Post-COVID-19 condition is not only a question of persistent symptoms: structured screening including health-related quality of life reveals two separate clusters of post-COVID
Benjamin Giszas, Sabine Trommer, Nane Schüßler, Andrea Rodewald, Bianca Besteher, Jutta Bleidorn, Petra Dickmann, Kathrin Finke, Katrin Katzer, Katja Lehmann, Christina Lemhöfer, Mathias W. Pletz, Christian Puta, Stefanie Quickert, Martin A. Walter, Andreas Stallmach, Philipp A. Reuken
Abstract
PURPOSE: Some patients experience long-term sequelae after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, despite a present post-COVID condition, defined as "any symptom lasting longer than 12 weeks," only a subset of patients search for medical help and therapy. METHOD: We invited all adults with a positive real-time polymerase chain reaction (RT-PCR) for SARS-CoV-2 between March 2020 and September 2021 (n = 4091) in the city of Jena to answer a standardized questionnaire including demographic information, the course of the acute infection and current health status. K-means-clustering of quality of life (QoL) was used to explore post-COVID subgroups. RESULTS: A total of 909 participants at a median interval of 367 (IQR 291/403) days after acute infection were included in the analysis. Of those, 643 (70.7%) complained of having experienced persistent symptoms at the time of the survey. Cluster analysis based on QoL revealed two subgroups of people with persistent post-COVID symptoms. Whereas 189/643 participants (29.4%) showed markedly diminished QoL, normal QoL was detected in 454/643 individuals (70.6%). CONCLUSION: Despite persistent symptoms being reported by nearly three quarters of participants, only one-third of these described a significant reduction in QoL (cluster 1), whereas the other two-thirds reported a near-normal QoL (cluster 2), thus indicating a differentiation between "post-COVID disease" and "post-COVID condition". The prevalence of clinically relevant post-COVID disease was at least 20.7%. Health policies should focus on this subset.