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COVID Impacts

Detailed information and resources on the long-term health consequences of COVID-19 infection and the broad social impacts of the COVID-19 pandemic

Long COVID Subtypes

Clinical Manifestations of Long COVID Clusters

Various studies around the world are documenting clusters of Long Covid symptoms, often tied to specific SARS-CoV-2 variants. Below are some the large-scale studies.

Multi-System Cluster

The multi-system cluster included significant levels of laboratory abnormalities. The group is dominated by heart, kidney and circulation-related symptoms.

Patients in this group, compared with those in other groups, were older on average, more likely to be male, had a relatively high rate of COVID hospitalization and had relatively more pre-existing conditions. Data suggests this cluster may actually be ongoing residual clinical manifestations of severe acute infection. These patients also were at the highest risk for mortality in the post-acute period.

The majority of patients in the cluster were patients sickened by SARS-CoV-2 during the first big U.S. wave from March to June 2020.

Neuropsychiatric Cluster

Neuropsychiatric symptom cluster included headaches, respiratory and sleep issues, anxiety, and mood disorders.

Patients with this pattern were mostly female and a much lower rate of COVID hospitalization.

Most of these patients tested positive for COVID-19 in later waves, from November 2020 to November 2021. Pre-existing conditions in this cluster centered on respiratory problems such as chronic obstructive pulmonary disorder and asthma.

Cardiovascular Cluster

This cluster included patients with a high degree of tachycardia, palpitations and hypoxemia. It also included pulmonary embolism.

Pulmonary Cluster

Patients with this phenotype had higher frequencies of cough and hypoxemia.

Fatigue Cluster

This cluster included significant fatigue symptoms included ME/CSF.

Pain/Musculoskeletal Cluster

Dominated by musculoskeletal and nervous system symptoms including arthritis pain. This cluster includes multi-system pain with significant overlap with the multi-system cluster, but without the laboratory abnormalities.

Unlike the multi-system cluster, the cluster is predominantly female. Evidence available prior to our study suggests that sex differences exist that influence the clinical course of COVID-19. For instance, although males are more likely to be hospitalized or die with acute COVID-19, females are more likely to develop long COVID

These patients had higher baseline comorbidity burdens of autoimmune and allergy conditions, such as rheumatoid arthritis and asthma, as well as other musculoskeletal and nervous system conditions, including soft tissue, bone and sleep disorders.

Gastrointestinal Cluster

This cluster included patients with significant digestive symptoms. While patients in this cluster had the lowest risk of severe acute COVID-19 infection and lower overall burden of underlying conditions, their symptoms were centered around the digestive system, such as hematemesis, stomach and duodenum disorders and digestive system neoplasm, and more incident prescription digestive system medications.