Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients

Bliddal, Sofie; Banasik, Karina; Pedersen, Ole Birger; Nissen, I; Cantwell, Lisa; Schwinn, Michael; Tulstrup, Morten; Westergaard, David; Ullum, Henrik; Brunak, Søren; Tommerup, Niels; Feenstra, Bjarke; Geller, Frank; Ostrowski, Sisse Rye; Groenbaek, Kirsten; Nielsen, Claus Henrik; Nielsen, Susanne Dam; Feldt‐Rasmussen, Ulla

doi:10.1101/2021.01.22.21249945

Cited by 48 publications

(86 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…D'Cruz et al and Taboada et al, analyzing prospectively two cohorts of 119 and 91 severe/critical COVID-19 patients, respectively, showed the presence of dyspnoea on exertion (57%), asthaenia (37%), myalgia (37%), and arthralgia (29%) up to 2 months after symptoms onset and a general decrease in quality of life (mobility, usual activities, self-care, pain/discomfort, anxiety/depression) in 67% of patients at up to 6 months of follow-up (77, 100). However, these widespread long-term symptoms were not only present in severe COVID-19 patients, but also in patients who had mild and moderate disease (72,76,80,94,98,146,159). Carvalho-Schneider et al, in a prospective study on 150 mild/moderate COVID-19 patients at 2 months of follow-up, highlighted dyspnea and asthenia, respectively, in 30 and 40% of patients (74,98).…”

Section: Widespread Persistent Symptomsmentioning

confidence: 98%

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

et al. 2021

View full text Add to dashboard Cite

Whilst the entire world is battling the second wave of COVID-19, a substantial proportion of patients who have suffered from the condition in the past months are reporting symptoms that last for months after recovery, i. e., long-term COVID-19 symptoms. We aimed to assess the current evidence on the long-term symptoms in COVID-19 patients. We did a systematic review on PubMed, Web of Science, EMBASE, and Google Scholar from database inception to February 15, 2021, for studies on long-term COVID-19 symptoms. We included all type of papers that reported at least one long-term COVID-19 symptom. We screened studies using a standardized data collection form and pooled data from published studies. Cohort cross-sectional, case-report, cases-series, case-control studies, and review were graded using specific quality assessment tools. Of 11,361 publications found following our initial search we assessed 218 full-text articles, of which 145 met all selection criteria. We found that 20.70% of reports on long-term COVID-19 symptoms were on abnormal lung functions, 24.13% on neurologic complaints and olfactory dysfunctions, and 55.17% on specific widespread symptoms, mainly chronic fatigue, and pain. Despite the relatively high heterogeneity of the reviewed studies, our findings highlighted that a noteworthy proportion of patients who have suffered from SARS-CoV-2 infection present a “post-COVID syndrome.” The multifaceted understanding of all aspects of the COVID-19 pandemic, including these long-term symptoms, will allow us to respond to all the global health challenges, thus paving the way to a stronger public health.

show abstract

Section: Widespread Persistent Symptomsmentioning

confidence: 98%

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

et al. 2021

View full text Add to dashboard Cite

show abstract

“…There were no major differences in the prevalence of symptoms at these two time points other than loss of smell/taste being less common at 12 than 4 weeks from onset. Women and people with higher body mass index were more likely to suffer from persistent illness 16 . Another US study (preprint) of mainly non-hospitalised PCR positive cases (n=357) found a prevalence of symptoms of 36% after 30 days from onset and 15% at 90 days 35 .…”

Section: Main Findings and Comparison To Other Datamentioning

confidence: 99%

“…For example, the ONS study based their estimates on a list of 12 symptoms included in the ONS infection survey 15 , with some of the common symptoms of Long Covid such as chest pain, palpitations and cognitive problems missing from that list. Other studies, some with a wider symptom list, estimate the prevalence of persisting symptoms to be higher at around one in three people for up to 18 weeks post infection 4,5,16 .…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Long Covid: findings from a social media survey

