Making it Personal: Identifying Personalised Symptom Patterns and Triggers in Long COVID

Long COVID is a heterogenous condition with >50 different clinical symptoms affecting 10 different body systems (Décary et al., 2021). Definitions of long COVID vary, but the most common definition is when a person who has had COVID-19 experiences symptoms for >12 weeks. Many people with long COVID report experiencing post-exertional malaise (PEM), which is a marked exacerbation of 1 or more symptoms in response to physical or cognitive exertion. The specific constellation of symptoms experienced by people with long COVID differs from one individual to another. Factors such as sleep, stress and physical activity may exacerbate symptoms. This study involves a series of N-of-1 observational studies. No intervention will be applied. In this study, participants will complete brief questionnaire items about symptoms and potential triggers (e.g. physical activity, sleep, stress, mood) on a daily basis for a period of 6 weeks via a wrist worn electronic diary device with an inbuilt accelerometer ('PRO-Diary'). Fatigue will be measured as the primary clinical outcome measure because it represents the most commonly experienced symptom of long COVID. Questionnaire items related to personally-relevant symptoms (e.g. body pain) and potential symptom triggers will be selected by participants at the start of the study and incorporated into to the design of the daily questionnaires. Participants will complete the brief questionnaires three times per day (morning, afternoon and evening) and they will take approximately 1-2 minutes to complete. Participants will be given the option to extend their participation for a further 6 weeks (12 weeks in total).