It was published barely a month ago in the journal Nature, and it is one of the largest studies ever Kovid continuously. they sign it physicians, scientists and bioinformaticiansbecause in addition to studying the cases of about 35 thousand patientsused a machine learning algorithm to find patterns of symptoms, i.e, Common features that allow to delimit and better define Continuous spread map of Covid so far.

Researcher They have found four subtypes of “long covid”, in thousands of cases studied according to the symptoms presented by the patients. Is it:

  • Problem heart and kidneys
  • Problem Respiratory, anxiety, sleep disorders, headache and chest
  • symptoms musculoskeletal and nervous system
  • symptoms digestion and respiration

But the study also provides other interesting data, because In each subtype of persistent COVID, patients have similar characteristics: In form of what infection they had, when they passed it, their gender or their age,

“notice Case clustering can seriously affect prognosis and patient care”warn the authors of the study, which is led by the Department of Population Health Sciences at Weill Corner Medical Center in New York.

Thousand Cases, Pre-Omicron

study is important because So far, persistent Covid symptoms have been studied more in isolation That together. And this is the first thing that the authors notice. “In contrast to existing research, which has studied these conditions independently, we developed a data-driven framework Identify subphenotypes of patients infected with SARS-CoV-2 based on symptoms reported between 30 and 180 days after the date of confirmed infection.

and it’s also important because analyzed thousands of data points drawn from the medical records of two large groups of patients: Insight (20,881 patients from New York State) and OneFlorida+ (13,724 from the states of Florida, Georgia, and Alabama). by applying your algorithm to both Cohorts from North and South America found very similar results.

overall they studied Data of 34,605 ​​patients with persistent COVIDcollected between March 2020 and November 2021, ie, pre-omicron variantWhich came in December 2021.

author, scientist and bioinformatician from various US universities and institutes, Analyzed “more than 137 different symptoms and conditions” in the period following acute SARS-CoV-2 infectionand identified “four PASC subphenotypes” that are present in similar percentages in both groups. Most often, those with subtypes 1 and 2.

  1. heart and kidneys (present in 33.75% and 25.43% of patients in each cohort, respectively)
  2. breathing, sleep and anxiety (32,75% and 38,48%)
  3. musculoskeletal and nervous system (23.37% and 23.35%)
  4. Digestive and respiratory systems (10.14% and 12.74%)

Cardiovascular and renal symptoms: older patients of the first wave

The first subtype detected was Heart and kidney symptoms. This is the pattern present in one-third of cases., “Problems related to heart, kidney, circulation, kidney failure, anemia and fluid and electrolyte disorders,” he explains in the study.

Persistently within this subtype of Covid, The patients share other characteristics.

  • equal proportion of males and females
  • More than a third of patients (37%) became infected in first wave of the epidemic (from March to June 2020)
  • There are more than the other three subtypes: average age 65 years
  • had more pre-existing medical conditions than other subtypes
  • registered a high rate of hospitalization due to covid (61%)

Respiratory problems, sleep, anxiety: middle-aged women

Second pattern or subtype of persistent Covid, Compared to the previous one in terms of frequency (one third of the studied patients) included respiratory conditions, anxiety, sleep disorders And others like headache and chest pain. Other common features typical of this group are:

  • about two thirds of patients women (63%)
  • most got infected later waves: November 2020 to November 2021
  • the average age is 51 years
  • Your pre-existing conditions were breathing problems (COPD and asthma)
  • Covid hospitalization rate was very low (31%)

Musculoskeletal, nervous, digestive: less frequent symptoms

loss Two other subtypes of “long Covid” affect fewer patients., They include the following symptoms, respectively:

  • musculoskeletal and nervous system (headaches, sleep-wake disorders…)

have an effect on 23% of patients studied with a mean age of 57 years and a higher co-morbidity of autoimmune and allergic diseases, such as rheumatoid arthritis and asthma, as well as other diseases of the musculoskeletal and nervous systems. Symptoms of this subtype of persistent COVID are More common in women than in men (60%).

  • combination of digestive and respiratory symptoms

have an effect on 10% of patients with an average age of 54 years and mostly female (61%), They are patients with fewer underlying comorbidities, but “a slightly higher prevalence of digestive tract conditions.”

better understand why some people just can’t get better

It is significant that, In all subtypes of persistent COVID, except the first, the majority of patients (more than 60%) are women. “Difference by sex in terms of risk of persistent COVID-19 This is consistent with previous research, but so far very few studies have attempted to uncover the underlying mechanisms. for it,” says Wang.

The study has been funded by the RECOVER project of the US National Institutes of Health (NIH), which aims to Understand Covid recovery and why some people don’t make a full recovery And they develop “long covid” or persistent covid. they believe so “a wide variety of symptoms that persist weeks or months after the infection has been overcome”whatever is called ‘PASC’ (Acronym for Post Acute Sequelae of SARS-CoV-2).

Their findings, the authors caution, “may be useful to physicians and health systems. Developing models of care that meet the needs of patients with PASC“. Because, three years after SARS-CoV-2 came into our lives, persistent covid is still The pending issue of the pandemic.

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