Ziauddeen

Gurdasani

O’Hara³

et al. 2021

Preprint

View full text Add to dashboard Cite

Many people are not recovering for months after being infected with SARS-CoV-2. Long Covid has emerged as a major public health concern that needs defining, quantifying, and describing. We aimed to explore the initial and ongoing symptoms of Long Covid following SARS-CoV-2 infection and describe its impact on daily life in people who were not admitted to hospital during the first two weeks of the illness. We co-produced a survey with people living with Long Covid. We collected the data through an online survey using convenience non-probability sampling, with the survey posted both specifically on Long Covid support groups and generally on social media. The criteria for inclusion were adults with lab-confirmed (PCR or antibody) or suspected COVID-19 managed in the community (non-hospitalised) in the first two weeks of illness. We used agglomerative hierarchical clustering to identify specific symptom clusters, and their demographic and functional correlates. We analysed data from 2550 participants with a median duration of illness of 7.7 months (interquartile range (IQR) 7.4-8.0). The mean age was 46.5 years (standard deviation 11 years) with 82.8% females and 79.9% of participants based in the UK. 89.5% described their health as good, very good or excellent before COVID-19. The most common initial symptoms that persisted were exhaustion, chest pressure/tightness, shortness of breath and headache. Cough, fever, and chills were common initial symptoms that became less prevalent later in the illness, whereas cognitive dysfunction and palpitations became more prevalent later in the illness. 26.5% reported lab-confirmation of infection. The biggest difference in ongoing symptoms between those who reported testing positive and those who did not was loss of smell/taste. Ongoing symptoms affected at least 3 organ systems in 83.5% of participants. Most participants described fluctuating (57.7%) or relapsing symptoms (17.6%). Physical activity, stress and sleep disturbance commonly triggered symptoms. A third (32%) reported they were unable to live alone without any assistance at six weeks from start of illness. 16.9% reported being unable to work solely due to COVID-19 illness. 66.4% reported taking time off sick (median of 60 days, IQR 20, 129). 37.0% reported loss of income due to illness, and 64.4% said they were unable to perform usual activities/duties. Acute systems clustered broadly into two groups: a majority cluster (n=2235, 88%) with cardiopulmonary predominant symptoms, and a minority cluster (n=305, 12%) with multisystem symptoms. Similarly, ongoing symptoms broadly clustered in two groups; a majority cluster (n=2243, 88.8%) exhibiting mainly cardiopulmonary, cognitive symptoms and exhaustion, and a minority cluster (n=283, 11.2%) exhibited more multisystem symptoms. Belonging to the more severe multisystem cluster was associated with more severe functional impact, lower income, younger age, being female, worse baseline health, and inadequate rest in the first two weeks of the illness, with no major differences in the cluster patterns when restricting analysis to the lab-confirmed subgroup. This is an exploratory survey of Long Covid characteristics. Whilst it is important to acknowledge that it is a non-representative population sample, it highlights the heterogeneity of persistent symptoms, and the significant functional impact of prolonged illness following confirmed or suspected SARS-CoV-2 infection. To study prevalence, predictors and prognosis, research is needed in a representative population sample using standardised case definitions (to include those not lab-confirmed in the first pandemic wave).

show abstract

“…Full-text articles of these abstracts were obtained, and study criteria were applied. Thirty-one published studies[53-55 78-105] and eight medRxiv preprints[46 75 106-111], met the inclusion criteria for this systematic review (Figure 1). The sample sizes ranged from 18[102] to 1655[79], with mean age across studies ranging from 32.3 (SD = 8.5)[54] to 67.1 (SD =11.6)[87].…”

Section: Resultsmentioning

confidence: 99%

Fatigue symptoms associated with COVID-19 in convalescent or recovered COVID-19 patients; a systematic review and meta-analysis

Benzouak

Gunpat

Burns

et al. 2021

Preprint

View full text Add to dashboard Cite

BackgroundThe prevalence and prognosis of post-acute stage SARS-CoV-2 infection fatigue symptoms remain largely unknown.AimsWe performed a systematic review to evaluate the prevalence of fatigue in post-recovery from SARS-CoV-2 infection.MethodMedline, Embase, PsycINFO, CINAHL, Web of Science, Scopus, trial registries, Cochrane Central Register of Controlled Trials and Google Scholar were searched for studies on fatigue in samples that recovered from PCR diagnosed COVID-19. Meta-analyses were conducted separately for each recruitment setting.ResultsWe identified 39 studies with 8825 patients that recovered from COVID-19. Post-COVID-19 patients self-report of fatigue was higher compared to healthy controls (RR = 3.688, 95%CI [2.502, 5.436], p < 0.001). Over 50% of patients discharged from inpatient care reported symptoms of fatigue during the first (ER = 0.517, 95%CI [0.278, 0.749]) and second month following recovery (ER = 0.527, 95%CI [0.337, 0.709]). 10% of the community patients reported fatigue in the first month post-recovery. Patient setting moderated the association between COVID-19 recovery and fatigue symptoms (R2 = 0.12, p < 0.001). Female gender was associated with greater self-report of fatigue (OR =1.782, 95%CI [1.531, 2.870]). Patients recruited through social media had fatigue above 90% across multiple time points. Fatigue was highest in studies from Europe.ConclusionFatigue is a symptom associated with functional challenges which could have economic and social impacts. Developing long-term planning for fatigue management amongst patients beyond acute stages of SARS-CoV-2 infection is essential to optimizing patient care and public health outcomes.

show abstract

Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients

Cited by 48 publications

References 45 publications

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

Characteristics of Long Covid: findings from a social media survey

Fatigue symptoms associated with COVID-19 in convalescent or recovered COVID-19 patients; a systematic review and meta-analysis

Contact Info

Product

Resources

About