https://jamanetwork.com/journals/jama/fullarticle/2828329 December 18, 2024 2024 Update of the RECOVER-Adult Long COVID Research Index JAMA. Published online December 18, 2024. doi:10.1001/jama.2024.24184 Key Points Question How do updated data from nearly 4000 additional participants and expanded symptom questionnaires inform the prior research classification for long COVID (LC) or post–COVID-19 condition? Findings In this prospective, observational cohort study, data from 13 647 adults participating in the Researching COVID to Enhance Recovery (RECOVER-Adult) study were used to update the research index for classifying symptomatic LC and 5 symptom subtypes that differ in associated demographic features and quality of life. Meaning The 2024 LC research index may help researchers identify people with symptomatic LC and its symptom subtypes. Refinement of the index will be needed as research advances and the understanding of LC deepens. 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.
This is the type of technique I would like to see tried in ME/CFS. Unfortunately Leonard Jason doesn't like optional symptoms and symptom counting so he has never done it as far as I know.
The full text can currently be accessed here: https://jamanetwork.com/journals/ja...ign=ftm_links&utm_content=tfl&utm_term=121824 (from press release https://www.eurekalert.org/news-releases/1068279 ).
And here we have a study where more "likely LC" participants supposedly had PEM than fatigue or "postexertional soreness". Like the study from yesterday, this tells us nothing about PEM. It just tells us that the DePaul metrics being used to assess PEM are fundamentally broken.
Yes. I don’t know what malaise means in english, but from my french intuition “PEM” is practically as bad as “CFS”. To me when I first hear post exertional malaise it sounds like nausea and lightheadedness for a couple minutes after exercise. (what you get when you didn’t eat enough in the morning, or aren’t well hydrated).
12-minute video: — Long COVID is now defined as a heterogeneous, infection-associated chronic condition present for at least 3 months after SARS-CoV-2 infection. Author Leora Horwitz, MD, MHS, of NYU Grossman School of Medicine joins JAMA Executive Editor Gregory Curfman, MD, to discuss the JAMA article "2024 Update of the RECOVER-Adult Long COVID Research Index." —- https://www.youtube.com/watch?v=TGExXvy7R34
