The other COVID ‐19 survivors: Timing, duration, and health impact of post‐acute sequelae of SARS‐CoV ‐2 infection

  1. Natalie Lambert
  2. Survivor Corps
  3. Sarah A. El‐Azab
  4. Nathan S. Ramrakhiani
  5. Anthony Barisano
  6. Lu Yu
  7. Kaitlyn Taylor
  8. Álvaro Esperança
  9. Christian Mendiola
  10. Charles A. Downs
  11. Heather L. Abrahim
  12. Thomas Hughes
  13. Amir M. Rahmani
  14. Jessica L. Borelli
  15. Rana Chakraborty
  16. Melissa D. Pinto

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Abstract

Aims and Objectives

To determine the frequency, timing, and duration of post‐acute sequelae of SARS‐CoV‐2 infection (PASC) and their impact on health and function.

Background

Post‐acute sequelae of SARS‐CoV‐2 infection is an emerging major public health problem that is poorly understood and has no current treatment or cure. PASC is a new syndrome that has yet to be fully clinically characterised.

Design

Descriptive cross‐sectional survey ( n  = 5163) was conducted from online COVID‐19 survivor support groups who reported symptoms for more than 21 days following SARS‐CoV‐2 infection.

Methods

Participants reported background demographics and the date and method of their covid diagnosis, as well as all symptoms experienced since onset of covid in terms of the symptom start date, duration, and Likert scales measuring three symptom‐specific health impacts: pain and discomfort, work impairment, and social impairment. Descriptive statistics and measures of central tendencies were computed for participant demographics and symptom data.

Results

Participants reported experiencing a mean of 21 symptoms (range 1–93); fatigue (79.0%), headache (55.3%), shortness of breath (55.3%) and difficulty concentrating (53.6%) were the most common. Symptoms often remitted and relapsed for extended periods of time (duration M  = 112 days), longest lasting symptoms included the inability to exercise ( M  = 106.5 days), fatigue ( M  = 101.7 days) and difficulty concentrating, associated with memory impairment ( M  = 101.1 days). Participants reported extreme pressure at the base of the head, syncope, sharp or sudden chest pain, and “brain pressure” among the most distressing and impacting daily life.

Conclusions

Post‐acute sequelae of SARS‐CoV‐2 infection can be characterised by a wide range of symptoms, many of which cause moderate‐to‐severe distress and can hinder survivors' overall well‐being.

Relevance to Clinical Practice

This study advances our understanding of the symptoms of PASC and their health impacts.

Article activity feed

  1. Version published to 10.1111/jocn.16541
  2. ScreenIT

    SciScore for 10.1101/2021.03.22.21254026: (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
    In August 2020, a REDCap survey was disseminated to Survivor Corps group members on Facebook and in other online COVID-19 groups.
    REDCap
    suggested: (REDCap, RRID:SCR_003445)
    To focus on the experiences of people with PASC, the data analyzed were further limited to respondents who had experienced symptoms for longer than 21 days.
    PASC
    suggested: (PASC , RRID:SCR_016642)

    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.

  3. Version published to 10.1101/2021.03.22.21254026 on medRxiv