More than half of COVID-19 patients report persistent symptoms 12 months after infection

It has been 487 days since the index case or patient zero of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) occurred on December 1, 2019 in Wuhan, China. To date, the virus has spread worldwide, infecting over 138 million people and claiming the lives of over 2.97 million.

Over 78 million people have recovered. However, many patients report the persistence of some symptoms of SARS-CoV-2 infection, including cough, insomnia, headaches, and body aches.

In a new study published on the pre-print server medRxiv *, researchers from the University of Trieste and the Istituto Auxologico Italiano IRCCS in Italy report that more than half of patients with previous mild to moderate symptomatic COVID-19 have the Persistence complained of at least one symptom 12 months after the onset of the disease.

Persistent symptoms

SARS-CoV-2 can spread via respiratory droplets or aerosols and cause a variety of symptoms.

The most common symptoms are fever, cough, sore throat, loss of smell and taste, headache, body pain, and difficulty breathing. Although most infected people develop mild to moderate symptoms, some can develop severe illness.

As the pandemic developed, doctors observed that some symptoms may last long in some of the patients who had recovered from the acute phase of infection. Persistent symptoms can affect the lives of “long distance riders”. This term describes patients who continue to experience COVID-19 symptoms after they have recovered. The condition is also known as chronic COVID, chronic COVID syndrome, and long-term COVID.

An increasing number of studies have focused on long-term COVID, but these mainly focus on previously hospitalized severe COVID-19 patients who reported symptoms up to six months after infection. However, the current study aimed to assess the prevalence of COVID-19-related symptoms one year after the onset of mild to moderate illness.

The figure shows the percentage of patients with COVID-19-related symptoms during the acute phase of illness (blue) and after 12 months (orange) according to severity (mild = mild;

The figure shows the percentage of patients with COVID-19-related symptoms during the acute phase of the disease (blue) and after 12 months (orange) according to severity (light = mild; dark = severe).

Long COVID in light to moderate patients

To arrive at the study results, the researchers conducted a prospective study of mild to moderate symptomatic adult patients who tested positive for SARS-CoV-2 RNA from March 1 to 31, 2020 at the Cattinara University Hospital, Trieste, Italy were made by polymerase chain reaction (PCR).

Initially, all patients with mild to moderate symptoms were isolated at home. Patients have mild symptoms when they have less severe clinical symptoms with no signs of pneumonia. These patients do not require hospitalization.

Of the 304 patients who completed the survey at the start of the study and in the follow-up interview, 161 or 53 percent of the patients stated that at least one symptom persists after 12 months. The most common symptom reported was tiredness or fatigue, followed by an impaired sense of smell and taste, difficulty breathing or shortness of breath, and muscle pain.

Women aged 40 to 54, women with a body mass index (BMI) over 30, and women with more symptoms during the acute infection phase were more likely to have long-term COVID.

People with long-term COVID can have a significant impact on their quality of life and depression scale scores. The quality of life was clearly impaired by fatigue, shortness of breath and insomnia. Meanwhile, fatigue had a significant impact on the depression scale.

The researchers conclude: “Our study shows that more than half of patients with mild to moderate illness can detect persistent symptoms of SARS-CoV-2 infection for more than 12 months after the onset of the illness. Identifying patients at risk for prevention and treatment is critical to improving outcomes and reducing healthcare costs. Finally, a structured and validated questionnaire for assessing symptoms in COVID-19 patients is highly desirable in order to characterize the full clinical spectrum of long COVID and to improve the reliability and reproducibility of clinical studies. “


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