Evolving phenotypes of non-hospitalized patients that indicate long COVID - Archive ouverte HAL Access content directly
Journal Articles BMC Medicine Year : 2021

Evolving phenotypes of non-hospitalized patients that indicate long COVID

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Hossein Estiri
Gabriel Brat
Chirag Patel
  • Function : Author
Shawn Murphy
James Aaron
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Giuseppe Agapito
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Adem Albayrak
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Mario Alessiani
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Danilo Amendola
Li Anthony
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Bruce Aronow
Fatima Ashraf
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Andrew Atz
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Paul Avillach
James Balshi
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Brett Beaulieu-Jones
Douglas Bell
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Antonio Bellasi
Riccardo Bellazzi
Vincent Benoit
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Michele Beraghi
José Luis Bernal Sobrino
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Mélodie Bernaux
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Romain Bey
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Alvar Blanco Martínez
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Martin Boeker
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Clara-Lea Bonzel
John Booth
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Silvano Bosari
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Florence Bourgeois
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Robert Bradford
Stéphane Bréant
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Nicholas Brown
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William Bryant
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Mauro Bucalo
Anita Burgun
Tianxi Cai
Mario Cannataro
Aldo Carmona
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Charlotte Caucheteux
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Julien Champ
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Jin Chen
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Krista Chen
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Luca Chiovato
Lorenzo Chiudinelli
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Kelly Cho
James Cimino
Tiago Colicchio
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Sylvie Cormont
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Sébastien Cossin
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Jean Craig
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Juan Luis Cruz Bermúdez
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Jaime Cruz Rojo
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Arianna Dagliati
Mohamad Daniar
Christel Daniel
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Anahita Davoudi
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Batsal Devkota
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Julien Dubiel
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Loic Esteve
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Shirley Fan
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Robert Follett
Paula Gaiolla
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Thomas Ganslandt
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Noelia García Barrio
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Lana Garmire
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Nils Gehlenborg
Alon Geva
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Tobias Gradinger
  • Function : Author
Alexandre Gramfort
Romain Griffier
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Nicolas Griffon
Olivier Grisel
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Alba Gutiérrez-Sacristán
David Hanauer
Christian Haverkamp
  • Function : Author
Bing He
  • Function : Author
Darren Henderson
Martin Hilka
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John Holmes
Chuan Hong
Petar Horki
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Kenneth Huling
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Meghan Hutch
Richard Issitt
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Anne Sophie Jannot
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Vianney Jouhet
Mark Keller
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Katie Kirchoff
Jeffrey Klann
Isaac Kohane
Ian Krantz
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Detlef Kraska
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Ashok Krishnamurthy
Sehi L’yi
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Trang Le
Judith Leblanc
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Andressa Leite
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Guillaume Lemaitre
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Leslie Lenert
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Damien Leprovost
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Molei Liu
Ne Hooi Will Loh
Sara Lozano-Zahonero
Yuan Luo
Kristine Lynch
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Sadiqa Mahmood
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Sarah Maidlow
Alberto Malovini
Kenneth Mandl
Chengsheng Mao
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Anupama Maram
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Patricia Martel
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Aaron Masino
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Maria Mazzitelli
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Arthur Mensch
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Marianna Milano
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Marcos Minicucci
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Bertrand Moal
Jason Moore
Cinta Moraleda
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Jeffrey Morris
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Michele Morris
Karyn Moshal
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Sajad Mousavi
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Danielle Mowery
Douglas Murad
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Thomas Naughton
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Kee Yuan Ngiam
James Norman
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Jihad Obeid
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Marina Okoshi
Karen Olson
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Gilbert Omenn
Nina Orlova
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Brian Ostasiewski
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Nathan Palmer
Nicolas Paris
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Lav Patel
Miguel Pedrera Jimenez
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Emily Pfaff
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Danielle Pillion
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Hans Prokosch
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Robson Prudente
Víctor Quirós González
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Rachel Ramoni
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Maryna Raskin
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Siegbert Rieg
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Gustavo Roig Domínguez
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Pablo Rojo
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Carlos Sáez
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Elisa Salamanca
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Malarkodi Samayamuthu
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Arnaud Sandrin
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Janaina Santos
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Maria Savino
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Emily Schriver
Petra Schubert
Juergen Schuettler
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Luigia Scudeller
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Neil Sebire
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Pablo Serrano Balazote
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Patricia Serre
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Arnaud Serret-Larmande
Zahra Shakeri
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Domenick Silvio
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Piotr Sliz
Jiyeon Son
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Charles Sonday
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Andrew South
Anastasia Spiridou
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Amelia Tan
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Bryce Tan
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Byorn Tan
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Suzana Tanni
Deanne Taylor
Ana Terriza Torres
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Valentina Tibollo
Patric Tippmann
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Carlo Torti
Enrico Trecarichi
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Yi-Ju Tseng
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Andrew Vallejos
Gael Varoquaux
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Margaret Vella
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Guillaume Verdy
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Jill-Jênn Vie
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Shyam Visweswaran
Michele Vitacca
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Kavishwar Wagholikar
Lemuel Waitman
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Xuan Wang
Demian Wassermann
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Griffin Weber
Zongqi Xia
Nadir Yehya
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William Yuan
Alberto Zambelli
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Harrison Zhang
Daniel Zoeller
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Chiara Zucco
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Abstract

