Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020

By M. Tenforde, Sara S Kim, C. Lindsell, Erica Billig Rose, N. Shapiro, D. Files, K. Gibbs, H. Erickson, Jay S. Steingrub, H. Smithline and 28 more. MMWR. Morbidity and mortality weekly report, 2020

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Prolonged symptom duration and disability are common in adults hospitalized with severe coronavirus disease 2019 (COVID-19). Characterizing return to baseline health among outpatients with milder COVID-19 illness is important for understanding the full spectrum of COVID-19-associated illness and tailoring public health messaging, interventions, and policy. During April 15-June 25, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had a first positive reverse transcription-polymerase chain reaction (RT-PCR) test for SARS-CoV-2, the virus that causes COVID-19, at an outpatient visit at one of 14 U.S. academic health care systems in 13 states. Interviews were conducted 14-21 days after the test date. Respondents were asked about demographic characteristics, baseline chronic medical conditions, symptoms present at the time of testing, whether those symptoms had resolved by the interview date, and whether they had returned to their usual state of health at the time of interview. Among 292 respondents, 94% (274) reported experiencing one or more symptoms at the time of testing; 35% of these symptomatic respondents reported not having returned to their usual state of health by the date of the interview (median = 16 days from testing date), including 26% among those aged 18-34 years, 32% among those aged 35-49 years, and 47% among those aged ≥50 years. Among respondents reporting cough, fatigue, or shortness of breath at the time of testing, 43%, 35%, and 29%, respectively, continued to experience these symptoms at the time of the interview. These findings indicate that COVID-19 can result in prolonged illness even among persons with milder outpatient illness, including young adults. Effective public health messaging targeting these groups is warranted. Preventative measures, including social distancing, frequent handwashing, and the consistent and correct use of face coverings in public, should be strongly encouraged to slow the spread of SARS-CoV-2.

Subfields: Clinical Psychology, Infectious Diseases, Neurology

View Paper: https://www.semanticscholar.org/paper/c86e819d5e2176c06cf250512fe0dce2fffe55c6

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Citations in the corpus

Characterizing long COVID in an international cohort: 7 months of symptoms and their impact (2020, background): “tical dashed lines indicate the range for “No fatigue”[10-21], “Fatigue”[22-34], and “Extreme” (>=35).”
How and why patients made Long Covid (2020, neutral): “In July, peer-reviewed studies started reporting sequelae (cardio-logical, neurological) even in ‘mild ’ COVID-19 (Paterson et al., 2020; Puntmann et al., 2020; Tenforde, 2020).”
More Than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta-Analysis (2021, neutral): “Symptoms, signs, or abnormal clinical parameters persisting two or more weeks after COVID-19 onset that do not return to a healthy baseline can potentially be considered long-term effects of the disease(2).”