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

Tenforde, Mark W; Kim, Sara S.; Lindsell, Christopher J.; Rose, Erica Billig; Shapiro, Nathan I.; Files, D. Clark; Gibbs, Kevin W.; Erickson, Heidi L.; Steingrub, Jay S.; Smithline, Howard; Gong, Michelle N.; Aboodi, Michael S.; Exline, Matthew C.; Henning, Daniel J.; Wilson, Jennifer G.; Khan, Akram; Qadir, Nida; Brown, Samuel M.; Peltan, Ithan D.; Rice, Todd W.; Hager, David N.; Ginde, Adit A.; Stubblefield, William B; Patel, Manish; Self, Wesley H.; Feldstein, Leora R.; Hart, Kimberly W.; McClellan, R. Trigg; Dorough, Layne; Dzuris, Nicole; Griggs, Eric P.; Kassem, Ahmed M.; Marcet, Paula L.; Ogokeh, Constance; Sciarratta, Courtney N.; Siddula, Akshita; Smith, Emily; Wu, Michael

doi:10.15585/mmwr.mm6930e1

Cited by 1,115 publications

(1,215 citation statements)

References 8 publications

(9 reference statements)

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“…This percentage is lower than that cited in many published observational studies,89 whose denominator populations were those admitted to hospital or attending specialist clinics. A recent US study found that only 65% of people had returned to their previous level of health 14-21 days after a positive test 10…”

Section: Defining Post-acute Covid-19mentioning

confidence: 99%

Management of post-acute covid-19 in primary care

Greenhalgh

Knight

A’Court

et al. 2020

BMJ

1,258

1,240

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Section: Defining Post-acute Covid-19mentioning

confidence: 99%

Management of post-acute covid-19 in primary care

Greenhalgh

Knight

A’Court

et al. 2020

BMJ

1,258

1,240

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“…But this attitude was cavalier. A multistate US survey found that about a quarter of people with symptomatic covid-19 aged 18-34 years develop post-acute covid,7 a potentially disabling illness that can cause severe complications 89. One regional US college football competition was cancelled after at least 15 healthy student players developed covid related myocarditis 10…”

mentioning

confidence: 99%

Covid-19: re-opening universities is high risk

Yamey

Walensky²

2020

BMJ

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“…patients required to achieve a usual state of health reported that sixty-ve 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]. Although most infections are self-limited, an estimated 15% of infected adults develop severe pneumonia that requires treatment with supplemental oxygen and hospitalization [5].…”

mentioning

confidence: 99%

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.

Delgado‐Enciso

Paz-Garcia²,

Barajas-Saucedo

et al. 2020

Preprint

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Background: Coronavirus disease (COVID-19) is currently the main public health problem worldwide. The administration of neutral electrolyzed saline, a solution that contains reactive species of chlorine and oxygen (ROS), may be an effective therapeutic alternative due to its immunomodulating characteristics, in systemic inflammation control, as well as in immune response improvement, promoting control of the viral infection. The present study evaluated the efficacy of treatment with intravenous and/or nebulized neutral electrolyzed saline combined with usual medical care versus usual medical care alone, in ambulatory patients with COVID-19.Methods: A prospective, 2-arm, parallel group, randomized, open-label, phase I-II clinical trial included 39 patients in the control group (usual medical care alone) and 45 patients in the experimental group (usual medical care + intravenous and/or nebulized electrolyzed saline, with dose escalation). Two aspects were evaluated during the twenty-day follow-up: i) the number of patients with disease progression (hospitalization or death); and ii) the Patient Acceptable Symptom State (PASS), a single-question outcome that determines patient well-being thresholds for pain and function. Biochemical and hematologic parameters, as well as adverse effects, were evaluated in the experimental group. Results: The experimental treatment decreased the risk for hospitalization by 92% (adjusted RR=0.08, 95% CI: 0.01-0.50, P=0.007), with a 43-fold increase in the probability of achieving an acceptable symptom state on day 5 (adjusted RR= 42.96, 95% CI: 9.22-200.0, P<0.001). Intravenous + nebulized administration was better than nebulized administration alone, but nebulized administration was better than usual medical care alone. Clinical improvement correlated with a decrease in C-reactive protein, and aberrant monocytes and an increase of lymphocytes, and platelets. Cortisol and testosterone levels were also evaluated, observing a decrease in cortisol levels and an increment of testosterone-cortisol ratio, on days 2 and 4. Conclusions: The experimental treatment produced no serious adverse effects. In conclusion, intravenous and/or nebulized neutral electrolyzed saline importantly reduced the symptomatology and risk of progression (hospitalization and death), in ambulatory patients with COVID-19.Trial registration: Cuban Public Registry of Clinical Trials (RPCEC) Database RPCEC00000309. Registered: 05. May 2020. https://rpcec.sld.cu/en/trials/RPCEC00000309-En

show abstract

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

Cited by 1,115 publications

References 8 publications

Management of post-acute covid-19 in primary care

Management of post-acute covid-19 in primary care

Covid-19: re-opening universities is high risk

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.

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