Clinical phenotypes and quality of life to define post-COVID-19 syndrome: a cluster analysis of the multinational, prospective ORCHESTRA cohort

作者：Elisa Gentilotti, Anna Górska, Adriana Tami, Roy Gusinow, Massimo Mirandola, Jesús Rodríguez‐Baño, Zaira R. Palacios‐Baena, Elisa Rossi, Jan Hasenauer, Iris Lopes-Rafegas, Elda Righi, Natascia Caroccia, Salvatore Cataudella, Zeno Pasquini, Thomas Osmo, Lidia Del Piccolo, Alessia Savoldi, Samir Kumar‐Singh, Fulvia Mazzaferri, Maria Giulia Caponcello, Gerolf de Boer, Gabriel Levy Hara, Mariana Guedes, Gaia Maccarrone, Maria Diletta Pezzani, Marcella Sibani, Ruth Joanna Davies, Stefania Vitali, Giorgia Franchina, Giorgia Tomassini, Concetta Sciammarella, Riccardo Cecchetto, Davide Gibellini, Chiara Konishi De Toffoli, Giulia Rosini, Chiara Perlini, Marco Meroi, Filippo Cioli Puviani, Daniele Fasan, Claudio Micheletto, Stefania Montemezzi, Nicolò Cardobi, Gianluca Vantini, Gloria Mazzali, Giovanni Stabile, Maddalena Marcanti, Marco Pattaro Zonta, Deborah Calì, Anna Mason, Cinzia Perlini, Paolo Gisondi, Maria Mongardi, Simona Sorbello, Karin I. Wold, María F. Vincenti‐González, A.C.M. Veloo, Valerie P. R. Harmsma, Daniele Pantano, Margriet van der Meer, Lilli Gard, Erley Lizarazo, Marjolein Knoester, Alex W. Friedrich, Hubert G.M. Niesters, Pierluigi Viale, Domenico Marzolla, Federica Cosentino, Michela Di Chiara, Giacomo Fornaro, Cecilia Bonazzetti, Beatrice Tazza, Alice Toschi, Oana Vetamanu, Maria Eugenia Giacomini, Filippo Trapani, Lorenzo Marconi, Luciano Attard, Sara Tedeschi, Liliana Gabrielli, Tiziana Lazzarotto, Paula Olivares, Javier Castilla, J. Velez, Virginia Almadana Pacheco, Lucía Martín-Barrera, Ana Belén Martín-Gutiérrez, David Gutiérrez-Campos, Marta Fernández-Regaña, Ana Silva-Campos, Patricia Fernández‐Riejos, Maria-Isabel García-Sanchéz, Carla V. Giuliano, Carlota López, Gabriela Neumann, Julieta Camporro, Lautaro De Vedia, Hugo Agugliaro, Gabriella Scipione, Chiara Dellacasa, Balasubramanian Chandramouli, Silvia Gioiosa, Juan Mata Naranjo, M. Ortali, Angelina Konnova, Akshita Gupta, Mathias Smet, An Hotterbeekx, Matilda Berkell, Elisa Sicuri, Delphine Bachelet, Lila Bouadma, Minerva Cervantes-Gonzalez, Anissa Chair, Charlotte Charpentier, Léo Chenard, Diane Descamps, Hang Thi Doan, Xavier Duval, Marina Esposito‐Farèse, Isabelle Hoffmann, Ouifiya Kafif, Quentin Le Hingrat, Sophie Letrou, France Mentré, Marion Schneider, Coralie Tardivon, Jean‐François Timsit, Sarah Tubiana, Amal Abrous, Sandrine Couffin-Cadiergues, Fernanda Dias Da Silva, Hélène Espérou, Ikram Houas, Salma Jaafoura, Aurélie Papadopoulos, Séverine Ansart, Adrien Auvet, Firouzé Bani‐Sadr, Louis Bernard, François Bissuel, Élisabeth Botelho-Nevers, Damien Bouhour, André Cabie, Pauline Caraux Paz, Christian Chidiac, Catherine Chirouze, Tomasz Chroboczek, Hugues Cordel, Roxane Courtois, Nathalie De Castro, Sylvain Diamamntis, Jean-Luc Diehl, Félix Djossou, Céline Dorival, Olivier Épaulard, Valerie Gaborieau, François Goehringer, Marie Gousseff, Simon Jamard, Cédric Joseph, Karine Lacombe, Soizic Le Mestre, Vincent Le Moing, Jean‐Daniel Lelièvre, O. Lesens, Marina Machado, Mylène Maillet, Victoria Manda, Guillaume Martin‐Blondel, M. Martinot, Vanina Meysonnier, Jean‐Michel Molina, Eric Oziol, Vincent Pestre, Lionel Piroth, Julien Poissy, Christian Rabaud, François Raffi, Blandine Rammaert, Christophe Rapp, Stanislas Rebaudet, Pierre‐Marie Roger, Damien Roux, Eric Senneville, Pierre Tattevin, Aurélie Wiedemann, David Zucman, Pasquale De Nardo, Surbhi Malhotra, Lorenzo Maria Canziani, Jade Ghosn, Aline-Marie Florence, Nadhem Lafhej, Bernardina T.F. van der Gun, Maddalena Giannella, Cédric Laouenan, Evelina Tacconelli · 发表于：EClinicalMedicine · 年份：2023 · DOI：10.1016/j.eclinm.2023.102107 · 被引用次数：108 · 研究领域：Long-Term Effects of COVID-19、Fibromyalgia and Chronic Fatigue Syndrome Research、Pharmacological Receptor Mechanisms and Effects

Background: Lack of specific definitions of clinical characteristics, disease severity, and risk and preventive factors of post-COVID-19 syndrome (PCS) severely impacts research and discovery of new preventive and therapeutics drugs. Methods: This prospective multicenter cohort study was conducted from February 2020 to June 2022 in 5 countries, enrolling SARS-CoV-2 out- and in-patients followed at 3-, 6-, and 12-month from diagnosis, with assessment of clinical and biochemical features, antibody (Ab) response, Variant of Concern (VoC), and physical and mental quality of life (QoL). Outcome of interest was identification of risk and protective factors of PCS by clinical phenotype, setting, severity of disease, treatment, and vaccination status. We used SF-36 questionnaire to assess evolution in QoL index during follow-up and unsupervised machine learning algorithms (principal component analysis, PCA) to explore symptom clusters. Severity of PCS was defined by clinical phenotype and QoL. We also used generalized linear models to analyse the impact of PCS on QoL and associated risk and preventive factors. CT registration number: NCT05097677. Findings: Among 1796 patients enrolled, 1030 (57%) suffered from at least one symptom at 12-month. PCA identified 4 clinical phenotypes: chronic fatigue-like syndrome (CFs: fatigue, headache and memory loss, 757 patients, 42%), respiratory syndrome (REs: cough and dyspnoea, 502, 23%); chronic pain syndrome (CPs: arthralgia and myalgia, 399, ...