Acute COVID-19: The Persistent Symptoms of Previously Infected Patients

As COVID-19 swept the globe in early 2020, none were more immediately impacted and dramatically affected at the time than Italy. A large portion of patients infected with SARS-CoV-2 in Italy presented with symptoms. In fact, about 71.4 percent of the 31,845 cases by June 3, 2020, were fraught with common symptoms like fever, musculoskeletal symptoms, dyspnea, cough, anosmia, and more.

That being said, the actual information on the symptoms that persisted after recovery is lacking—there’s little to no research that explains the persistent symptoms that remained after SARS-CoV-2 recovery.

In this evaluation, a report published on the JAMA Network takes an in-depth look at the continued symptoms of patients previously infected with SARS-CoV-2 who were discharged from the hospital prior to their recovery from COVID-19.

Assessing Persistent Symptoms: The Methodology

At the end of April 2020, the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, Italy established an outpatient service in Rome, Italy for patients who were discharged from the hospital after recovery from COVID-19.

All patients who met WHO’s criteria for discontinuation of quarantine were followed up. Data on all clinical characteristics, including clinical and pharmacological history, vaccination status, body measurements, and more were collected in the COVID-10 post-acute outpatient service.

Patients who were enrolled in this service were required to answer a standardized questionnaire and asked to retrospectively recount the presence or absence of symptoms during the acute phase of COVID-19—and further, to discuss whether each system presided at the time of the visit. The questionnaire made it available for more than 1 symptom to be listed.

The Results You Need to Know

So, what happened? Of the 179 patients who were potentially eligible for the follow-up post-acute care assessment from April 21- May 29, 2020, 14 people (8 percent of the 179) refused to participate and 22 had positive test results.

Only 143 patients were included, of them, the mean age was 56.5 years (the ages ranged from 19-84), 53 of them were women, and during hospitalization, 727.7 percent of them had evidence of interstitial pneumonia.

Of the 143 patients, the mean length of hospital stay was about 13.5 days, and of them, 21 patients received noninvasive ventilation while 7 patients received invasive ventilation.

After a mean of 60.3  days prior to the onset of the first COVID-19 symptom, only about 18 were completely free of any COVID-19 symptoms. About 32 percent of patients had 1 or 2 symptoms and about 55 percent had 3 or more.

The study ended up establishing that, of the patients who had recovered from COVID-19, about 87.4 percent of them reported persistence of at least 1 symptom—particularly fatigue and dyspnea. This single-center study examined a relatively small number of patients without a control group of patients discharged for other reasons, so it’s important to remember these findings might not be exclusive to COVID-19.