Long-COVID syndrome is a complex clinical condition whose pathogenetic mechanisms are not yet fully understood and which is estimated to affect 65 million patients worldwide. To date, more than 200 symptoms attributable to long COVID have been described, the most common of which are fatigue, muscle and joint pain, difficulty in concentrating, memory loss and respiratory disturbances, such as dyspnoea and persisting cough.
The ORCHESTRA-study followed a cohort of 1800 patients up for 12 months to understand the determinants and clinical presentations of the so-called 'long COVID' syndrome. Highly advanced statistical analysis techniques such as factor analysis and machine learning were used. The results of the study, coordinated by the University of Verona and funded by the European Union's Horizon 2020, are presented in the prestigious journal eClinical Medicine .
The data and samples provided by the participants of the COVID HOME study were essential for the understanding of Long COVID, as approximately 40% of the patients participating in this study reported long-term symptoms 12 months after infection. The research team of the COVID HOME study was involved in data and sample collection, data harmonization, sample testing as well as with significant intellectual contribution to the analysis and writing of the publication in the scientific journal.
The results of the ORCHESTRA- study highlight new evidence that long COVID syndrome can be classified according to the combination of symptoms, with a different impact on physical and mental quality of life and different pathogenetic mechanisms, as demonstrated by the analysis of risk and protective factors associated with each clinical phenotype and severe long COVID syndrome.
These findings may contribute to the design of pathogenesis studies and the selection of high-risk patients for inclusion in clinical trials for the evaluation of new treatments for long COVID. Furthermore, they could support awareness campaigns and guide health policies.
The COVID HOME study was led by Adriana Tami and her core team composed by Ieneke van der Gun, Karin Wold, Gerolf de Boer, Linda Veloo, Maria F. Vincenti, Margriet van der Meer and others.
The ORCHESTRA-project, a multicentre prospective study, was conducted from February 2020 to June 2022. SARS-CoV-2 patients, both outpatients and inpatients, were enrolled and followed up at 3-, 6- and 12-months post-acute infection through clinical and laboratory assessments. Clinical and biochemical features, antibody response, viral variants of interest, and the patients' physical and mental quality of life were assessed. The main objective was to identify risk and protective factors for the occurrence of long COVID syndrome based on patient characteristics and comorbidities, COVID disease severity, treatment and vaccination status.
