Characterizing the Symptoms of Long COVID

Research Objectives: To assess the symptoms related to Long COVID and evaluate outcome measures used to assess PEM that impacts the individual’s activity and participation in their daily lives using the International Classification of Functioning, Disability, and Health (ICF) framework

Design: This study utilized a mixed methods approach with a scoping review and qualitative research design. For the scoping review,

Setting: Community

Participants: 7 participants, 3 clinicians and 4 patients, were recruited for one-on-one interviews. Of the patient participants, the median age was 56, with ages ranging from 35 to 77. Of these patients, 75% reported their race as White and 25% reported being White and Asian. Of the clinician participants, the
median age was 53, with ages ranging from 49 to 58. Of these clinicians, 66.66% reported their race as White and 33.33% reported their race as Asian.

Interventions: N/A

Main Outcome Measures: N/A

Results: The thematic content analyses from the interviews revealed a variety of symptoms associated with Long COVID. The most common symptom found was related to brain function/cognition (16%), followed by PEM (13%), autonomic-related symptoms (11%), and fatigue (8%). The least reported
symptoms were related to gastrointestinal dysfunction (0.2%), neurological (0.6%), and viral-like symptoms (2%). Symptoms unique to Long COVID included participation and activity limitations due to disability and menstrual cycle changes. The participants also revealed barriers to timely access to
appropriate care, for instance participants mentioned extensive clinic wait lists and misdiagnoses. Participants stated pacing and breathing strategies as interventions provided for Long COVID care. The review of literature revealed variability in outcome measures used to assess PEM. The Depaul Symptom Questionnaire (DSQ) was the primary outcome utilized.

Conclusions: Long COVID is a complex, debilitating disease that manifests as a multi-system pathophysiological process. Those affected have severe functional limitations. Furthermore, there are social, psychological, and psychosocial impacts as well. A thorough evaluation of symptoms in individuals experiencing Long COVID is crucial for distinguishing it from other fatigue-related conditions. This assessment can then inform treatment plans, including the implementation of effective pacing strategies, preventing patients from overexerting themselves, and managing both psychological and physical symptoms within the patient's tolerance level.

Author(s) Disclosures: None