Three types of long Covid identified as scientists find unique sets of symptoms

There are three different “types” of long Covid according to researchers who said their findings should help the 2 million people in the UK with the condition get better treatment.

Experts from King’s College London (KCL) said that people with long Covid appear to be split into three main groups, each with its own sets of symptoms.

The largest group is those with neurological symptoms including fatigue, brain fog and headache – most commonly found among those who became infected when the most dominant coronavirus strains were Alpha and Delta.

A second group experienced respiratory symptoms including chest pain and shortness of breath, which could point to lung damage. This was found more commonly among those infected during the first wave of the virus. This was the largest cluster in the period when the population was unvaccinated.

A final group is experiencing diverse symptoms including heart palpitations, muscle ache and pain, and changes in skin and hair, the researchers said. Although there are differences to separate the groups, the scientists said these three subtypes were evident in all variants.

Crucially, the data also suggested that the symptom types for people who did experience symptoms for 12 weeks or more were similar in vaccinated and unvaccinated people, at least with variants which had these data. They were expecting different clustering of symptoms depending on vaccination status given the risk of long Covid reduced by vaccination. Existing data shows that the risk of long-Covid overall is reduced by vaccination.

They examined 1,459 people living with long Covid – defined by the study authors as suffering symptoms for at least 84 days after infection – who were taking part in the Zoe health study.

Clinical lead author Dr Claire Steves, from KCL, said: “These data show clearly that post-Covid syndrome is not just one condition, but appears to have at several subtypes. Understanding the root causes of these subtypes may help in finding treatment strategies.

“Moreover, these data emphasise the need for long Covid services to incorporate a personalised approach sensitive to the issues of each individual.”

First author Dr Liane Canas, also from KCL, added: “These insights could aid in the development of personalised diagnosis and treatment for these individuals.”

The pre-print of the study is published on medRxiv.

Some 2 million people are estimated to have long Covid in the UK, according to the most recent estimate from the Office of National Statistics. Fatigue continued to be the most common symptom reported as part of individuals’ experience of long Covid (56 per cent) of those with self-reported long Covid), followed by shortness of breath (31 per cent), loss of smell (22 per cent), and muscle ache (21 per cent).

The NHS has established 69 assessment centres which are taking referrals from GPs for people experiencing brain fog, anxiety, depression, breathlessness, fatigue and other debilitating symptoms of long Covid.

However, a report published in January by MPs on the Health and Social Care Committee found there are issues with the capacity of secondary care long Covid support clinics, workforce availability, services for children with long Covid, and understanding of long Covid in primary care. Even after gaining access to a long Covid assessment service, navigating the system can be “profoundly bewildering”, they found.