Longitudinal symptom dynamics of COVID-19 infection

Abstract

As the COVID-19 pandemic progresses, obtaining information on symptoms dynamics is of essence. Here, we extracted data from primary-care electronic health records and nationwide distributed surveys to assess the longitudinal dynamics of symptoms prior to and throughout SARS-CoV-2 infection. Information was available for 206,377 individuals, including 2471 positive cases. The two datasources were discordant, with survey data capturing most of the symptoms more sensitively. The most prevalent symptoms included fever, cough and fatigue. Loss of taste and smell 3 weeks prior to testing, either self-reported or recorded by physicians, were the most discriminative symptoms for COVID-19. Additional discriminative symptoms included self-reported headache and fatigue and a documentation of syncope, rhinorrhea and fever. Children had a significantly shorter disease duration. Several symptoms were reported weeks after recovery. By a unique integration of two datasources, our study shed light on the longitudinal course of symptoms experienced by cases in primary care.

Onset, duration and unresolved symptoms, including smell and taste changes, in mild COVID-19 infection: a cohort study in Israeli patients

“…Our findings are in-line with other longitudinal studies of mild COVID-19 patients, that also found high variability in the clinical course of the disease, and long durations (weeks after infection) of fatigue, shortness of breath [26], and smell and taste changes [27,28].…”

“…In light of the limited data available for mild COVID-19 patients, especially in the long term [9,11,26,27], our study provides important inputs regarding the disease course over a six-month period in ambulatory patients. The careful phone follow-up interviews further contributed to our findings' reliability.…”

An Italian individual-level data study investigating on the association between air pollution exposure and Covid-19 severity in primary-care setting

“…The spectrum of Covid-19 clinical manifestation is very wide, as it includes asymptomatic infection, mild upper respiratory tract symptoms, mild and severe pneumonia, acute respiratory distress syndrome, sepsis and septic shock, [ 2 ] but also myalgia, fatigue, sputum production, headache, hemoptysis, diarrhea, anosmia, and ageusia. Furthermore, as clinical data became available, potential cardiovascular, gastrointestinal, neurological, and cutaneous manifestations of the disease were described by scientific literature [ 3 ]. Despite the course of the disease is often mild and undistinguishable from a common flu, in a considerable number of cases Covid-19 infection may require hospitalization, and can lead to an acute respiratory distress syndrome (ARDS) and death [ 1 ] [ 4 ].…”

Kinetics and correlates of the neutralizing antibody response to SARS-CoV-2

“…Since then, the virus has rapidly spread across the globe and caused more than 90 million proven infections and over 2 million deaths. Disease severity ranges from asymptomatic infection to symptoms like cough, fever, muscle pain, and diarrhea to severe courses of infection including pneumonia with severe respiratory distress and a high risk of death [3][4][5] . While the majority of infected individuals experience a mild course of disease, elderly or individuals with pre-existing conditions are at higher risk for severe courses of COVID-19 6 .…”