{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,2]],"date-time":"2026-11-02T16:34:27Z","timestamp":1793637267504,"version":"4.5.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,6,25]],"date-time":"2024-06-25T00:00:00Z","timestamp":1719273600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"name":"Defense Health Program","award":["HU00012020067"],"award-info":[{"award-number":["HU00012020067"]}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["HU00011920111"],"award-info":[{"award-number":["HU00011920111"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["HU00012020070"],"award-info":[{"award-number":["HU00012020070"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Infectious Disease Clinical Research Program"},{"DOI":"10.13039\/100000005","name":"Department of Defense","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000005","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007188","name":"Uniformed Services University of the Health Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007188","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["Y1-AI-5072"],"award-info":[{"award-number":["Y1-AI-5072"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,7,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Post-COVID conditions (PCC) are difficult to characterize, diagnose, predict, and treat due to overlapping symptoms and poorly understood pathology. Identifying inflammatory profiles may improve clinical prognostication and trial endpoints.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This analysis included 1988 SARS-CoV-2 positive U.S. Military Health System beneficiaries who had quantitative post\u2013COVID symptom scores. Among participants who reported moderate-to-severe symptoms on surveys collected 6 months post-SARS-CoV-2 infection, principal component analysis followed by k-means clustering identified distinct clusters of symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Three symptom-based clusters were identified: a sensory cluster (loss of smell and\/or taste), a fatigue\/difficulty thinking cluster, and a difficulty breathing\/exercise intolerance cluster. Individuals within the sensory cluster were all outpatients during their initial COVID-19 presentation. The difficulty breathing cluster had a higher likelihood of obesity and COVID-19 hospitalization than those with no\/mild symptoms at 6 months post-infection. Multinomial regression linked early post-infection D-dimer and IL-1RA elevation to fatigue\/difficulty thinking and elevated ICAM-1 concentrations to sensory symptoms.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We identified three distinct symptom-based PCC phenotypes with specific clinical risk factors and early post-infection inflammatory predictors. With further validation and characterization, this framework may allow more precise classification of PCC cases and potentially improve the diagnosis, prognostication, and treatment of PCC.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiae318","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T10:28:12Z","timestamp":1718360892000},"page":"39-49","source":"Crossref","is-referenced-by-count":18,"title":["Precision Symptom Phenotyping Identifies Early Clinical and Proteomic Predictors of Distinct COVID-19 Sequelae"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5363-075X","authenticated-orcid":false,"given":"Nusrat J","family":"Epsi","sequence":"first","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josh G","family":"Chenoweth","sequence":"additional","affiliation":[{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W","family":"Blair","sequence":"additional","affiliation":[{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland ,","place":["USA"]},{"name":"Department of Pathology, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A","family":"Lindholm","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Brooke Army Medical Center , San Antonio, Texas ,","place":["USA"]},{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Ganesan","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland ,","place":["USA"]},{"name":"Division of Infectious Diseases, Walter Reed National Military Medical Center , Bethesda, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9361-2991","authenticated-orcid":false,"given":"Tahaniyat","family":"Lalani","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland ,","place":["USA"]},{"name":"Division of Infectious Diseases, Naval Medical Center Portsmouth , Portsmouth, Virginia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred","family":"Smith","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Naval Medical Center Portsmouth , Portsmouth, Virginia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupal M","family":"Mody","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, William Beaumont Army Medical Center , El Paso, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milissa U","family":"Jones","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Tripler Army Medical Center , Honolulu, Hawaii ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rhonda E","family":"Colombo","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Henry M. Jackson Foundation for the Advancement of Military Medicine , Bethesda, Maryland ,","place":["USA"]},{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Division of Infectious Diseases, Madigan Army Medical Center , Tacoma, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5499-3368","authenticated-orcid":false,"given":"Christopher J","family":"Colombo","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Madigan Army Medical Center , Tacoma, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Schofield","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Madigan Army Medical Center , Tacoma, Washington ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan C","family":"Ewers","sequence":"additional","affiliation":[{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Division of Infectious Diseases, Tripler Army Medical Center , Honolulu, Hawaii ,","place":["USA"]},{"name":"Division of Infectious Diseases, Alexander T. Augusta Military Medical Center , Fort Belvoir, Virginia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek T","family":"Larson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Division of Infectious Diseases, Alexander T. Augusta Military Medical Center , Fort Belvoir, Virginia ,","place":["USA"]},{"name":"Infectious Diseases and Internal Medicine, Naval Medical Center San Diego , San Diego, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M","family":"Berjohn","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Infectious Diseases and Internal Medicine, Naval Medical Center San Diego , San Diego, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan C","family":"Maves","sequence":"additional","affiliation":[{"name":"Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Sections of Infectious Diseases and Critical Care Medicine, Wake Forest University School of Medicine , Winston-Salem, North Carolina ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony C","family":"Fries","sequence":"additional","affiliation":[{"name":"The Applied Technology and Genomics (PHT) Division, U.S. Air Force School of Aerospace Medicine , Dayton, Ohio ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Uniformed Services University of the Health Sciences , Bethesda, Maryland ,","place":["USA"]},{"name":"Division of Infectious Diseases, Alexander T. 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