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Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study #MMPMID34027514
Augustin M; Schommers P; Stecher M; Dewald F; Gieselmann L; Gruell H; Horn C; Vanshylla K; Cristanziano VD; Osebold L; Roventa M; Riaz T; Tschernoster N; Altmueller J; Rose L; Salomon S; Priesner V; Luers JC; Albus C; Rosenkranz S; Gathof B; Fatkenheuer G; Hallek M; Klein F; Suarez I; Lehmann C
Lancet Reg Health Eur 2021[Jul]; 6 (?): 100122 PMID34027514show ga
BACKGROUND: While the leading symptoms during coronavirus disease 2019 (COVID-19) are acute and the majority of patients fully recover, a significant fraction of patients now increasingly experience long-term health consequences. However, most data available focus on health-related events after severe infection and hospitalisation. We present a longitudinal, prospective analysis of health consequences in patients who initially presented with no or minor symptoms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. Hence, we focus on mild COVID-19 in non-hospitalised patients. METHODS: 958 Patients with confirmed SARS-CoV-2 infection were observed from April 6th to December 2nd 2020 for long-term symptoms and SARS-CoV-2 antibodies. We identified anosmia, ageusia, fatigue or shortness of breath as most common, persisting symptoms at month 4 and 7 and summarised presence of such long-term health consequences as post-COVID syndrome (PCS). Predictors of long-term symptoms were assessed using an uni- and multivariable logistic regression model. FINDINGS: We observed 442 and 353 patients over four and seven months after symptom onset, respectively. Four months post SARS-CoV-2 infection, 8*6% (38/442) of patients presented with shortness of breath, 12*4% (55/442) with anosmia, 11*1% (49/442) with ageusia and 9*7% (43/442) with fatigue. At least one of these characteristic symptoms was present in 27*8% (123/442) and 34*8% (123/353) at month 4 and 7 post-infection, respectively. A lower baseline level of SARS-CoV-2 IgG, anosmia and diarrhoea during acute COVID-19 were associated with higher risk to develop long-term symptoms. INTERPRETATION: The on-going presence of either shortness of breath, anosmia, ageusia or fatigue as long-lasting symptoms even in non-hospitalised patients was observed at four and seven months post-infection and summarised as post-COVID syndrome (PCS). The continued assessment of patients with PCS will become a major task to define and mitigate the socioeconomic and medical long-term effects of COVID-19. FUNDING: COVIM:"NaFoUniMedCovid19"(FKZ: 01KX2021).
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Lancet+Reg+Health+Eur 2021 ; 6 (?): 100122
