Cluster analysis of long COVID in Japan and association of its trajectory of symptoms and quality of life

BMJ Open Respir Res. 2024 Feb 23;11(1):e002111. doi: 10.1136/bmjresp-2023-002111.

Abstract

Background: Multiple prolonged symptoms observed in patients who recovered from COVID-19 are defined as long COVID. Although diverse phenotypic combinations are possible, they remain unclear. This study aimed to perform a cluster analysis of long COVID in Japan and clarify the association between its characteristics and background factors and quality of life (QOL).

Methods: This multicentre prospective cohort study collected various symptoms and QOL after COVID-19 from January 2020 to February 2021. This study included 935 patients aged ≥18 years with COVID-19 at 26 participating medical facilities. Hierarchical cluster analysis was performed using 24 long COVID symptom at 3 months after diagnosis.

Results: Participants were divided into the following five clusters: numerous symptoms across multiple organs (cluster 1, n=54); no or minor symptoms (cluster 2, n=546); taste and olfactory disorders (cluster 3, n=76); fatigue, psychoneurotic symptoms and dyspnoea (low prevalence of cough and sputum) (cluster 4, n=207) and fatigue and dyspnoea (high prevalence of cough and sputum) (cluster 5, n=52). Cluster 1 included elderly patients with severe symptoms, while cluster 3 included young female with mild symptoms. No significant differences were observed in the comorbidities. Cluster 1 showed the most impaired QOL, followed by clusters 4 and 5; these changes as well as the composition of symptoms were observed over 1 year.

Conclusions: We identified patients with long COVID with diverse characteristics into five clusters. Future analysis of these different pathologies could result in individualised treatment of long COVID.

Trial registration number: The study protocol is registered at UMIN clinical trials registry (UMIN000042299).

Keywords: COVID-19; infection control.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • COVID-19* / epidemiology
  • Cluster Analysis
  • Cough
  • Dyspnea / epidemiology
  • Dyspnea / etiology
  • Dyspnea / therapy
  • Fatigue
  • Female
  • Humans
  • Japan / epidemiology
  • Post-Acute COVID-19 Syndrome
  • Prospective Studies
  • Quality of Life