Journal Article

Use of latent class analysis and patient reported outcome measures to identify distinct long COVID phenotypes: A longitudinal cohort study

Sbihi, Hind, Wong, Alyson W., Russell, James A., Binka, Mawuena, Carlsten, Christopher, Tran, Karen C., Janjua, Naveed Z., Levin, Adeera, Ryerson, Christopher J.

2023

Overview

We sought to 1) identify long COVID phenotypes based on patient reported outcome measures (PROMs) and 2) determine whether the phenotypes were associated with quality of life (QoL) and/or lung function. This was a longitudinal cohort study of hospitalized and non-hospitalized patients from March 2020 to January 2022 that was conducted across 4 Post-COVID Recovery Clinics in British Columbia, Canada. Latent class analysis was used to identify long COVID phenotypes using baseline PROMs (fatigue, dyspnea, cough, anxiety, depression, and post-traumatic stress disorder). We then explored the association between the phenotypes and QoL (using the EuroQoL 5 dimensions visual analogue scale [EQ5D VAS]) and lung function (using the diffusing capacity of the lung for carbon monoxide [DLCO]). There were 1,344 patients enrolled in the study (mean age 51 ±15 years; 780 [58%] were females; 769 (57%) were of a non-White race). Three distinct long COVID phenotypes were identified: Class 1) fatigue and dyspnea, Class 2) anxiety and depression, and Class 3) fatigue, dyspnea, anxiety, and depression. Class 3 had a significantly lower EQ5D VAS at 3 (50±19) and 6 months (54 ± 22) compared to Classes 1 and 2 (p<0.001). The EQ5D VAS significantly improved between 3 and 6 months for Class 1 (median difference of 6.0 [95% CI, 4.0 to 8.0]) and Class 3 (median difference of 5.0 [95% CI, 0 to 8.5]). There were no differences in DLCO between the classes. There were 3 distinct long COVID phenotypes with different outcomes in QoL between 3 and 6 months after symptom onset. These phenotypes suggest that long COVID is a heterogeneous condition with distinct subpopulations who may have different outcomes and warrant tailored therapeutic approaches.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Analysis / Anxiety / Biology and Life Sciences / Carbon monoxide / Clinical outcomes / Cohort analysis / Cough / COVID-19 / Dyspnea / Fatigue / Illnesses / Latent class analysis / Long COVID / Lungs / Medicine and Health Sciences / Mental depression / Mental disorders / Patients / Phenotype / Phenotypes / Post traumatic stress disorder / Posttraumatic stress disorder / Psychological stress / Quality of life / Questionnaires / Respiration / Respiratory function / Severe acute respiratory syndrome coronavirus 2 / Social Sciences / Statistical analysis / Subpopulations