Department of Twin Research and Genetic Epidemiology, School of Life Course and Population Sciences, King's College London, London, UK.
The Alan Turing Institute, London, UK.
Eur J Epidemiol. 2023 Feb;38(2):199-210. doi: 10.1007/s10654-022-00962-6. Epub 2023 Jan 21.
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.
多项全球人群研究已经确定了 2019 年冠状病毒病（COVID-19）和长新冠的主要症状特征。然而，由于这些症状也可能在没有 COVID-19 的情况下出现，因此缺乏适当的对照往往意味着症状对急性 COVID-19 或长新冠的特异性，以及它们在 COVID-19 后升高的程度和持续时间，无法进行检查。我们分析了九个英国纵向研究中的个体症状流行率，并描述了 COVID-19 和长新冠症状的模式，这些研究总计超过 42000 名参与者。我们分别在三组（“无 COVID-19”、“过去 12 周内 COVID-19”和“过去 12 周前 COVID-19”）中进行潜在类别分析，数据不支持每组存在超过两种不同的症状模式，代表高和低症状负担。将“过去 12 周内 COVID-19”和“无 COVID-19”组之间的高症状负担类别进行比较，我们确定了与急性 COVID-19 相关的症状，包括味觉和嗅觉丧失、疲劳、咳嗽、呼吸急促以及肌肉疼痛或酸痛。将“过去 12 周前 COVID-19”和“无 COVID-19”组之间的高症状负担类别进行比较，我们确定了与长新冠相关的症状，包括疲劳、呼吸急促、肌肉疼痛或酸痛、注意力集中困难和胸闷。过去 12 周前患有 COVID-19 的个体中确定的症状模式与因 COVID-19 症状而无法正常运作的自我报告时间长度密切相关，这表明所确定的症状模式与长新冠相对应。建立关于典型长新冠症状的证据基础将改善对该病症的诊断能力，并能够引出潜在的生物学机制，从而使更多患者能够获得治疗和服务。
