2024 Update of the RECOVER-Adult Long COVID Research Index

Authors

Linda N. Geng, Stanford University, Stanford, CA
Kristine M. Erlandson, University of Colorado Anschutz Medical Campus, Aurora, CO
Mady Hornig, RECOVER patient representative, New York, NY
Rebecca Letts, RECOVER patient/caregiver representative, New York, NY
Caitlin Selvaggi, Massachusetts General Hospital Biostatistics, Boston, MA
Hassan Ashktorab, Howard University, Washington, DC
Ornina Atieh, Case Western Reserve University, Cleveland, OH
Logan Bartram, Icahn School of Medicine at Mount Sinai, New York, NY
Hassan Brim, Howard University, Washington, DC
Shari B. Brosnahan, NYU Grossman School of Medicine, New York, NY
Jeanette Brown, University of Utah Health, Salt Lake City, UT
Mario Castro, University of Kansas Medical Center, Kansas City, Kansas
Alexander Charney, Icahn School of Medicine at Mount Sinai, New York, NY
Peter Chen, Women's Guild Lung Institute, Los Angeles, CA
Steven G. Deeks, University of California, San Francisco, CA
Nathaniel Erdmann, University of Alabama at Birmingham, AL
Valerie J. Flaherman, University of California San Francisco, CAFollow
Maher A. Ghamloush, Tufts Medical Center, Boston, MA
Paul Goepfert, University of Alabama at Birmingham, AL
Jason D. Goldman, Providence Swedish Medical Center, Seattle, WA
Jenny E. Han, Emory University, Atlanta, GA
Rachel Hess, University of Utah, Salt Lake City, UT
Ellie Hirshberg, Intermountain Health, Salt Lake City, UT
Susan E. Hoover, Sanford Health, Sioux Falls, SD
Stuart D. Katz, NYU Grossman School of Medicine, New York, NY
J Daniel Kelly, University of California, San Francisco, CA
Jonathan D. Klein, ILLInet RECOVER, Chicago, IL
Jerry A. Krishnan, ILLInet RECOVER, Chicago, IL
Judd Shellito, LSU Health Sciences Center - New OrleansFollow
et al

Document Type

Article

Publication Date

12-18-2024

Publication Title

JAMA

Abstract

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.

PubMed ID

39693079

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