| Autor: |
Nusrat J. Epsi, John H. Powers, David A. Lindholm, Katrin Mende, Allison Malloy, Anuradha Ganesan, Nikhil Huprikar, Tahaniyat Lalani, Alfred Smith, Rupal M. Mody, Milissa U. Jones, Samantha E. Bazan, Rhonda E. Colombo, Christopher J. Colombo, Evan C. Ewers, Derek T. Larson, Catherine M. Berjohn, Carlos J. Maldonado, Paul W. Blair, Josh Chenoweth, David L. Saunders, Jeffrey Livezey, Ryan C. Maves, Margaret Sanchez Edwards, Julia S. Rozman, Mark P. Simons, David R. Tribble, Brian K. Agan, Timothy H. Burgess, Simon D. Pollett, for the EPICC COVID-19 Cohort Study Group |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
PLoS ONE, Vol 18, Iss 2 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
1932-6203 |
| Popis: |
Background Accurate COVID-19 prognosis is a critical aspect of acute and long-term clinical management. We identified discrete clusters of early stage-symptoms which may delineate groups with distinct disease severity phenotypes, including risk of developing long-term symptoms and associated inflammatory profiles. Methods 1,273 SARS-CoV-2 positive U.S. Military Health System beneficiaries with quantitative symptom scores (FLU-PRO Plus) were included in this analysis. We employed machine-learning approaches to identify symptom clusters and compared risk of hospitalization, long-term symptoms, as well as peak CRP and IL-6 concentrations. Results We identified three distinct clusters of participants based on their FLU-PRO Plus symptoms: cluster 1 (“Nasal cluster”) is highly correlated with reporting runny/stuffy nose and sneezing, cluster 2 (“Sensory cluster”) is highly correlated with loss of smell or taste, and cluster 3 (“Respiratory/Systemic cluster”) is highly correlated with the respiratory (cough, trouble breathing, among others) and systemic (body aches, chills, among others) domain symptoms. Participants in the Respiratory/Systemic cluster were twice as likely as those in the Nasal cluster to have been hospitalized, and 1.5 times as likely to report that they had not returned-to-activities, which remained significant after controlling for confounding covariates (P < 0.01). Respiratory/Systemic and Sensory clusters were more likely to have symptoms at six-months post-symptom-onset (P = 0.03). We observed higher peak CRP and IL-6 in the Respiratory/Systemic cluster (P < 0.01). Conclusions We identified early symptom profiles potentially associated with hospitalization, return-to-activities, long-term symptoms, and inflammatory profiles. These findings may assist in patient prognosis, including prediction of long COVID risk. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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