Characterization of Prolonged COVID-19 Symptoms in an Outpatient Telemedicine Clinic

  1. Michele Cellai
  2. James B O’Keefe

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Abstract

We identified patients with coronavirus disease 2019 in a telemedicine clinic who requested ongoing follow-up calls 6 weeks after symptom onset. In this group, respiratory symptoms are the most common complaints, asthma and lung disease are frequent comorbidities, and patients often have not returned to work or usual activity.

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  1. Version published to 10.1093/ofid/ofaa420
  2. ScreenIT

    SciScore for 10.1101/2020.07.05.20146886: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board Statementnot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Symptom results were analyzed in Microsoft Excel using descriptive statistics.
    Microsoft Excel
    suggested: (Microsoft Excel, RRID:SCR_016137)
    Comparison between prolonged symptom group and the rest of the VOMC were conducted with Fisher’s exact test using SPSS version 26 (IBM).
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The majority of patients had specific documentation of difficulty with usual activity and/or work due to functional limitation, with only 26.5% demonstrating a return to baseline health. We found, however, that most patients had an improving symptom course in the 6th week of symptoms. In this cohort, the majority of patients sought further evaluation for their symptoms, with only one patient identified to have a non-COVID-19 alternate diagnosis. Importantly, in patients evaluated for persistent symptoms, a contributing atopic diagnosis or chronic lung disease was often suspected, which lead to specific directed treatments. This possible association is also suggested by comparison of comorbidities between the prolonged symptom group and the overall VOMC cohort (table 2): the incidence of asthma and chronic lung disease (coded at intake visit) were more frequent in the persistent symptom cohort. Anecdotally, we note that many providers report that inhaled bronchodilators and corticosteroids are effective for prolonged COVID-19 symptoms (see video: https://youtu.be/ecPjhdVf41k) and our findings in this report strengthen the case for further research. While respiratory symptoms (cough, dyspnea on exertion, and other) are most common, a variety of symptoms may present across organ systems including neurologic, cardiac, and gastrointestinal. These manifestations merit further investigation as possible evidence of organ-specific dysfunction caused by “mild” COVID-19 in outpatients.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.07.05.20146886v1 on medRxiv