Abstract
Multiple studies across global populations have established the primary symptoms characterising Coronavirus Disease 2019 (COVID-19) and long COVID. However, as symptoms may also occur in the absence of COVID-19, a lack of appropriate controls has often meant that specificity of symptoms to acute COVID-19 or long COVID, and the extent and length of time for which they are elevated after COVID-19, could not be examined. We analysed individual symptom prevalences and characterised patterns of COVID-19 and long COVID symptoms across nine UK longitudinal studies, totalling over 42,000 participants. Conducting latent class analyses separately in three groups (‘no COVID-19’, ‘COVID-19 in last 12 weeks’, ‘COVID-19 > 12 weeks ago’), the data did not support the presence of more than two distinct symptom patterns, representing high and low symptom burden, in each group. Comparing the high symptom burden classes between the ‘COVID-19 in last 12 weeks’ and ‘no COVID-19’ groups we identified symptoms characteristic of acute COVID-19, including loss of taste and smell, fatigue, cough, shortness of breath and muscle pains or aches. Comparing the high symptom burden classes between the ‘COVID-19 > 12 weeks ago’ and ‘no COVID-19’ groups we identified symptoms characteristic of long COVID, including fatigue, shortness of breath, muscle pain or aches, difficulty concentrating and chest tightness. The identified symptom patterns among individuals with COVID-19 > 12 weeks ago were strongly associated with self-reported length of time unable to function as normal due to COVID-19 symptoms, suggesting that the symptom pattern identified corresponds to long COVID. Building the evidence base regarding typical long COVID symptoms will improve diagnosis of this condition and the ability to elicit underlying biological mechanisms, leading to better patient access to treatment and services.
| Original language | English |
|---|---|
| Pages (from-to) | 199-210 |
| Number of pages | 12 |
| Journal | European Journal of Epidemiology |
| Volume | 38 |
| Issue number | 2 |
| Early online date | 21 Jan 2023 |
| DOIs | |
| Publication status | Published - 1 Feb 2023 |
Bibliographical note
Funding Information:This work was supported by the National Core Studies, an initiative funded by UKRI, NIHR and the Health and Safety Executive. The COVID-19 Longitudinal Health and Wellbeing National Core Study was funded by the Medical Research Council (MC_PC_20030 and MC_PC_20059). The research was also underpinned by additional NIHR funding (COV-LT-0009). Data gathered from questionnaire(s) was provided by Wellcome Longitudinal Population Study (LPS) COVID-19 Steering Group and Secretariat (221574/Z/20/Z). The 1946 National Child Development Study, the 1970 British Cohort Study, Next Steps and the Millennium Cohort Study are supported by the Centre for Longitudinal Studies Resource Centre 2015-20 grant (ES/M001660/1) and a host of other co-funders. The COVID-19 data collections in these five cohorts were funded by the UKRI grant Understanding the economic, social and health impacts of COVID-19 using lifetime data: evidence from 5 nationally representative UK cohorts (ES/V012789/1). Born in Bradford (BiB) receives core infrastructure funding from the Wellcome Trust (WT101597MA), and a joint grant from the UK Medical Research Council (MRC) and UK Economic and Social Science Research Council (ESRC) (MR/N024397/1),the British Heart Foundation (BHF) (CS/16/4/32482), and The Health Foundation COVID-19 award (2301201). The National Institute for Health Research Yorkshire and Humber Applied Research Collaboration (ARC) (NIHR200166), and Clinical Research Network both provide support for BiB research. Born in Bradford is only possible because of the enthusiasm and commitment of the children and parents in BiB. We are grateful to all the participants, health professionals, schools and researchers who have made Born in Bradford happen.The UK Medical Research Council and Wellcome (Grant Ref: 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. A comprehensive list of grants funding is available on the ALSPAC website ( http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf ). We are extremely grateful to all the families who took part in this study, the midwives for their help in recruiting them, and the whole ALSPAC team, which includes interviewers, computer and laboratory technicians, clerical workers, research scientists, volunteers, managers, receptionists and nurses. Please note that the study website contains details of all the data that is available through a fully searchable data dictionary and variable search tool" and reference the following webpage: http://www.bristol.ac.uk/alspac/researchers/our-data/ . Ethical approval for the study was obtained from the ALSPAC Ethics and Law Committee and the Local Research Ethics Committees. Part of this data was collected using REDCap, see the REDCap website for details https://projectredcap.org/resources/citations/ . Generation Scotland received core support from the Chief Scientist Office of the Scottish Government Health Directorates [CZD/16/6] and the Scottish Funding Council [HR03006]. Genotyping of the GS:SFHS samples was carried out by the Genetics Core Laboratory at the Wellcome Trust Clinical Research Facility, Edinburgh, Scotland and was funded by the Medical Research Council UK and the Wellcome Trust (Wellcome Trust Strategic Award “STratifying Resilience and Depression Longitudinally” (STRADL) Reference 104036/Z/14/Z). Generation Scotland is funded by the Wellcome Trust (216767/Z/19/Z) and (221574/Z/20/Z). Understanding Society is an initiative funded by the Economic and Social Research Council and various Government Departments, with scientific leadership by the Institute for Social and Economic Research, University of Essex, and survey delivery by NatCen Social Research and Kantar Public. The Understanding Society COVID-19 study is funded by the Economic and Social Research Council (ES/K005146/1) and the Health Foundation (2076161). The research data are distributed by the UK Data Service. TwinsUK receives funding from the Wellcome Trust (WT212904/Z/18/Z), the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The TwinsUK COVID-19 personal experience study was funded by the King's Together Rapid COVID-19 Call award, under the projects original title ‘Keeping together through coronavirus: The physical and mental health implications of self-isolation due to the Covid-19'. TwinsUK is also supported by the Chronic Disease Research Foundation and Zoe Global Ltd. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. NJT is a Wellcome Trust Investigator (202802/Z/16/Z), is the PI of the Avon Longitudinal Study of Parents and Children (MRC & WT 217065/Z/19/Z), is supported by the University of Bristol NIHR Biomedical Research Centre, the MRC Integrative Epidemiology Unit (MC_UU_00011/1) and works within the CRUK Integrative Cancer Epidemiology Programme (C18281/A29019). ASFK acknowledges funding from the ESRC (ES/V011650/1). MK is supported by the Medical Research Council (MR/W021315/1). GBP acknowledges funding from the Economic and Social Research Council (ES/V012789/1). KT works in a Unit that is supported by the University of Bristol and UK Medical Research Council (MC_UU_00011/3). NC is supported by funding from the UK Medical Research Council (MC_UU_00019/2).
Publisher Copyright:
© 2023, The Author(s).
Keywords
- Clustering
- COVID-19
- Long COVID
- Longitudinal studies
- Symptom patterns