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Characteristics and impact of Long Covid: findings from an online survey

Characteristics and impact of Long Covid: findings from an online survey
Characteristics and impact of Long Covid: findings from an online survey
Background: Long Covid is a public health concern that needs defining, quantifying, and describing. We aimed to explore the initial and ongoing symptoms of Long Covid following SARS-CoV-2 infection and describe its impact on daily life.

Methods: We collected self-reported data through an online survey using convenience non-probability sampling. The survey enrolled adults who reported lab-confirmed (PCR or antibody) or suspected COVID-19 who were not hospitalised in the first two weeks of illness. This analysis was restricted to those with self-reported Long Covid. Univariate comparisons between those with and without confirmed COVID-19 infection were carried out and agglomerative hierarchical clustering was used to identify specific symptom clusters, and their demographic and functional correlates.

Results: We analysed data from 2550 participants with a median duration of illness of 7.6 months (interquartile range (IQR) 7.1-7.9). 26.5% reported lab-confirmation of infection. The mean age was 46.5 years (standard deviation 11 years) with 82.8% females and 79.9% of participants based in the UK. 89.5% described their health as good, very good or excellent before COVID-19. The most common initial symptoms that persisted were exhaustion, chest pressure/tightness, shortness of breath and headache. Cognitive dysfunction and palpitations became more prevalent later in the illness. Most participants described fluctuating (57.7%) or relapsing symptoms (17.6%). Physical activity, stress, and sleep disturbance commonly triggered symptoms. A third (32%) reported they were unable to live alone without any assistance at six weeks from start of illness. 16.9% reported being unable to work solely due to COVID-19 illness. 37.0% reported loss of income due to illness, and 64.4% said they were unable to perform usual activities/duties.
Acute systems clustered broadly into two groups: a majority cluster (n=2235, 88%) with cardiopulmonary predominant symptoms, and a minority cluster (n=305, 12%) with multisystem symptoms. Similarly, ongoing symptoms broadly clustered in two groups; a majority cluster (n=2243, 88.8%) exhibiting mainly cardiopulmonary, cognitive symptoms and exhaustion, and a minority cluster (n=283, 11.2%) exhibiting more multisystem symptoms. Belonging to the more severe multisystem cluster was associated with more severe functional impact, lower income, younger age, being female, worse baseline health, and inadequate rest in the first two weeks of the illness, with no major differences in the cluster patterns when restricting analysis to the lab-confirmed subgroup.

Conclusion: This is an exploratory survey of Long Covid characteristics. Whilst this is a non-representative population sample, it highlights the heterogeneity of persistent symptoms, and the significant functional impact of prolonged illness following confirmed or suspected SARS-CoV-2 infection. To study prevalence, predictors and prognosis, research is needed in a representative population sample using standardised case definitions.
1932-6203
Ziauddeen, Nida
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Gurdasani, Deepti
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O'Hara, Margaret E.
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Hastie, Claire
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Roderick, Paul
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Yao, Guiqing Lily
93c8b843-35ee-4a63-8486-98efa85cb7f5
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382
Ziauddeen, Nida
8b233a4a-9763-410b-90c7-df5c7d1a26e4
Gurdasani, Deepti
b713a791-6d6f-4c8b-997d-b33bb0f83a73
O'Hara, Margaret E.
afdd0e4e-d8dd-4720-afc4-d5d195874807
Hastie, Claire
00b5a5a1-da64-4c54-be0e-06e2e6ffe6a0
Roderick, Paul
dbb3cd11-4c51-4844-982b-0eb30ad5085a
Yao, Guiqing Lily
93c8b843-35ee-4a63-8486-98efa85cb7f5
Alwan, Nisreen
0d37b320-f325-4ed3-ba51-0fe2866d5382

Ziauddeen, Nida, Gurdasani, Deepti, O'Hara, Margaret E., Hastie, Claire, Roderick, Paul, Yao, Guiqing Lily and Alwan, Nisreen (2022) Characteristics and impact of Long Covid: findings from an online survey. PLoS ONE, 17 (3 March), [e0264331]. (doi:10.1371/journal.pone.0264331).

