1887
  1. Home
  2. Eurosurveillance
  3. Volume 26, Issue 43, 28/Oct/2021
  4. Article
Research Open Access
Like 0
Download

Abstract

Background

Detailed information on symptom duration and temporal course of patients with mild COVID-19 was scarce at the beginning of the COVID-19 pandemic.

Aim

We aimed to determine the longitudinal course of clinical symptoms in non-hospitalised COVID-19 patients in Berlin, Germany.

Methods

Between March and May 2020, 102 confirmed COVID-19 cases in home isolation notified in Berlin, Germany, were sampled using total population sampling. Data on 25 symptoms were collected during telephone consultations (a maximum of four consultations) with each patient. We collected information on prevalence and duration of symptoms for each day of the first 2 weeks after symptom onset and for day 30 and 60 after symptom onset.

Results

Median age was 35 years (range 18–74), 57% (58/102) were female, and 37% (38/102) reported having comorbidities. During the first 2 weeks, most common symptoms were malaise (94%, 92/98), headache (71%, 70/98), and rhinitis (69%, 68/98). Malaise was present for a median of 11 days (IQR 7–14 days) with 35% (34/98) of cases still reporting malaise on day 14. Headache and muscle pain mostly occurred during the first week, whereas dysosmia and dysgeusia mostly occurred during the second week. Symptoms persisted in 41% (39/95) and 20% (18/88) of patients on day 30 and 60, respectively.

Conclusion

Our study shows that a significant proportion of non-hospitalised COVID-19 cases endured symptoms for at least 2 months. Further research is needed to assess the frequency of long-term adverse health effects in non-hospitalised COVID-19 patients.

© Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Loading

Article metrics loading...

/content/10.2807/1560-7917.ES.2021.26.43.2001757
2021-10-28
2024-12-31
/content/10.2807/1560-7917.ES.2021.26.43.2001757
Loading
Loading full text...

Full text loading...

/deliver/fulltext/eurosurveillance/26/43/eurosurv-26-43-3.html?itemId=/content/10.2807/1560-7917.ES.2021.26.43.2001757&mimeType=html&fmt=ahah

