Predictors of disease duration and symptom course of outpatients with acute covid-19: a retrospective cohort study

Abstract

Objective: To describe the symptom course in outpatients with coronavirus disease 2019 (COVID-19). Design: Retrospective chart review of standardized symptom checklist for patients followed at home by telephone calls during their acute COVID-19 illness. Compile results by day of illness into a single heatmap representation of symptoms. Setting: COVID-19 Virtual Outpatient Management Clinic (VOMC) in Atlanta, Georgia; a practice that follows patients with mild COVID-19 at home. Participants: 272 patients with confirmed COVID-19 by nasopharyngeal PCR, who presented to the VOMC within 10 days of symptom onset and within 5 days of screening PCR test. Main outcome measure: Each symptom is recorded as yes/no for each patient on each day. The total number of yes replies is divided by the total number of patients in VOMC to generate a result for each cell in the heatmap. Patients admitted to the hospital are censored from the denominator. Results: The mean duration of follow-up was 20.2 days. The most commonly reported symptoms in the course of illness were cough (83%), headache (73%) loss of smell or taste (71%), sinus congestion (71%), and body ache (67%). Symptoms remained common at 3 weeks, including cough (41%), shortness of breath on exertion (24%), loss of smell or taste (23%), sinus congestion (23%), and headache (20%). Conclusions: Symptoms of acute COVID-19 frequently last longer than the minimum duration of isolation and patients and healthcare providers should be aware that symptom resolution may be gradual.

Hyperventilation: A Possible Explanation for Long-Lasting Exercise Intolerance in Mild COVID-19 Survivors?

“…In contrast to hospitalized COVID-19 patients, conventional risk factors such as age and the presence of comorbidities do not seem to have an impact on the duration and severity of persistent symptoms. A study by O’Keefe et al (2020) analyzed 273 non-hospitalized patients recovering from COVID-19. Interestingly, the authors found no correlation between symptom duration and patient factors such as age or comorbidities.…”

Patient-Reported Health Outcomes After Treatment of COVID-19 with Nebulized and/or Intravenous Neutral Electrolyzed Saline Combined with Usual Medical Care Versus Usual Medical care alone: A Randomized, Open-Label, Controlled Trial.

“…Previous studies reported that the most common initial symptoms are systemic, upper respiratory and cough. Lower respiratory and gastrointestinal symptoms are less frequent and generally appear at the late stage of the disease [ 3 ]. The symptoms, if present, of longest duration are cough, loss of sense of smell or taste, sinus congestion, shortness of breath upon exertion, body aches, and headache [ 3 ].…”

“…Lower respiratory and gastrointestinal symptoms are less frequent and generally appear at the late stage of the disease [ 3 ]. The symptoms, if present, of longest duration are cough, loss of sense of smell or taste, sinus congestion, shortness of breath upon exertion, body aches, and headache [ 3 ]. A study about the time that COVID-19 patients required to achieve a usual state of health reported that sixty-five percent have returned to their usual state of health 7 days from the date of diagnosed, whereas 35% of patients had not returned to their usual state of health, 12–14 days after receiving a positive test result [ 4 ].…”

Current Data Gaps in Modeling Essential Worker Absenteeism Due to COVID-19

“…Two prepeer-reviewed studies with longitudinal follow-up for non-hospitalized patients revealed that, on average, symptoms in outpatients resolved after 3 weeks with a standard deviation of 1.25 weeks, not accounting for the possibility that an employee's symptoms could worsen, requiring hospitalization and extending his or her absence. 2,3 We have found no data nor proxy for estimating the recovery time after discharge, though we would expect that those hospitalized, especially those requiring intensive care, would need extensive time to recuperate prior to re-entering the workforce.…”