Post-acute COVID-19 syndrome negatively impacts health and wellbeing despite less severe acute infection

  1. Laura Tabacof
  2. Jenna Tosto-Mancuso
  3. Jamie Wood
  4. Mar Cortes
  5. Amy Kontorovich
  6. Dayna McCarthy
  7. Dahlia Rizk
  8. Nicki Mohammadi
  9. Erica Breyman
  10. Leila Nasr
  11. Christopher Kellner
  12. David Putrino

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

Introduction

One of the noted features of COVID-19 is the spectrum of expressivity in symptoms among those with the disease, ranging from no or mild symptoms that may last a small number of days, to severe and/or longer lasting symptoms. It is emerging that many patients have long lasting symptoms, several months after initial infection with COVID-19. The aim of this research was to characterize post-acute COVID-19 syndrome (PACS).

Methods

This was a retrospective cross-sectional observational study. Participants were patients recovering from COVID-19 infection, enrolled in Mount Sinai Hospital’s COVID-19 Precision Recovery Program (PRP). Inclusion criteria were confirmed or probable (based on World Health Organization criteria) initial diagnosis of COVID-19; post-acute COVID-19 syndrome (defined as experiencing symptoms > 6 weeks since acute symptom onset) and being currently enrolled in the PRP during the months of July and August 2020. Study survey data were collected using REDCap. Demographic data, COVID-19 clinical data and patient-reported outcomes for breathlessness (Medical Research Council Breathlessness Scale), fatigue and quality of life (EuroQoL 5D-5L) were collected.

Results

84 individuals with PACS were included. Symptoms persisted at mean (range) 151 (54 to 255) days. The most prevalent persistent symptoms were fatigue (92%), loss of concentration/memory (74%), weakness (68%), headache (65%) and dizziness (64%). Most participants reported increased levels of disability associated with breathlessness, increased fatigue and reduced quality of life.

Conclusions

Persistent symptoms following COVID-19 infection are prevalent, debilitating and appear to affect individuals regardless of acute infection severity or prior health status. More detailed research is required in order to identify specific symptom clusters associated with PACS, and to devise effective interventional strategies.

Article activity feed

  1. ScreenIT

    SciScore for 10.1101/2020.11.04.20226126: (What is this?)

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

    Table 1: Rigor

    Institutional Review Board StatementConsent: Inclusion criteria were confirmed or probable (i.e. confirmed by a medical doctor in accordance with World Health Organization recommendations [WHO] [10]) initial diagnosis of COVID-19; PACS (defined as experiencing symptoms > 6 weeks since initial symptom onset); and provision of consent for clinical data to be used for research purposes.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Data collection and Outcomes: Study data were collected and managed using REDCap (Research Electronic Data Capture) electronic data capture tools hosted at Mount Sinai Health System
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    Statistical analyses: Statistical analyses were undertaken with Stata (StataCorp, Stata Statistical Software Release: V.14).
    StataCorp
    suggested: (Stata, RRID:SCR_012763)

    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: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    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.

  2. Version published to 10.1101/2020.11.04.20226126v1 on medRxiv