Persisting symptoms three to eight months after non-hospitalized COVID-19, a prospective cohort study

Abstract

Long-COVID-19 is a proposed syndrome negatively affecting the health of COVID-19 patients. We present data on self-rated health three to eight months after laboratory confirmed COVID-19 disease compared to a control group of SARS-CoV-2 negative patients. We followed a cohort of 8786 non-hospitalized patients who were invited after SARS-CoV-2 testing between February 1 and April 15, 2020 (794 positive, 7229 negative). Participants answered online surveys at baseline and follow-up including questions on demographics, symptoms, risk factors for SARS-CoV-2, and self-rated health compared to one year ago. Determinants for a worsening of self-rated health as compared to one year ago among the SARS-CoV-2 positive group were analyzed using multivariate logistic regression and also compared to the population norm. The follow-up questionnaire was completed by 85% of the SARS-CoV-2 positive and 75% of the SARS-CoV-2 negative participants on average 132 days after the SARS-CoV-2 test. At follow-up, 36% of the SARS-CoV-2 positive participants rated their health “somewhat” or “much” worse than one year ago. In contrast, 18% of the SARS-CoV-2 negative participants reported a similar deterioration of health while the population norm is 12%. Sore throat and cough were more frequently reported by the control group at follow-up. Neither gender nor follow-up time was associated with the multivariate odds of worsening of self-reported health compared to one year ago. Age had an inverted-U formed association with a worsening of health while being fit and being a health professional were associated with lower multivariate odds. A significant proportion of non-hospitalized COVID-19 patients, regardless of age, have not returned to their usual health three to eight months after infection.

Cardiac Post-acute Sequelae symptoms of SARS-CoV-2 in Community-Dwelling Adults: Cross-sectional Study

“…25 Subsequently, evidence is emerging on the substantial burden of PASC among communitydwelling persons who represent the majority of persons with COVID-19. 26 Our results are consistent with reports on enduring PASC in non-hospitalized patients, 27 including reports of fatigue as the most common PASC. 28 12 Investment in cardiac-related PASC research is equally important to inform potential therapeutic strategies for PASC.…”

“…25 Subsequently, evidence is emerging on the substantial burden of PASC among community-dwelling persons who represent the majority of persons with COVID-19. 26 Our results are consistent with reports on enduring PASC in non-hospitalized patients, 27 including reports of fatigue as the most common PASC. 28 In our analyses, we observed that among persons with cardiac-related PASC symptoms, those who were hospitalized, 88% reported severe fatigue, lasting well over 6 months since recovery from acute COVID-19 infection.…”

“…25 Subsequently, evidence is emerging on the substantial burden of PASC among communitydwelling persons who represent the majority of persons with COVID-19. 26 Our results are consistent with reports on enduring PASC in non-hospitalized patients, 27 including reports of fatigue as the most common PASC. 28 22 The implications of these results include the substantial challenges for individual with PASC and increased utilization of already strained health resources, systems, and healthcare workers.…”

Evolution of neurologic symptoms in non‐hospitalized COVID‐19 “long haulers”

“… 42 Three to 8 months from onset, another study showed that 36% of non‐hospitalized COVID‐19 patients reported worsened health, while only 18% of SARS‐CoV‐2 − patients reported a similar deterioration, suggesting a long‐term burden of COVID‐19 that may last months beyond initial infection. 8 Altogether, our study patients displayed a greater symptom burden at follow‐up than other published reports. It is possible that patients who came to our clinic had more severe long‐COVID syndrome at baseline relative to the average non‐hospitalized “long hauler,” which influenced their decision to seek care.…”

“… 2 , 3 , 4 Neurologic manifestations of PASC (Neuro‐PASC) often occur in people who had mild initial respiratory symptoms and never required hospitalization for pneumonia or hypoxemia, known as COVID‐19 “long haulers.” 5 While most studies have focused on long‐COVID syndrome in previously hospitalized patients, most COVID‐19 patients have a mild initial presentation. However, there have been few investigations into long‐term effects of COVID‐19 in non‐hospitalized “long haulers.” 6 , 7 , 8 Additionally, while SARS‐CoV‐2 vaccination can reduce rates of COVID‐19 and death, its effect on long‐COVID syndrome remains unclear. 9 , 10 …”