Symptom Profiles and Progression in Hospitalized and Nonhospitalized Patients with Coronavirus Disease, Colorado, USA, 2020

Abstract

To improve recognition of coronavirus disease (COVID-19) and inform clinical and public health guidance, we randomly selected 600 COVID-19 case-patients in Colorado. A telephone questionnaire captured symptoms experienced, when symptoms occurred, and how long each lasted. Among 128 hospitalized patients, commonly reported symptoms included fever (84%), fatigue (83%), cough (73%), and dyspnea (72%). Among 236 nonhospitalized patients, commonly reported symptoms included fatigue (90%), fever (83%), cough (83%), and myalgia (74%). The most commonly reported initial symptoms were cough (21%–25%) and fever (20%–25%). In multivariable analysis, vomiting, dyspnea, altered mental status, dehydration, and wheezing were significantly associated with hospitalization, whereas rhinorrhea, headache, sore throat, and anosmia or ageusia were significantly associated with nonhospitalization. General symptoms and upper respiratory symptoms occurred earlier in disease, and anosmia, ageusia, lower respiratory symptoms, and gastrointestinal symptoms occurred later. Symptoms should be considered alongside other epidemiologic factors in clinical and public health decisions regarding potential COVID-19 cases.

Phenotyping of acute and persistent COVID-19 features in the outpatient setting: exploratory analysis of an international cross-sectional online survey

“…(3) This frequency is located within the reported range (13-76%) of long COVID depending on sample size, observation time and research design. (7,8,25,26) In line with recent evidence, those long COVID subjects had both a two-fold elevated number of acute symptoms and a halved resolution pace as compared to the subgroup without persistent symptoms.…”

Secondary bacterial infections trigger New Onset Atrial Fibrillation in ICU Covid-19 ARDS patients

“…An early, in the course of the infection, virally driven hyperin ammation-cytokine storm has been proposed as a possible mechanism, partially explaining NOAF occurrence in patients hospitalized in the wards [2,9]. In our study, NOAF appeared late in the course of the disease, approximately during the 18th post symptom onset day (8th ICU day), when COVID-19 symptoms usually subside [39]. Although myocarditis has also been suggested as a possible mechanism for arrythmias in Covid-19, histological ndings indicate macrophage in ltration, with no clear association to myocardial injury, and, although troponin is high, myocarditis is established in only 4.5% of the severely ill, Covid-19 patients with heart failure, undergoing endomyocardial biopsies; thus, the virus does not seem to directly invade the cardiac cells in order to initiate AF [12,40].…”

“…Other studies con rm the increased NOAF incidence in ICU Covid-19 patients, varying between 16.5-40%, yet, without specifying whether the virus or other factors, frequently present in critically-ill patients, are associated to its occurrence [9,10,11,[13][14][15][37][38][39]. Similarly, existing data lack information about the exact time of NOAF appearance in the course of Covid-19 [10,11,13,14,[37][38][39]]. An early, in the course of the infection, virally driven hyperin ammation-cytokine storm has been proposed as a possible mechanism, partially explaining NOAF occurrence in patients hospitalized in the wards [2,9].…”

Is loss of smell an early predictor of COVID-19 severity: a systematic review and meta-analysis

“…Our meta-analysis comprises a total of 11 reports that included data on the hospitalization status of patients. Of them, one was a preprint (Zobairy et al 2020 ), and the others were published studies (Avcı et al 2020 ; Bakhshaee et al 2021 ; Bianco et al 2021 ; D’Ascanio et al 2021 ; Izquierdo-Domínguez et al 2020 ; Killerby et al 2020 ; Nouchi et al 2021 ; Paderno et al 2020 ; Vahey et al 2021 ; Yan et al 2020 ). The LOS was present in 735 inpatients and 1295 outpatients.…”