 severity. By unsupervised self‐organizing map clustering, four patterns of innate myeloid response were identified and linked to varying levels of systemic inflammation, altered cellular iron trafficking and the severity of disease. These alterations of the myeloid leukocyte compartment during acute COVID‐19 may be hallmarks of inefficient viral control and immune hyperactivation and may help at risk prediction and treatment optimization.

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“…Clinical phenotypes will be categorised from milder to more severe disease presentation and potential predicting factors (measured at presentation) will be identified using generalized linear mixed models. Generalised mixed models will be also used to assess the associations between the duration and severity of signs/symptoms of COVID-19 disease and viral loads, anti-SARS-CoV-2 antibody kinetics 20 and change in laboratory parameters and cytokines, after adjusting for age and gender. The likelihood ratio test will assess statistical significance of the estimates at the 5% level.…”

Section: Acute Diseasementioning

confidence: 99%

“…The WHO clinical progression scale [19] classifies mild disease into asymptomatic and into two broad symptomatic strata. However, COVID-19 patients have diverse clinical presentations encompassing the number and duration of symptoms [20] as well as different alterations of laboratory parameters. Some of these clinical phenotypes could be linked to evolution to severe disease and/or to the development of long-term sequelae [21].…”

Section: Introductionmentioning

confidence: 99%

The COVID HOME study research protocol: Prospective cohort study of non-hospitalised COVID-19 patients

Tami

Gun

Wold

et al. 2022

Preprint

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Background. Guidelines on COVID-19 management are developed as we learn from this pandemic. However, most research has been done on hospitalised patients and the impact of the disease on non-hospitalised and their role in transmission are not yet well understood. The COVID HOME study conducts research among COVID-19 patients and their family members who were not hospitalised during acute disease, to guide patient care and inform public health guidelines for infection prevention and control in the community and household. Methods. An ongoing prospective longitudinal observational study of COVID-19 outpatients was established in March 2020 in the Netherlands. Laboratory confirmed SARS-CoV-2 infected individuals of all ages that did not merit hospitalisation, and their household (HH) members, were enrolled after written informed consent. Enrolled participants were visited at home within 48 hours after initial diagnosis, and then weekly on days 7, 14 and 21 to obtain clinical data, a blood sample for biochemical parameters/cytokines and serological determination; and a nasopharyngeal/throat swab plus urine, stool and sperm or vaginal secretion (if consenting) to test for SARS-CoV-2 by RT-PCR (viral shedding) and for viral culturing. Weekly nasopharyngeal/throat swabs and stool samples, plus a blood sample on days 0 and 21 were also taken from HH members to determine whether and when they became infected. All participants were invited to continue follow-up at 3-, 6-, 12- and 18-months post-infection to assess long-term sequelae and immunological status. Preliminary Results. A total of 256 participants belonging to 103 HH were included of which, 190 (74.2%) were positive for SARS-CoV-2 infection. Most individuals (183/190, 96.3%) developed mild to moderate disease. At the time of writing, all participants had reached the 3 and 6 month time-points of the long-term follow-up, while approximately 78% reached 12 month and 23% the 18 month time-point. Preliminary analysis showed that 43% (52/121) positive individuals reported having complaints at 3 months post-infection, while 42.7% (61/143) had complaints at 6 months.

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Phenotyping of acute and persistent COVID-19 features in the outpatient setting: exploratory analysis of an international cross-sectional online survey

Cited by 5 publications

References 21 publications

Most Common Long COVID Physical Symptoms in Working Age Adults Who Experienced Mild COVID-19 Infection: A Scoping Review

Most Common Long COVID Physical Symptoms in Working Age Adults Who Experienced Mild COVID-19 Infection: A Scoping Review

Alterations of blood monocyte subset distribution and surface phenotype are linked to infection severity in COVID‐19 inpatients

The COVID HOME study research protocol: Prospective cohort study of non-hospitalised COVID-19 patients

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