General

COVID-19 Symptoms: Longitudinal Evolution and Persistence in Outpatient Settings 

Nehme M, Braillard O, Alcoba G, Aebischer Perone S, Courvoisier D, Chappuis F, Guessous I; COVICARE TEAM. Ann Intern Med. 2021 May;174(5):723-725. doi: 10.7326/M20-5926. Epub 2020 Dec 8. PMID: 33284676; PMCID: PMC7741180.

Of 30 557 persons tested in Geneva during the study period, 18.1% tested positive (n= 5534); 22.2% of these were hospitalized (n= 1229), and 703 enrolled in COVICARE follow-up. Out of the initial cohort, 669 persons were ultimately included. The mean age was 42.8 years (SD, 13.7); 60% of included patients were women, 24.6% were health care workers, and 68.8% had no underlying risk factors. Forty participants were hospitalized during the study period.
At 30 to 45 days (mean, 43 days) from diagnosis, at least 32% of the 669 originally included patients reported 1 or more symptoms. Fatigue, dyspnea, and loss of taste or smell were the main persistent symptoms. 

Link to study : COVID-19 Symptoms: Longitudinal Evolution and Persistence in Outpatient Setting 

Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting 

Nehme M, Braillard O, Chappuis F, Courvoisier DS, Guessous I; CoviCare Study Team. Ann Intern Med. 2021 Sep;174(9):1252-1260. doi: 10.7326/M21-0878. Epub 2021 Jul 6. PMID: 34224254; PMCID: PMC8280535.

Persons who were a part of the CoviCare program at the Geneva University Hospitals from 18 March to 15 May 2020 were followed up at 7-9 months from their infection. Self-reported surveys and semi-structured phone interviews were conducted to evaluate the longitudinal evolution and persistence of symptoms at 7-9 months from diagnosis.
Residual symptoms after SARS-CoV-2 infection were common among otherwise young and healthy persons followed in an outpatient setting. Of the 629 participants in the study who completed the baseline interviews, 410 completed follow-up at 7 to 9 months after COVID-19 diagnosis; 39.0% reported residual symptoms. Fatigue (20.7%) was the most common symptom reported, followed by loss of taste or smell (16.8%), dyspnea (11.7%), and headache (10.0%). 

Link to study : Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting

Sequelae in Adults at 6 Months After COVID-19 Infection

Logue JK, Franko NM, McCulloch DJ, McDonald D, Magedson A, Wolf CR, Chu HY. JAMA Netw Open. 2021 Feb 1;4(2):e210830. doi: 10.1001/jamanetworkopen.2021.0830. Erratum in: JAMA Netw Open. 2021 Mar 1;4(3):e214572. PMID: 33606031; PMCID: PMC7896197.

A total of 177 out of 234 participants with COVID-19 at the University of Washington, USA, completed a single follow-up questionnaire with a mean time from illness onset of 169 days (range 31-300). Participants had a mean [range] age, 48.0 [18-94] years; and 57.1% were women.
Overall, 6.2% were asymptomatic, 84.7% were outpatients with mild illness, and 9.0% had moderate or severe disease requiring hospitalization. Approximately 30% of participants reported persistent symptoms at 9 months from their infection. Fatigue was the most commonly reported symptom (14%), with worsened quality of life in 29% of outpatients.

Link to study : Sequelae in Adults at 6 Months After COVID-19 Infection

High-dimensional characterization of post-acute sequelae of COVID-19

Al-Aly Z, Xie Y, Bowe B. Nature. 2021 Jun;594(7862):259-264. doi: 10.1038/s41586-021-03553-9. Epub 2021 Apr 22. PMID: 33887749.

Using the national healthcare databases of the US Department of Veterans Affairs (73 435 users), 6-month outcomes of incident diagnoses were identified. People with COVID-19 had a higher risk of death (hazard ratio of 1.59 (1.46–1.73)) and use of health resources (hazard ratio of 1.20 (1.19–1.21)) beyond the first 30 days of illness. Several sequelae were observed: respiratory (excess burden of 28.51 (26.40–30.50)), neurologic (excess burden 14.32 (12.16–16.36)), metabolic disorders, cardiovascular disorders, gastrointestinal disorders, malaise, fatigue (excess burden 12.64 (11.24–13.93), musculoskeletal pain and anemia. 

Link to study : High-dimensional characterization of post-acute sequelae of COVID-19

Post-acute effects of SARS-CoV-2 infection in individuals not requiring hospital admission: a Danish population-based cohort study 

Lund LC, Hallas J, Nielsen H, Koch A, Mogensen SH, Brun NC, Christiansen CF, Thomsen RW, Pottegård A. Lancet Infect Dis. 2021 Oct;21(10):1373-1382. doi: 10.1016/S1473-3099(21)00211-5. Epub 2021 May 10. PMID: 33984263; PMCID: PMC8110209.

An evaluation of the Danish prescription, patient and health insurance registries (10 498 eligible individuals tested positive for SARS-CoV-2, of whom 8 983 were alive and not hospitalized 2 weeks after their positive test) showed that outpatients with COVID-19 were at increased risk of dyspnea, and venous thromboembolism with an overall increase in visits to their primary care physician (Relative risk RR 1·18 [95% CI 1·15-1·22]) and outpatient hospital visits (RR 1·10 [1·05-1·16]) compared with SARS-CoV-2 negative individuals. Outpatients tested positive for COVID-19 were not at an increased risk of initiating new drugs except bronchodilating agents, specifically short-acting β2-agonists (117 [1·7%] of 6 935 positive individuals vs 743 [1·3%] of 57 206 negative individuals; RR 1·32 [1·09-1·60]) and triptans (33 [0·4%] of 8 292 vs 198 [0·3%] of 72 828; RR 1·55 [1·07-2·25]).

Link to study : Post-acute effects of SARS-CoV-2 infection in individuals not requiring hospital admission: a Danish population-based cohort study