Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy

Abstract Background Evidence on long COVID symptom clustering patterns among patients with COVID-19 is limited. We summarized long COVID symptoms in clusters defined by number of symptoms co-occurring together, and we assessed Health-Related Quality of Life (HQRoL), Work Productivity and Activity Im...

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Main Authors: Manuela Di Fusco, Joseph C. Cappelleri, Alon Yehoshua, Kelly J. Thomas Craig, Mary B. Alvarez, Kristen E. Allen, Thomas M. Porter, Santiago M.C. Lopez, Laura Puzniak, Xiaowu Sun
Format: Article
Language:English
Published: SpringerOpen 2024-10-01
Series:Journal of Patient-Reported Outcomes
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Online Access:https://doi.org/10.1186/s41687-024-00797-7
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author Manuela Di Fusco
Joseph C. Cappelleri
Alon Yehoshua
Kelly J. Thomas Craig
Mary B. Alvarez
Kristen E. Allen
Thomas M. Porter
Santiago M.C. Lopez
Laura Puzniak
Xiaowu Sun
author_facet Manuela Di Fusco
Joseph C. Cappelleri
Alon Yehoshua
Kelly J. Thomas Craig
Mary B. Alvarez
Kristen E. Allen
Thomas M. Porter
Santiago M.C. Lopez
Laura Puzniak
Xiaowu Sun
author_sort Manuela Di Fusco
collection DOAJ
description Abstract Background Evidence on long COVID symptom clustering patterns among patients with COVID-19 is limited. We summarized long COVID symptoms in clusters defined by number of symptoms co-occurring together, and we assessed Health-Related Quality of Life (HQRoL), Work Productivity and Activity Impairment (WPAI) outcomes across these clusters over time. We assessed associations between the clusters and BNT162b2 vaccination status. Methods A prospective longitudinal patient-reported outcomes (PRO) study recruited laboratory-confirmed symptomatic COVID-19 patients seeking testing from a national retail pharmacy. Long COVID-19 symptoms were self-reported by participants at 4-week, 3-month and 6-month surveys. Patient classes identified via latent class analysis (LCA) with long COVID-19 symptoms were simplified into clusters based on number of symptoms. HRQoL and WPAI outcomes were collected using EQ-ED-5L and WPAI: GH questionnaires. Mixed models for repeated measures analyses were conducted to examine associations between exposure groups and outcomes. Results The study included 328 participants that were segmented into three groups of long COVID-19 symptoms based on LCA and then simplified by the number of symptoms (Cluster 1 low, <2; Cluster 2 moderate, 2–6; and Cluster 3 high, >6 symptoms). The number of long COVID-19 symptoms was negatively associated with HRQoL and WPAI, whereby participants with high symptom burden (>6 symptoms) had the lowest HRQoL and WPAI scores assessed by absenteeism, presenteeism, work productivity loss, activity impairment, and hours worked metrics. Compared with those unvaccinated and not up-to-date with COVID-19 vaccination, subjects boosted with BNT162b2 consistently reported less symptom burden during the follow-up, regardless of their symptom-based cluster. Conclusion Three distinct patient clusters based on frequency of long COVID symptoms experienced different HRQoL and WPAI outcomes over 6 months. The cluster with more concomitant symptoms experienced greater burden than the others. Participants up-to-date with BNT162b2 reported lower symptom burden across all clusters and timeframes. Clinical trial registration Clinicaltrials.gov NCT05160636.
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spelling doaj-art-0a85fcbfc06d433ea880120ab4bf58ce2025-08-20T02:11:18ZengSpringerOpenJournal of Patient-Reported Outcomes2509-80202024-10-01811910.1186/s41687-024-00797-7Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacyManuela Di Fusco0Joseph C. Cappelleri1Alon Yehoshua2Kelly J. Thomas Craig3Mary B. Alvarez4Kristen E. Allen5Thomas M. Porter6Santiago M.C. Lopez7Laura Puzniak8Xiaowu Sun9Pfizer IncPfizer IncPfizer IncCVS HealthPfizer IncPfizer IncPfizer IncPfizer IncPfizer IncCVS HealthAbstract Background Evidence on long COVID symptom clustering patterns among patients with COVID-19 is limited. We summarized long COVID symptoms in clusters defined by number of symptoms co-occurring together, and we assessed Health-Related Quality of Life (HQRoL), Work Productivity and Activity Impairment (WPAI) outcomes across these clusters over time. We assessed associations between the clusters and BNT162b2 vaccination status. Methods A prospective longitudinal patient-reported outcomes (PRO) study recruited laboratory-confirmed symptomatic COVID-19 patients seeking testing from a national retail pharmacy. Long COVID-19 symptoms were self-reported by participants at 4-week, 3-month and 6-month surveys. Patient classes identified via latent class analysis (LCA) with long COVID-19 symptoms were simplified into clusters based on number of symptoms. HRQoL and WPAI outcomes were collected using EQ-ED-5L and WPAI: GH questionnaires. Mixed models for repeated measures analyses were conducted to examine associations between exposure groups and outcomes. Results The study included 328 participants that were segmented into three groups of long COVID-19 symptoms based on LCA and then simplified by the number of symptoms (Cluster 1 low, <2; Cluster 2 moderate, 2–6; and Cluster 3 high, >6 symptoms). The number of long COVID-19 symptoms was negatively associated with HRQoL and WPAI, whereby participants with high symptom burden (>6 symptoms) had the lowest HRQoL and WPAI scores assessed by absenteeism, presenteeism, work productivity loss, activity impairment, and hours worked metrics. Compared with those unvaccinated and not up-to-date with COVID-19 vaccination, subjects boosted with BNT162b2 consistently reported less symptom burden during the follow-up, regardless of their symptom-based cluster. Conclusion Three distinct patient clusters based on frequency of long COVID symptoms experienced different HRQoL and WPAI outcomes over 6 months. The cluster with more concomitant symptoms experienced greater burden than the others. Participants up-to-date with BNT162b2 reported lower symptom burden across all clusters and timeframes. Clinical trial registration Clinicaltrials.gov NCT05160636.https://doi.org/10.1186/s41687-024-00797-7SARS-CoV-2COVID-19BNT162b2long-COVID-19 symptomsHumanisticHRQoL
spellingShingle Manuela Di Fusco
Joseph C. Cappelleri
Alon Yehoshua
Kelly J. Thomas Craig
Mary B. Alvarez
Kristen E. Allen
Thomas M. Porter
Santiago M.C. Lopez
Laura Puzniak
Xiaowu Sun
Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy
Journal of Patient-Reported Outcomes
SARS-CoV-2
COVID-19
BNT162b2
long-COVID-19 symptoms
Humanistic
HRQoL
title Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy
title_full Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy
title_fullStr Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy
title_full_unstemmed Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy
title_short Associations between symptom-based long COVID clusters and long-term quality of life, work and daily activities among individuals testing positive for SARS-CoV-2 at a national retail pharmacy
title_sort associations between symptom based long covid clusters and long term quality of life work and daily activities among individuals testing positive for sars cov 2 at a national retail pharmacy
topic SARS-CoV-2
COVID-19
BNT162b2
long-COVID-19 symptoms
Humanistic
HRQoL
url https://doi.org/10.1186/s41687-024-00797-7
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