Symptoms of COVID-19 Outpatients in the United States

Pullen, Matthew F; Skipper, Caleb P; Hullsiek, Kathy Huppler; Bangdiwala, Ananta S; Pastick, Katelyn A; Okafor, Elizabeth C; Lofgren, Sarah M; Rajasingham, Radha; Engen, Nicole; Galdys, Alison; Williams, Darlisha A; Abassi, Mahsa; Boulware, David R.

doi:10.1093/ofid/ofaa271

Cited by 47 publications

(62 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While a great number of published studies focus on inpatient COVID-19 clinical presentation and outcome, 7 , 8 far fewer address the symptoms and disease course of the community outpatient population. 9 Although the number of symptoms did not differ between the outpatient and hospital populations in our study, diarrhea, rhinitis as well as taste and smell disturbances were much more common in outpatients than in the hospital—similar to what was reported in a study from the USA. 10 A possible reason could be a lack of questioning for minor symptoms at hospital admission or their omission in the discharge records, as versus the MHS record of daily telephone questioning about symptoms in the outpatient setting.…”

Section: Discussionsupporting

confidence: 89%

COVID-19 community care in Israel—a nationwide cohort study from a large health maintenance organization

David¹,

Cohen²,

Karplus³

et al. 2021

Journal of Public Health

View full text Add to dashboard Cite

Background Among the many medical challenges presented by the COVID-19 pandemic, management of the majority of patients in community outpatient settings is crucial. The aim of this study was to describe the characteristics and outcomes among confirmed COVID-19 cases who were managed at three settings: two outpatient settings and one inpatient. Methods A retrospective database cohort study was conducted in a large Israeli Health Maintenance Organization. All COVID-19 cases diagnosed between 28 February 2020 and 20 July 2020 were included. Cases in the community settings were managed through a nationwide remote monitoring center, using preliminary telehealth triage and 24/7 virtual care. Outcome parameters included hospital admission, disease severity, need for respiratory support and mortality. Results About 5448 cases, aged range 0–97 years, were enrolled; 88.7% were initially managed as outpatient either at home or in designated hotels, 3.1 and 2.1% of them, respectively, later required hospitalization. The main reason for hospitalization was dyspnea; 12 were diagnosed with severe disease; 56 patients (1.3%) died, five (0.1%) of whom were initially allocated to the outpatient settings. Conclusions Care for appropriately selected COVID-19 patients in the community provides a safe and effective option. This can contribute to reducing the hospitalization burden, with no evidence of increased morbidity or mortality.

show abstract

Section: Discussionsupporting

confidence: 89%

COVID-19 community care in Israel—a nationwide cohort study from a large health maintenance organization

David¹,

Cohen²,

Karplus³

et al. 2021

Journal of Public Health

View full text Add to dashboard Cite

show abstract

“…7 8 Although the duration of home isolation is defined based on symptoms, 7 understanding of the symptom course of outpatients with COVID-19 is limited and most reports include presenting symptoms alone or cross-sectional follow-up information. 9–18 Predictors of individual symptom duration have not been described.…”

Section: Introductionmentioning

confidence: 99%

Description of symptom course in a telemedicine monitoring clinic for acute symptomatic COVID-19: a retrospective cohort study

et al. 2021

View full text Add to dashboard Cite

ObjectiveDescribe the disease course in a cohort of outpatients with COVID-19 and evaluate factors predicting duration of symptoms.DesignRetrospective cohort study.SettingTelemedicine clinic at a large medical system in Atlanta, Georgia.Participants337 patients with acute COVID-19. Exclusion criteria included intake visit more than 10 days after symptom onset and hospitalisation prior to intake visit.Main outcome measuresSymptom duration in days.ResultsCommon symptoms at intake visit are upper respiratory (73% cough, 55% loss of smell or taste, 57% sinus congestion, 32% sore throat) and systemic (66% headache, 64% body aches, 53% chills, 30% dizziness, 36% fever). Day of symptom onset was earliest for systemic and upper respiratory symptoms (median onset day 1 for both), followed by lower respiratory symptoms (day 3, 95% CI 2 to 4), with later onset of gastrointestinal symptoms (day 4, 95% CI 3 to 5), when present. Cough had the longest duration when present with median 17 days (95% CI 15 to 21), with 42% not resolved at final visit. Loss of smell or taste had the second longest duration with 14 days (95% CI 12 to 17), with 38% not resolved at final visit. Initial symptom severity is a significant predictor of symptom duration (p<0.01 for multiple symptoms).ConclusionsCOVID-19 illness in outpatients follows a pattern of progression from systemic symptoms to lower respiratory symptoms and persistent symptoms are common across categories. Initial symptom severity is a significant predictor of disease duration for most considered symptoms.

show abstract

“…[7,8] Although the duration of home isolation is defined based on symptoms, [7] understanding of the symptom course of outpatients with covid-19 is limited and most reports include presenting symptoms alone or cross-sectional follow-up information. [9][10][11][12][13][14][15][16][17] Longitudinal symptom data and predictors of individual symptom duration have not been described.…”

Section: Introductionmentioning

confidence: 99%

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

O’Keefe

Tong

O’Keefe

et al. 2020

Preprint

View full text Add to dashboard Cite

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.

show abstract

Symptoms of COVID-19 Outpatients in the United States

Cited by 47 publications

References 8 publications

COVID-19 community care in Israel—a nationwide cohort study from a large health maintenance organization

COVID-19 community care in Israel—a nationwide cohort study from a large health maintenance organization

Description of symptom course in a telemedicine monitoring clinic for acute symptomatic COVID-19: a retrospective cohort study

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

Contact Info

Product

Resources

About