Abstract Background For some SARS-CoV-2 survivors, recovery from the acute phase of the infection has been grueling with lingering effects. Many of the symptoms characterized as the post-acute sequelae of COVID-19 (PASC) could have multiple causes or are similarly seen in non-COVID patients. Accurate identification of PASC phenotypes will be important to guide future research and help the healthcare system focus its efforts and resources on adequately controlled age- and gender-specific sequelae of a COVID-19 infection. Methods In this retrospective electronic health record (EHR) cohort study, we applied a computational framework for knowledge discovery from clinical data, MLHO, to identify phenotypes that positively associate with a past positive reverse transcription-polymerase chain reaction (RT-PCR) test for COVID-19. We evaluated the post-test phenotypes in two temporal windows at 3–6 and 6–9 months after the test and by age and gender. Data from longitudinal diagnosis records stored in EHRs from Mass General Brigham in the Boston Metropolitan Area was used for the analyses. Statistical analyses were performed on data from March 2020 to June 2021. Study participants included over 96 thousand patients who had tested positive or negative for COVID-19 and were not hospitalized. Results We identified 33 phenotypes among different age/gender cohorts or time windows that were positively associated with past SARS-CoV-2 infection. All identified phenotypes were newly recorded in patients’ medical records 2 months or longer after a COVID-19 RT-PCR test in non-hospitalized patients regardless of the test result. Among these phenotypes, a new diagnosis record for anosmia and dysgeusia (OR 2.60, 95% CI [1.94–3.46]), alopecia (OR 3.09, 95% CI [2.53–3.76]), chest pain (OR 1.27, 95% CI [1.09–1.48]), chronic fatigue syndrome (OR 2.60, 95% CI [1.22–2.10]), shortness of breath (OR 1.41, 95% CI [1.22–1.64]), pneumonia (OR 1.66, 95% CI [1.28–2.16]), and type 2 diabetes mellitus (OR 1.41, 95% CI [1.22–1.64]) is one of the most significant indicators of a past COVID-19 infection. Additionally, more new phenotypes were found with increased confidence among the cohorts who were younger than 65. Conclusions The findings of this study confirm many of the post-COVID-19 symptoms and suggest that a variety of new diagnoses, including new diabetes mellitus and neurological disorder diagnoses, are more common among those with a history of COVID-19 than those without the infection. Additionally, more than 63% of PASC phenotypes were observed in patients under 65 years of age, pointing out the importance of vaccination to minimize the risk of debilitating post-acute sequelae of COVID-19 among younger adults.

Dates and versions

hal-03476717 , version 1 (13-12-2021)

Identifiers

Cite

Hossein Estiri, Zachary Strasser, Gabriel Brat, Yevgeniy Semenov, Chirag Patel, et al.. Evolving phenotypes of non-hospitalized patients that indicate long COVID. BMC Medicine, 2021, 19 (1), pp.249. ⟨10.1186/s12916-021-02115-0⟩. ⟨hal-03476717⟩
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