Predictor-driven Dissection of the Post-COVID Syndrome (PCS) Score – A Population-Based Study

<bold>Background:</bold> The term ‘Post-COVID Syndrome’ (PCS) encompasses the multifaceted sequelae of COVID-19. A previously developed PCS scoring system used data from 667 participants in a prospective, multicentre, population-based study (COVIDOM/ NAPKON-POP), grading PCS severity based on 12 symptom complexes. Acute COVID-19 severity and individual resilience were identified as predictors, indicating two aetiologically and clinically distinct PCS sub-phenotypes. <bold>Aim:</bold> We established two novel scores from non-overlapping subsets of PCS symptom complexes in order to enhance the specificity of the scoring system. <bold>Methods:</bold> Symptom complexes were sub-selected by CART analyses and the new scores were applied in a expanded dataset (n=2,771). The newly defined resilience-specific PCS-R score comprised: persistent neurological symptoms, fatigue, and sleep disturbances. The acute severity-specific PCS-S score included: signs of acute infection, chemosensory deficits, exercise intolerance, and joint or muscle pain. <bold>Results:</bold> Each novel PCS score was specific for COVID-19 severity and resilience, as intended, and subsequently validated in two sub-cohorts. In addition to the known predictors, the PCS-R score was significantly influenced by the patients’ level of education and pre-existing neurological or psychiatric diseases (all p<0.05). Both novel scores exhibited a significant inverse correlation with quality of life (EQ-5D-5L index; PCS-R: r=-0.62; PCS-S: r=-0.50; both p<0.001). <bold>Conclusion:</bold> The two novel PCS scores allow for a more nuanced approach to assessing PCS severity and heterogeneity, highlighting the clinical need for different therapeutic and interventional strategies in these distinct PCS phenotypes.

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Published
2024-09-14
DOI
https://doi.org/10.1183/13993003.congress-2024.pa5109
Primary Topic
Long-Term Effects of COVID-19
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article
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article

Predictor-driven Dissection of the Post-COVID Syndrome (PCS) Score – A Population-Based Study

Thalea Tamminga, Lena Schmidbauer, Karl Georg Hæusler, Thomas Bahmer et al.
Long-Term Effects of COVID-19
article

Predictor-driven Dissection of the Post-COVID Syndrome (PCS) Score – A Population-Based Study

Thalea Tamminga, Lena Schmidbauer, Karl Georg Hæusler, Thomas Bahmer, Olga Miljukov, Carolin Nürnberger, Wolfgang Lieb, Jens Peter Reese, Julia Fricke, Peter U. Heuschmann, Klaus F. Rabe, Irina Chaplinskaya-Sobol, Jörg Janne Vehreschild, Jan Heyckendorf, Michael Krawczak, Corina Maetzler, Walter Maetzler, Derk Frank, Katharina S. Appel, Thomas Keil, Ann J. Russ, Martin Laudien, Lilian Krist, Stefan Störk, Sabrina Ballhausen, Caroline Morbach, Carmen Scheibenbogen, N. E. El Mokthari, Anna Horn, Sidney S. Schreiber, Martin Witzenrath
article en

Abstract

<bold>Background:</bold> The term ‘Post-COVID Syndrome’ (PCS) encompasses the multifaceted sequelae of COVID-19. A previously developed PCS scoring system used data from 667 participants in a prospective, multicentre, population-based study (COVIDOM/ NAPKON-POP), grading PCS severity based on 12 symptom complexes. Acute COVID-19 severity and individual resilience were identified as predictors, indicating two aetiologically and clinically distinct PCS sub-phenotypes. <bold>Aim:</bold> We established two novel scores from non-overlapping subsets of PCS symptom complexes in order to enhance the specificity of the scoring system. <bold>Methods:</bold> Symptom complexes were sub-selected by CART analyses and the new scores were applied in a expanded dataset (n=2,771). The newly defined resilience-specific PCS-R score comprised: persistent neurological symptoms, fatigue, and sleep disturbances. The acute severity-specific PCS-S score included: signs of acute infection, chemosensory deficits, exercise intolerance, and joint or muscle pain. <bold>Results:</bold> Each novel PCS score was specific for COVID-19 severity and resilience, as intended, and subsequently validated in two sub-cohorts. In addition to the known predictors, the PCS-R score was significantly influenced by the patients’ level of education and pre-existing neurological or psychiatric diseases (all p<0.05). Both novel scores exhibited a significant inverse correlation with quality of life (EQ-5D-5L index; PCS-R: r=-0.62; PCS-S: r=-0.50; both p<0.001). <bold>Conclusion:</bold> The two novel PCS scores allow for a more nuanced approach to assessing PCS severity and heterogeneity, highlighting the clinical need for different therapeutic and interventional strategies in these distinct PCS phenotypes.

Goethe University Frankfurt (DE), Zimmer Biomet (Netherlands) (NL), University of Würzburg (DE), University Hospital Schleswig-Holstein (DE), Universitätsmedizin Göttingen (DE), Universitätsklinikum Würzburg (DE), German Center for Lung Research (DE), Berlin Institute of Health at Charité - Universitätsmedizin Berlin (DE), LungenClinic Grosshansdorf (DE), University Hospital Cologne (DE), Institut für Berufliche Aus- und Fortbildung (DE), Berlin Center for Epidemiology and Health Research (DE), University of Göttingen (DE), Charité - Universitätsmedizin Berlin (DE), University of Lübeck (DE)
Openalex Percentile: Top 69%
Long-Term Effects of COVID-19
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