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Study: After COVID-19, Symptoms Persist for Majority of Patients


JAMA: After recovery from COVID-19, a majority of patients reported persistence of at least 1 symptom; more than half reported ≥3 symptoms.

Symptoms persist after COVID-19 Recovery


Among patients who had recovered from COVID-19, 87.4% reported persistence of at least 1 symptom, according to a research letter published online in the Journal of the American Medical Association.

At a mean of 60 days after hospital discharge, the 2 most prominent ongoing symptoms reported were fatigue and dyspnea.

Researchers from the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy, established a postacute outpatient service for patients discharged from hospital after recovering from COVID-19. Beginning on April 21, 2020, follow-up was conducted of all patients who met World Health Organization criteria for discontinuation of quarantine. Patients testing negative for SARS-CoV2 at enrollment were included in the study.

WHO Criteria for Ending Quarantine

* No fever for 3 consecutive days

* Improvement in other symptoms

* 2 negative test results for SARS-CoV2,
24 hours apart

A total of 143 patients were included; average age was 56.5 years (19-84 years) and 37% were women. Mean length of inpatient stay was 13.5 days; 72.7% of participants had evidence of interstitial pneumonia during hospitalization; 15% received noninvasive ventilation and 5% received invasive ventilation.

At study assessment (mean 60.3days after onset of first COVID-19 symptom):

* 12.6% were completely free of any COVID-19–related symptom

* 32% had 1 or 2 symptoms

* 55% had 3 or more

No patient had fever or any signs or symptoms of acute infection. Worsened quality of life, measured using the EuroQol visual analog scale, was observed among 44.1% of patients.

A high proportion of individuals continued to report:

* Fatigue 53.1%

* Dyspnea 43.4%

* Joint pain 27.3%

* Chest pain 21.7%

The authors acknowledge that focus on the acute phase of COVID-19 should be primary for clinicians and researchers but that ongoing monitoring after hospital discharge is needed to begin understanding the potential long-term effects of the infection.

Limitations to the study, the authors note, include absence of information on symptom history before acute COVID-19 and lack of details on symptom severity. They study also was conducted at a single site and with a relatively small group of participants without a control group of patients discharged who had other diagnoses.

Community acquired pneumonia is also associated with persistent symptoms and so the findings may not be exclusive to COVID-19, they said.

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