Record type: Article

Abstract

Background: Long Covid is a public health concern that needs defining, quantifying, and describing. We aimed to explore the initial and ongoing symptoms of Long Covid following SARS-CoV-2 infection and describe its impact on daily life.

Methods: We collected self-reported data through an online survey using convenience non-probability sampling. The survey enrolled adults who reported lab-confirmed (PCR or antibody) or suspected COVID-19 who were not hospitalised in the first two weeks of illness. This analysis was restricted to those with self-reported Long Covid. Univariate comparisons between those with and without confirmed COVID-19 infection were carried out and agglomerative hierarchical clustering was used to identify specific symptom clusters, and their demographic and functional correlates.

Results: We analysed data from 2550 participants with a median duration of illness of 7.6 months (interquartile range (IQR) 7.1-7.9). 26.5% reported lab-confirmation of infection. The mean age was 46.5 years (standard deviation 11 years) with 82.8% females and 79.9% of participants based in the UK. 89.5% described their health as good, very good or excellent before COVID-19. The most common initial symptoms that persisted were exhaustion, chest pressure/tightness, shortness of breath and headache. Cognitive dysfunction and palpitations became more prevalent later in the illness. Most participants described fluctuating (57.7%) or relapsing symptoms (17.6%). Physical activity, stress, and sleep disturbance commonly triggered symptoms. A third (32%) reported they were unable to live alone without any assistance at six weeks from start of illness. 16.9% reported being unable to work solely due to COVID-19 illness. 37.0% reported loss of income due to illness, and 64.4% said they were unable to perform usual activities/duties.
Acute systems clustered broadly into two groups: a majority cluster (n=2235, 88%) with cardiopulmonary predominant symptoms, and a minority cluster (n=305, 12%) with multisystem symptoms. Similarly, ongoing symptoms broadly clustered in two groups; a majority cluster (n=2243, 88.8%) exhibiting mainly cardiopulmonary, cognitive symptoms and exhaustion, and a minority cluster (n=283, 11.2%) exhibiting more multisystem symptoms. Belonging to the more severe multisystem cluster was associated with more severe functional impact, lower income, younger age, being female, worse baseline health, and inadequate rest in the first two weeks of the illness, with no major differences in the cluster patterns when restricting analysis to the lab-confirmed subgroup.

Conclusion: This is an exploratory survey of Long Covid characteristics. Whilst this is a non-representative population sample, it highlights the heterogeneity of persistent symptoms, and the significant functional impact of prolonged illness following confirmed or suspected SARS-CoV-2 infection. To study prevalence, predictors and prognosis, research is needed in a representative population sample using standardised case definitions.

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Accepted/In Press date: 9 February 2022
Published date: 8 March 2022
Additional Information: Funding Information: We thank all participants for their time and commitment completing this survey. We also sincerely thank members of the COVID-19 Research Involvement Group for providing feedback on earlier versions of the questionnaire. Margaret E O?Hara, Claire Hastie and Nisreen A Alwan experience(d) Long Covid symptoms. Publisher Copyright: © 2022 Ziauddeen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Copyright: Copyright 2022 Elsevier B.V., All rights reserved.

Identifiers

Local EPrints ID: 455028
URI: http://eprints.soton.ac.uk/id/eprint/455028
ISSN: 1932-6203
PURE UUID: fa5c04b5-63d8-475b-8a7d-81bae6eeba30
ORCID for Nida Ziauddeen: ORCID iD orcid.org/0000-0002-8964-5029
ORCID for Paul Roderick: ORCID iD orcid.org/0000-0001-9475-6850
ORCID for Nisreen Alwan: ORCID iD orcid.org/0000-0002-4134-8463

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Date deposited: 04 Mar 2022 17:30
Last modified: 26 Jul 2022 04:06

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Contributors

Author: Nida Ziauddeen ORCID iD
Author: Deepti Gurdasani
Author: Margaret E. O'Hara
Author: Claire Hastie
Author: Paul Roderick ORCID iD
Author: Guiqing Lily Yao
Author: Nisreen Alwan ORCID iD

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