2024 Update of the RECOVER-Adult Long COVID Research Index
Importance
Classification of persons with long COVID (LC) or post–COVID-19 condition must encompass the complexity and heterogeneity of the condition. Iterative refinement of the classification index for research is needed to incorporate newly available data as the field rapidly evolves.
Objective
To update the 2023 research index for adults with LC using additional participant data from the Researching COVID to Enhance Recovery (RECOVER-Adult) study and an expanded symptom list based on input from patient communities.
Design, Setting, and Participants
Prospective, observational cohort study including adults 18 years or older with or without known prior SARS-CoV-2 infection who were enrolled at 83 sites in the US and Puerto Rico. Included participants had at least 1 study visit taking place 4.5 months after first SARS-CoV-2 infection or later, and not within 30 days of a reinfection. The study visits took place between October 2021 and March 2024.
Exposure
SARS-CoV-2 infection.
Main Outcomes and Measures
Presence of LC and participant-reported symptoms.
Results
A total of 13 647 participants (11 743 with known SARS-CoV-2 infection and 1904 without known prior SARS-CoV-2 infection; median age, 45 years [IQR, 34-69 years]; and 73% were female) were included. Using the least absolute shrinkage and selection operator analysis regression approach from the 2023 model, symptoms contributing to the updated 2024 index included postexertional malaise, fatigue, brain fog, dizziness, palpitations, change in smell or taste, thirst, chronic cough, chest pain, shortness of breath, and sleep apnea. For the 2024 LC research index, the optimal threshold to identify participants with highly symptomatic LC was a score of 11 or greater. The 2024 index classified 20% of participants with known prior SARS-CoV-2 infection and 4% of those without known prior SARS-CoV-2 infection as having likely LC (vs 21% and 5%, respectively, using the 2023 index) and 39% of participants with known prior SARS-CoV-2 infection as having possible LC, which is a new category for the 2024 model. Cluster analysis identified 5 LC subtypes that tracked quality-of-life measures.
Conclusions and Relevance
The 2024 LC research index for adults builds on the 2023 index with additional data and symptoms to help researchers classify symptomatic LC and its symptom subtypes. Continued future refinement of the index will be needed as the understanding of LC evolves.
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Журналы
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bioRxiv
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medRxiv
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JAMA network open
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Frontiers in Medicine
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Journal of Clinical Medicine
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Scientific Reports
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Frontiers in Neuroscience
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Deutsche Medizinische Wochenschrift
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European Journal of Epidemiology
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Clinical Immunology
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Infektiologie up2date
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JAMA Pediatrics
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Molecular Diagnosis and Therapy
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Pharmacology and Therapeutics
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Physical Therapy
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Annals of Internal Medicine
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American Journal of Respiratory and Critical Care Medicine
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Public Health Reports
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Journal of the American Geriatrics Society
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Cardiopulmonary Physical Therapy Journal
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Brain Behavior & Immunity - Health
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Open Forum Infectious Diseases
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Journal of Osteopathic Medicine
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NeuroImmune Pharmacology and Therapeutics
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Nature Communications
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Journal of General Internal Medicine
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Springer Nature
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openRxiv
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Elsevier
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MDPI
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American Medical Association (AMA)
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Frontiers Media S.A.
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Oxford University Press
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Ovid Technologies (Wolters Kluwer Health)
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Georg Thieme Verlag KG
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De Gruyter Brill
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Public Library of Science (PLoS)
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American College of Physicians
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American Thoracic Society
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SAGE
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Wiley
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Institute of Electrical and Electronics Engineers (IEEE)
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