Clinical and Haematological Phenotypes in Long COVID

There are estimated to be tens of thousands of long-Covid patients in the UK, and the number is set to grow as the pandemic continues. Little is known about the cause of long-Covid clinical syndromes and there are no evidence-based treatments available to patients. There is therefore an urgent need to undertake research into long-Covid. Long-Covid referral to our general medical outpatient clinics has been growing, as these patients typically present with multiple symptoms that require a holistic approach to patient care. Patients are often distressed and disabled by their symptoms, exacerbated by the lack of any detailed understanding about their condition, and the absence of specific treatment strategies. Anecdotal reports of ongoing inflammation in long-Covid, not typically measurable in routine blood tests, have prompted interest in exploring the nature of this inflammation further. In addition, some long-Covid patients have reported clinical improvement following empiric treatment with anti-inflammatory medications including anti-histamines and corticosteroids. These clinical observations, and the enthusiasm expressed by the long-Covid patient community for further research to be conducted, have been the key drivers for this study. Patients attending our clinics have all without exception expressed their interest in participating in this work. This small sample size study sets out to explore whether there are identifiable abnormalities in the blood cells of long-Covid patients that might correlate with patients' clinical presentations which may in turn trigger further avenues of investigation. The study participants are all patients with a history of Covid19 infection and who either have ongoing symptoms or who have fully recovered. The clinical information is available in case records as part clinical care and patients' blood samples are sent for analysis as part of ongoing clinical care. Patients are informed about their blood test results as part of ongoing clinic care. All patients are provided with information about the study and asked to consent to their anonymised clinical and laboratory data being used as part of this observational study. We also seek consent to save serum for additional blood analysis depending on the results of the initial study. No genetic investigations will be conducted. This study does not involve any treatment intervention, and there is no risk of harm to patients. The use of person-identifiable information will be restricted to an absolute minimum, and all data will be anonymised for purposes of our study analysis. The members of the research team all work within one organisation adhering to GDPR standards, and all email communication remains within that organisation and is password-protected. No conflicts of interest have been identified. We have undertaken to share individual results with participating patients by the end of the study.