References

  1. Cummings MJ, Baldwin MR, Abrams D, Jacobson SD, Meyer BJ, Balough EM, et al. Epidemiology, clinical course, and outcomes of critically ill adults with COVID-19 in New York City: a prospective cohort study. Lancet. 2020;395(10239):1763-70.  https://doi.org/10.1016/S0140-6736(20)31189-2  PMID: 32442528 
  2. Karagiannidis C, Mostert C, Hentschker C, Voshaar T, Malzahn J, Schillinger G, et al. Case characteristics, resource use, and outcomes of 10 021 patients with COVID-19 admitted to 920 German hospitals: an observational study. Lancet Respir Med. 2020;8(9):853-62.  https://doi.org/10.1016/S2213-2600(20)30316-7  PMID: 32735842 
  3. Yang R, Gui X, Xiong Y. Patients with respiratory symptoms are at greater risk of COVID-19 transmission. Respir Med. 2020;165:105935.  https://doi.org/10.1016/j.rmed.2020.105935  PMID: 32308203 
  4. Augustin M, Schommers P, Stecher M, Dewald F, Gieselmann L, Gruell H, et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur. 2021;6:100122.  https://doi.org/10.1016/j.lanepe.2021.100122  PMID: 34027514 
  5. Blomberg B, Mohn KG-I, Brokstad KA, Zhou F, Linchausen DW, Hansen B-A, et al. Long COVID in a prospective cohort of home-isolated patients. Nat Med. 2021;27(9):1607-13.  https://doi.org/10.1038/s41591-021-01433-3  PMID: 34163090 
  6. Goërtz YMJ, Van Herck M, Delbressine JM, Vaes AW, Meys R, Machado FVC, et al. Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome? ERJ Open Res. 2020;6(4):00542-2020.  https://doi.org/10.1183/23120541.00542-2020  PMID: 33257910 
  7. Johnsen S, Sattler SM, Miskowiak KW, Kunalan K, Victor A, Pedersen L, et al. Descriptive analysis of long COVID sequelae identified in a multidisciplinary clinic serving hospitalised and non-hospitalised patients. ERJ Open Res. 2021;7(3):00205-2021.  https://doi.org/10.1183/23120541.00205-2021  PMID: 34345629 
  8. Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, Á Steig B, Gaini S, et al. Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients. Clin Infect Dis. 2020;ciaa1792.  https://doi.org/10.1093/cid/ciaa1792  PMID: 33252665 
  9. Stavem K, Ghanima W, Olsen MK, Gilboe HM, Einvik G. Persistent symptoms 1.5-6 months after COVID-19 in non-hospitalised subjects: a population-based cohort study. Thorax. 2021;76(4):405-7.  https://doi.org/10.1136/thoraxjnl-2020-216377  PMID: 33273028 
  10. Lauritsen JM, Bruus M. EpiData (version 3.1). A comprehensive tool for validated entry and documentation of data. The EpiData Association. [Accessed: 1 Mar 2020]. Available from: https://epidata.dk
  11. Bundesministerium der Justiz und für Verbraucherschutz (BMJV). Gesetz zur Verhütung und Bekämpfung von Infektionskrankheiten beim Menschen (Infektionsschutzgesetz - IfSG). [Act for the prevention and control of human infectious diseases (Protection against infection act)]. Berlin: BMJV; 2020. German. Available from: https://www.gesetze-im-internet.de/ifsg/
  12. Shen Y, Zheng F, Sun D, Ling Y, Chen J, Li F, et al. Epidemiology and clinical course of COVID-19 in Shanghai, China. Emerg Microbes Infect. 2020;9(1):1537-45.  https://doi.org/10.1080/22221751.2020.1787103  PMID: 32573353 
  13. Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. Clinical Characteristics of Coronavirus Disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.  https://doi.org/10.1056/NEJMoa2002032  PMID: 32109013 
  14. Wang D, Yin Y, Hu C, Liu X, Zhang X, Zhou S, et al. Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China. Crit Care. 2020;24(1):188.  https://doi.org/10.1186/s13054-020-02895-6  PMID: 32354360 
  15. Tostmann A, Bradley J, Bousema T, Yiek WK, Holwerda M, Bleeker-Rovers C, et al. Strong associations and moderate predictive value of early symptoms for SARS-CoV-2 test positivity among healthcare workers, the Netherlands, March 2020. Euro Surveill. 2020;25(16):2000508.  https://doi.org/10.2807/1560-7917.ES.2020.25.16.2000508  PMID: 32347200 
  16. Sudre CH, Lee KA, Lochlainn MN, Varsavsky T, Murray B, Graham MS, et al. Symptom clusters in COVID-19: A potential clinical prediction tool from the COVID Symptom Study app. Sci Adv. 2021;7(12):eabd4177.  https://doi.org/10.1126/sciadv.abd4177  PMID: 33741586 
  17. Struyf T, Deeks JJ, Dinnes J, Takwoingi Y, Davenport C, Leeflang MM, et al. Signs and symptoms to determine if a patient presenting in primary care or hospital outpatient settings has COVID-19 disease. Cochrane Database Syst Rev. 2020;7:CD013665. PMID: 32633856 
  18. European Centre for Disease Prevention and Control (ECDC). Case definition for coronavirus disease 2019 (COVID-19). Stockholm: ECDC. [Accessed: 1 Mar 2020]. Available from: https://www.ecdc.europa.eu/en/covid-19/surveillance/case-definition
  19. European Centre for Disease Prevention and Control (ECDC). Guidance for discharge and ending isolation in the context of widespread community transmission of COVID-19. Stockholm: ECDC. 8 April 2020. Available from: https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-guidance-discharge-and-ending-isolation-first%20update.pdf
  20. Ferrucci R, Dini M, Groppo E, Rosci C, Reitano MR, Bai F, et al. Long-Lasting Cognitive Abnormalities after COVID-19. Brain Sci. 2021;11(2):235.  https://doi.org/10.3390/brainsci11020235  PMID: 33668456 
  21. Hugon J, Msika EF, Queneau M, Farid K, Paquet C. Long COVID: cognitive complaints (brain fog) and dysfunction of the cingulate cortex. J Neurol. 2021;1-3. PMID: 34143277 
  22. Carfì A, Bernabei R, Landi F, Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603-5.  https://doi.org/10.1001/jama.2020.12603  PMID: 32644129 
  23. Tenforde MW, Kim SS, Lindsell CJ, Billig Rose E, Shapiro NI, Files DC, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network - United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(30):993-8.  https://doi.org/10.15585/mmwr.mm6930e1  PMID: 32730238 
  24. Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Post-discharge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J Med Virol. 2020.
  25. Mahase E. Covid-19: What do we know about "long covid"? BMJ. 2020;370:m2815.  https://doi.org/10.1136/bmj.m2815  PMID: 32665317 
  26. Federal Ministry of Health. Verordnung zum Anspruch auf bestimmte Testungen für den Nachweis des Vorliegens einer Infektion mit dem Coronavirus SARS-CoV-2. [Ordinance on the right to certain tests to prove the presence of an infection with the SARS-CoV-2 coronavirus]. Berlin: Federal Ministry of Health. 8 Jun 2020. German. Available from: https://www.bundesanzeiger.de/pub/publication/tStb7Z9SHEGX5Lep0Ha/content/tStb7Z9SHEGX5Lep0Ha/BAnz%20AT%2009.06.2020%20V1.pdf?inline
A longitudinal study on symptom duration and 60-day clinical course in non-hospitalised COVID-19 cases in Berlin, Germany, March to May, 2020
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Neil+J.+Saad&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Saad Neil J.</a>, <a href="/search?value1=Felix+Moek&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Moek Felix</a>, <a href="/search?value1=Fabienne+Steitz&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Steitz Fabienne</a>, <a href="/search?value1=Lukas+Murajda&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Murajda Lukas</a>, <a href="/search?value1=Till+B%C3%A4rnighausen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Bärnighausen Till</a>, <a href="/search?value1=Thomas+Zoller&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Zoller Thomas</a>, <a href="/search?value1=Kirsten+P%C3%B6rtner&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pörtner Kirsten</a>, <a href="/search?value1=Nadine+Muller&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Muller Nadine</a></span>. A longitudinal study on symptom duration and 60-day clinical course in non-hospitalised COVID-19 cases in Berlin, Germany, March to May, 2020. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(43):pii=2001757. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.43.2001757" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.43.2001757</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 05 Oct 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 13 Apr 2021 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.43.2001757
/content/10.2807/1560-7917.ES.2021.26.43.2001757
Loading

Data & Media loading...

Supplementary data

Submit comment
Close
Comment moderation successfully completed
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error