Some permanent long covid

Link to free download of John’s 2 textbooks. (you may need to cut and paste this link into a brouser)

Profiling post-COVID syndrome across different variants of SARS-CoV-2

Across all variants

Central neurological cluster of symptoms

Cardiorespiratory cluster of symptoms

Debilitating multi-organ systemic inflammatory symptoms

Central neurological cluster of symptoms

Anosmia / dysosmia






(Largest cluster in both alpha and delta variants, and the second largest for the wild-type variant)

Consistent UK Biobank study

SARS-CoV-2 is associated with changes in brain structure in UK Biobank

Reduction in grey matter thickness

Tissue damage in primary olfactory cortex

Reduction in global brain size

Cardiorespiratory cluster of symptoms

(Largest cluster in the wild-type period)

Symptoms may reflect lung damage


Chest pain



Consistent study from Medicine

Clinical characteristics and outcomes of post-COVID-19 pulmonary fibrosis

Post-COVID-19 pulmonary fibrosis is a severe complication that leads to permanent lung damage or death.

Debilitating multi-organ symptoms

(Present in all variants)


Abdominal symptoms

Myalgias (muscle pain)

Vaccination and long covid

we did not observe evidence of qualitatively different symptom clustering in vaccinated vs. unvaccinated individuals,

with either alpha or delta variants.


It is now evident that post-COVID syndrome presents with heterogeneous profiles,

need characterisation to enable personalised care


Prospective longitudinal cohort study

N = 336,652 subjects

(Covid Symptom Study)

Tested positive

Long-COVID = lasting longer than 28 days

N = 1,459 with post-COVID syndrome (more than 12 weeks of symptoms)

One in 230 symptomatic, test confirmed cases

Clustering analysis, to identify distinct symptom profiles


Variants of SARS-CoV-2

Vaccination status at the time of infection

Clusters were characterised

Symptom prevalence



Prior conditions (comorbidities)


We identified distinct profiles of symptoms for post-COVID syndrome

Wild-type variant

Four endotypes identified

Alpha variant

Seven endotypes

Delta variant

Five endotypes in vaccinated subjects


a subtype of a disease condition,

defined by a distinct pathophysiological mechanism


Our classification may be useful to understand distinct mechanisms of the post-COVID syndrome, as well as subgroups of individuals at risk of prolonged debilitation.

Dr Claire Steves, clinical lead author, King’s College London

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.

Dr Liane Canas, author

These insights could aid in the development of personalised diagnosis and treatment for these individuals