CHRONIC POST-COVID NEUROPSYCHIATRIC SYMPTOM CLUSTERS DO NOT SHARE THE SAME RISK FACTORS IN A COHORT INFECTED BY THE OMICRON VARIANT

Abstract Background It is suggested that post-COVID neuropsychiatric symptoms are not a unified syndrome, but a heterogeneous entity consisting of distinct symptom clusters (Chau et al., 2023). In a cohort infected by pre-Omicron strain, we showed that the symptoms could be clustered into a cognitive dysfunction- fatigue cluster and an anxiety-depression cluster, which do not share the same predictors. Aims & Objectives We aim to test whether we can discover the same symptom structure in a larger cohort infected by the Omicron variant of SARS-CoV-2 virus, and whether the symptom clusters have different risk factors as well. Method:We recruited 508 adult subjects who were infected by the Omicron variant, but not the pre-Omicron variants of SARS-CoV-2 for the first time more than one year ago from the community. They completed a COVID symptom checklist, questionnaires on the demographics, socioeconomic status and health status and self-reported symptom scales on mood, anxiety, insomnia, and PTSD symptoms via a mobile app. Results The mean age of the subjects is 38.2 years. 68% of them are female and 5.1% had known psychiatric illness prior to COVID. 74% of them suffered from asymptomatic to mild acute COVID, and none of them required oxygen therapy. Partial correlation network analysis discovered two symptom clusters: one features cognitive complaints and another one features anxiety-depression (Figure 1). Multiple regression model showed that, while the number of pre-COVID medical conditions and existence of pre- COVID mental illness predicts the number of symptoms from either cluster, level of pre-COVID material deprivation only predicts number of symptoms from the anxiety depression cluster, and the severity of the index infection only predicts number of symptoms from the cognitive complaints cluster. Discussion & Conclusion Our result from the Omicron cohort replicated our previous findings from the pre-Omicron cohort by demonstrating that cognitive complaints and anxiety-depression symptoms are distinct sub-syndromes with overlapping yet distinct risk factors. This replication suggests that the characteristics of chronic post-COVID neuropsychiatric symptoms from the pre-Omicron and Omicron strains infection are similar. This replication also strengthens the argument that the two symptom clusters should not be considered a unified entity. References Chau, S.W.H, et al. 'Chronic post-COVID neuropsychiatric symptoms persisting beyond one year from infection: a case-control study and network analysis’. Under review.