Link to free download of John’s 2 textbooks.
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Profiling post-COVID syndrome across different variants of SARS-CoV-2
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Across all variants
Central neurological cluster of symptoms
Cardiorespiratory cluster of symptoms
Debilitating multi-organ systemic inflammatory symptoms
Central neurological cluster of symptoms
Anosmia / dysosmia
Fatigue
Brain-fog
Depression
Delirium
Headache
(Largest cluster in both alpha and delta variants, and the second largest for the wild-type variant)
Consistent UK Biobank study
SARS-CoV-2 is associated with changes in brain structure in UK Biobank
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Reduction in grey matter thickness
Tissue damage in primary olfactory cortex
Reduction in global brain size
Cardiorespiratory cluster of symptoms
(Largest cluster in the wild-type period)
Symptoms may reflect lung damage
Dyspnoea
Chest pain
Fatigue
Palpitations
Consistent study from Medicine
Clinical characteristics and outcomes of post-COVID-19 pulmonary fibrosis
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Post-COVID-19 pulmonary fibrosis is a severe complication that leads to permanent lung damage or death.
Debilitating multi-organ symptoms
(Present in all variants)
Systemic/inflammatory
Abdominal symptoms
Myalgias (muscle pain)
Vaccination and long covid
we did not observe evidence of qualitatively different symptom clustering in vaccinated vs. unvaccinated individuals,
with either alpha or delta variants.
Background
It is now evident that post-COVID syndrome presents with heterogeneous profiles,
need characterisation to enable personalised care
Methods
Prospective longitudinal cohort study
N = 336,652 subjects
(Covid Symptom Study)
Tested positive
Long-COVID = lasting longer than 28 days
N = 1,459 with post-COVID syndrome (more than 12 weeks of symptoms)
One in 230 symptomatic, test confirmed cases
Clustering analysis, to identify distinct symptom profiles
Across
Variants of SARS-CoV-2
Vaccination status at the time of infection
Clusters were characterised
Symptom prevalence
Duration
Demography
Prior conditions (comorbidities)
Findings
We identified distinct profiles of symptoms for post-COVID syndrome
Wild-type variant
Four endotypes identified
Alpha variant
Seven endotypes
Delta variant
Five endotypes in vaccinated subjects
Endotype
a subtype of a disease condition,
defined by a distinct pathophysiological mechanism
Interpretation
Our classification may be useful to understand distinct mechanisms of the post-COVID syndrome, as well as subgroups of individuals at risk of prolonged debilitation.
Dr Claire Steves, clinical lead author, King's College London
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These data show clearly that post-COVID syndrome is not just one condition, but appears to have at several subtypes.
Understanding the root causes of these subtypes may help in finding treatment strategies.
Moreover, these data emphasise the need for long COVID services to incorporate a personalised approach sensitive to the issues of each individual.
Dr Liane Canas, author
These insights could aid in the development of personalised diagnosis and treatment for these individuals
