Phenotyping of Acute and Persistent Coronavirus Disease 2019 Features in the Outpatient Setting: Exploratory Analysis of an International Cross-sectional Online Survey
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Abstract
Background
Long COVID, defined as the presence of coronavirus disease 2019 (COVID-19) symptoms ≥28 days after clinical onset, is an emerging challenge to healthcare systems. The objective of the current study was to explore recovery phenotypes in nonhospitalized individuals with COVID-19.
Methods
A dual cohort, online survey study was conducted between September 2020 and July 2021 in the neighboring European regions Tyrol (TY; Austria, n = 1157) and South Tyrol (STY; Italy, n = 893). Data were collected on demographics, comorbid conditions, COVID-19 symptoms, and recovery in adult outpatients. Phenotypes of acute COVID-19, postacute sequelae, and risk of protracted recovery were explored using semi-supervised clustering and multiparameter least absolute shrinkage and selection operator (LASSO) modeling.
Results
Participants in the study cohorts were predominantly working age (median age [interquartile range], 43 [31–53] years] for TY and 45 [35–55] years] for STY) and female (65.1% in TY and 68.3% in STY). Nearly half (47.6% in TY and 49.3% in STY) reported symptom persistence beyond 28 days. Two acute COVID-19 phenotypes were discerned: the nonspecific infection phenotype and the multiorgan phenotype (MOP). Acute MOP symptoms encompassing multiple neurological, cardiopulmonary, gastrointestinal, and dermatological symptoms were linked to elevated risk of protracted recovery. The major subset of individuals with long COVID (49.3% in TY; 55.6% in STY) displayed no persistent hyposmia or hypogeusia but high counts of postacute MOP symptoms and poor self-reported physical recovery.
Conclusions
The results of our 2-cohort analysis delineated phenotypic diversity of acute and postacute COVID-19 manifestations in home-isolated patients, which must be considered in predicting protracted convalescence and allocating medical resources.
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SciScore for 10.1101/2021.08.05.21261677: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: This study was approved by the institutional review boards of the Medical University of Innsbruck (Austria) (approval number: 1257/2020) and the South Tyrol Province (Italy) (0150701).
Consent: Each participant gave a digital informed consent at the survey start.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study bears limitations. As indicated by the prevalence of long COVID, fraction of females, …
SciScore for 10.1101/2021.08.05.21261677: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Ethics IRB: This study was approved by the institutional review boards of the Medical University of Innsbruck (Austria) (approval number: 1257/2020) and the South Tyrol Province (Italy) (0150701).
Consent: Each participant gave a digital informed consent at the survey start.Sex as a biological variable not detected. Randomization not detected. Blinding not detected. Power Analysis not detected. Table 2: Resources
No key resources detected.
Results from OddPub: Thank you for sharing your code and data.
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:Our study bears limitations. As indicated by the prevalence of long COVID, fraction of females, middle-aged and over-representation of health care workers in the study collectives, the survey might have targeted primarily individuals more affected by the disease and health-aware people of the general convalescent populations. Additionally, the retrospective and cross sectional study character precluded detailed tracking of particular symptom kinetic and relapses. Furthermore, it may explain the significant effect of the observation time on the readouts of long COVID in the multi-parameter modeling. Even though our data are highly consistent for both study populations differing in multiple demographic, socioeconomic and clinical features and the confounding impact of sex, age and observation time was included in the risk modeling, our findings will require an independent prospective validation.
Results from TrialIdentifier: We found the following clinical trial numbers in your paper:
Identifier Status Title NCT04661462 Recruiting Health After Covid-19 in Tyrol Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
Results from scite Reference Check: We found no unreliable references.
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