Symptoms persist in patients after acute COVID-19


Background: A large proportion of Italian patients with COVID-19 presented with symptoms, most commonly cough, fever, dyspnea, myalgias, anosmia, and gastrointestinal symptoms. Information is lacking on persistent symptoms after recovery.

Dr. Taylor Walker

Study design: Retrospective observational study.

Setting: Hospital system in Rome.

Synopsis: A postacute outpatient service for individuals discharged after recovery from COVID-19 was established. All patients who met World Health Organization criteria for discontinuation of quarantine (no fever for 3 consecutive days, improved symptoms, and two negative SARS-CoV-2 tests 24 hours apart) were offered a comprehensive medical assessment. Patients were asked to retrospectively recount the presence or absence of symptoms during the acute phase of COVID-19 and whether each symptom persisted at the time of the visit.

From April 21 to May 29, 2020, 179 patients were potentially eligible; 143 ultimately were included. During hospitalization, 72.7% of participants had evidence of interstitial pneumonia. Patients were assessed a mean of 60.3 days after onset of the first COVID-19 symptom. Only 18 (12.6%) were completely free of any COVID-19–related symptoms, 32% had one or two symptoms, and 55% had three or more. Worsened quality of life was observed among 44.1% of patients.

Bottom line: 87.4% of patients who had recovered from COVID-19 reported persistence of at least one symptom, particularly fatigue and dyspnea.

Citation: Carfi A et al. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324(6):603-5.

Dr. Walker is a hospitalist at the Lexington (Ky.) VA Health Care System.

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