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Sahanic S, Tymoszuk P, Ausserhofer D, Rass V, Pizzini A, Nordmeyer G, Hüfner K, Kurz K, Weber PM, Sonnweber T, Boehm A, Aichner M, Cima K, Boeckle B, Holzner B, Rumpold G, Puelacher C, Kiechl S, Huber A, Wiedermann CJ, Sperner-Unterweger B, Tancevski I, Bellmann-Weiler R, Bachler H, Piccoliori G, Helbok R, Weiss G, Loeffler-Ragg J. Phenotyping of acute and persistent COVID-19 features in the outpatient setting: exploratory analysis of an international cross-sectional online survey. Clin Infect Dis 2021; 75:e418-e431. [PMID: 34849652 PMCID: PMC8767855 DOI: 10.1093/cid/ciab978] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Long COVID, defined as presence of COVID-19 symptoms 28 days or more after clinical onset, is an emerging challenge to healthcare systems. The objective of this study was to explore recovery phenotypes in non-hospitalized COVID-19 individuals. METHODS A dual cohort, online survey study was conducted between September 2020 and July 2021 in the neighboring European regions Tyrol (TY, Austria, n = 1157) and South Tyrol (STY, Italy, n = 893). Data on demographics, comorbidities, COVID-19 symptoms and recovery adult outpatients were collected. Phenotypes of acute COVID-19, post-acute sequelae and risk of protracted recovery were explored by semi-supervised clustering and multi-parameter LASSO modeling. RESULTS Working age subjects (TY: 43 yrs (IQR: 31 – 53), STY: 45 yrs (IQR: 35 – 55)) and females (TY: 65.1%, STY: 68.3%) predominated the study cohorts. Nearly half of the participants (TY: 47.6%, STY: 49.3%) reported symptom persistence beyond 28 days. Two acute COVID-19 phenotypes were discerned: the non-specific infection phenotype and the multi-organ phenotype (MOP). Acute MOP symptoms encompassing multiple neurological, cardiopulmonary, gastrointestinal and dermatological complaints were linked to elevated risk of protracted recovery. The major subset of long COVID individuals (TY: 49.3%, STY: 55.6%) displayed no persistent hyposmia or hypogeusia but high counts of post-acute MOP symptoms and poor self-reported physical recovery. CONCLUSION The results of our two-cohort analysis delineated phenotypic diversity of acute and post-acute COVID-19 manifestations in home-isolated patients which needs to be considered for predicting protracted convalescence and allocation of medical resources.
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Affiliation(s)
- Sabina Sahanic
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Piotr Tymoszuk
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria.,Data Analytics As a Service Tirol, Innsbruck, Austria
| | | | - Verena Rass
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Alex Pizzini
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Katharina Hüfner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Kurz
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Paulina Maria Weber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Sonnweber
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Anna Boehm
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Magdalena Aichner
- Department of Dermatology and Venereology, Medical University of Innsbruck, Innsbruck, Austria
| | - Katharina Cima
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Barbara Boeckle
- Department of Dermatology and Venereology, Medical University of Innsbruck, Innsbruck, Austria
| | - Bernhard Holzner
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria.,Evaluation Software Development, Innsbruck, Austria
| | - Gerhard Rumpold
- Evaluation Software Development, Innsbruck, Austria.,Department of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Christoph Puelacher
- REHA-MED Tirol, Center for outpatient cardiac and pulmonary rehabilitation, Innsbruck, Austria
| | - Stefan Kiechl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Andreas Huber
- Tyrolean Federal Institute for Integrated Care, Innsbruck, Austria
| | | | - Barbara Sperner-Unterweger
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital for Psychiatry II, Medical University of Innsbruck, Innsbruck, Austria
| | - Ivan Tancevski
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Rosa Bellmann-Weiler
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Herbert Bachler
- Institute of General Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | | | - Raimund Helbok
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Guenter Weiss
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Loeffler-Ragg
- Department of Internal Medicine II, Medical University of Innsbruck, Innsbruck, Austria
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