TY - JOUR
T1 - The Progression of Symptoms in Post COVID-19 Patients
T2 - A Multicentre, Prospective, Observational Cohort Study
AU - Cornelissen, Merel E B
AU - Haarman, Myrthe M
AU - Twisk, Jos W R
AU - Houweling, Laura
AU - Baalbaki, Nadia
AU - Sondermeijer, Brigitte
AU - Beijers, Rosanne J H C G
AU - Gach, Debbie
AU - Bloemsma, Lizan D
AU - Maitland-van der Zee, Anke H
AU - P4O2 Consortium
PY - 2024/10/30
Y1 - 2024/10/30
N2 - BACKGROUND: Although the coronavirus disease 2019 (COVID-19) pandemic is no longer a public health emergency of international concern, 30% of COVID-19 patients still have long-term complaints. A better understanding of the progression of symptoms after COVID-19 is needed to reduce the burden of the post COVID-19 condition. OBJECTIVE: This study aims to investigate the progression of symptoms, identify patterns of symptom progression, and assess their associations with patient characteristics. METHODS: Within the P4O2 COVID-19 study, patients aged 40-65 years were recruited from five Dutch hospitals. At 3-6 and 12-18 months post COVID-19, medical data were collected, and pulmonary function tests were performed. In between, symptoms were assessed monthly with a questionnaire. Latent class mixed modelling was used to identify symptom progression patterns over time, with multinomial logistic regression to examine associations with patient characteristics. RESULTS: Eighty-eight patients (aged 54.4 years, 48.9% males) were included. Three trajectories were identified for fatigue and dyspnoea: decreasing, high persistent, and low persistent. The odds of "decreasing fatigue" was higher for never smokers and participants in the lifestyle intervention and lower for those having a comorbidity. The odds of "decreasing dyspnoea" was higher for moderate COVID-19 patients and lifestyle intervention participants and lower for males, mild COVID-19 patients, and those with a higher age. CONCLUSIONS: Three distinct trajectories were identified for fatigue and dyspnoea, delineating patterns of symptom persistence following COVID-19. Sex, age, smoking status, participation in lifestyle interventions and COVID-19 severity were associated with the likelihood of belonging to different trajectories. These findings highlight the heterogeneity of the long-term symptoms experienced by post COVID-19 patients and emphasise the importance of personalised treatment strategies.
AB - BACKGROUND: Although the coronavirus disease 2019 (COVID-19) pandemic is no longer a public health emergency of international concern, 30% of COVID-19 patients still have long-term complaints. A better understanding of the progression of symptoms after COVID-19 is needed to reduce the burden of the post COVID-19 condition. OBJECTIVE: This study aims to investigate the progression of symptoms, identify patterns of symptom progression, and assess their associations with patient characteristics. METHODS: Within the P4O2 COVID-19 study, patients aged 40-65 years were recruited from five Dutch hospitals. At 3-6 and 12-18 months post COVID-19, medical data were collected, and pulmonary function tests were performed. In between, symptoms were assessed monthly with a questionnaire. Latent class mixed modelling was used to identify symptom progression patterns over time, with multinomial logistic regression to examine associations with patient characteristics. RESULTS: Eighty-eight patients (aged 54.4 years, 48.9% males) were included. Three trajectories were identified for fatigue and dyspnoea: decreasing, high persistent, and low persistent. The odds of "decreasing fatigue" was higher for never smokers and participants in the lifestyle intervention and lower for those having a comorbidity. The odds of "decreasing dyspnoea" was higher for moderate COVID-19 patients and lifestyle intervention participants and lower for males, mild COVID-19 patients, and those with a higher age. CONCLUSIONS: Three distinct trajectories were identified for fatigue and dyspnoea, delineating patterns of symptom persistence following COVID-19. Sex, age, smoking status, participation in lifestyle interventions and COVID-19 severity were associated with the likelihood of belonging to different trajectories. These findings highlight the heterogeneity of the long-term symptoms experienced by post COVID-19 patients and emphasise the importance of personalised treatment strategies.
KW - dyspnoea
KW - fatigue
KW - post COVID-19 condition
KW - symptom progression
KW - trajectories
U2 - 10.3390/biomedicines12112493
DO - 10.3390/biomedicines12112493
M3 - Article
SN - 2227-9059
VL - 12
JO - Biomedicines
JF - Biomedicines
IS - 11
M1 - 2493
ER -