Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with Covid-19 in a Multistate Health Care Systems Network — United States, March–June 2020

Bibliographic Data

ID23318692
AuthorsMark W Tenforde (0000-0002-8702-8393, Response Biomedical (Canada), corresponding author), Sara Kim (0000-0002-9300-1445, Response Biomedical (Canada)), Sara S Kim, Christopher J Lindsell (0000-0002-3297-2811, Response Biomedical (Canada)), Erica Billig Rose (0000-0001-7056-511X, Response Biomedical (Canada)), Nathan I Shapiro (0000-0003-3508-4390, Response Biomedical (Canada)), D Clark Files (0000-0002-1595-4080, Response Biomedical (Canada)), Kevin W Gibbs (0000-0002-5272-2289, Response Biomedical (Canada)), Heidi L Erickson (0000-0001-5537-8893, Response Biomedical (Canada)), Jay S Steingrub (0000-0002-6019-6725, Response Biomedical (Canada)), Howard Smithline (Response Biomedical (Canada)), Howard A Smithline (0000-0001-6972-5833), Michelle N Gong (0000-0001-7952-5384, Response Biomedical (Canada)), Michael S Aboodi (Response Biomedical (Canada)), Matthew C Exline (0000-0001-6797-158X, Response Biomedical (Canada)), Daniel J Henning (Response Biomedical (Canada)), Jennifer G Wilson (0000-0002-4254-8475, Response Biomedical (Canada)), Akram Khan (0000-0003-3091-632X, Response Biomedical (Canada)), Nida Qadir (0000-0001-7791-049X, Response Biomedical (Canada)), Samuel M Brown (0000-0003-1206-6261, Response Biomedical (Canada)), Ithan D Peltan (0000-0003-1730-234X, Response Biomedical (Canada)), Todd W Rice (0000-0002-7136-5408, Response Biomedical (Canada)), David N Hager (0000-0002-5148-4872, Response Biomedical (Canada)), Adit A Ginde (0000-0003-2325-206X, Response Biomedical (Canada)), William B Stubblefield (0000-0003-3817-1414, Response Biomedical (Canada)), Manish M Patel (0000-0001-8949-6548, Response Biomedical (Canada)), Wesley H Self (0000-0002-9300-3045, Response Biomedical (Canada)), Leora R Feldstein (0000-0002-4430-6760, Response Biomedical (Canada)), CDC COVID-19 Response Team, Kimberly W Hart (0009-0000-4432-9455), Robert Mcclellan, R Trigg McClellan, Layne Dorough, Nicole Dzuris, Eric P Griggs, Ahmed M Kassem (0000-0003-4053-7841), Paula L Marcet (0000-0002-0676-3020, Response Biomedical (Canada)), Constance Ogokeh, Constance E Ogokeh, Courtney N Sciarratta (0009-0002-8255-1369), Akshita Siddula, Emily Smith (0000-0002-2633-5189), Emily R Smith (0000-0001-5715-9459), Michael Wu (0000-0002-0233-0957), Michael J Wu
Year2020
Volume69
Issue30
Pages993-998
Publication date2020-07-31
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueMMWR. Surveillance Summaries (JOURNAL)
Journal identifiersISSN: 1546-0738 • E-ISSN: 1545-8636
PublisherCenters for Disease Control MMWR Office (PUBLISHER)
DOI10.15585/mmwr.mm6930e1
PMID32730238
OpenAlexW3044231852
LanguageEN
Citations received74
References cited7

Prolonged symptom duration and disability are common in adults hospitalized with severe coronavirus disease 2019 (COVID-19). Characterizing return to baseline health among outpatients with milder COVID-19 illness is important for understanding the full spectrum of COVID-19-associated illness and tailoring public health messaging, interventions, and policy. During April 15-June 25, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had a first positive reverse transcription-polymerase chain reaction (RT-PCR) test for SARS-CoV-2, the virus that causes COVID-19, at an outpatient visit at one of 14 U.S. academic health care systems in 13 states. Interviews were conducted 14-21 days after the test date. Respondents were asked about demographic characteristics, baseline chronic medical conditions, symptoms present at the time of testing, whether those symptoms had resolved by the interview date, and whether they had returned to their usual state of health at the time of interview. Among 292 respondents, 94% (274) reported experiencing one or more symptoms at the time of testing; 35% of these symptomatic respondents reported not having returned to their usual state of health by the date of the interview (median = 16 days from testing date), including 26% among those aged 18-34 years, 32% among those aged 35-49 years, and 47% among those aged ≥50 years. Among respondents reporting cough, fatigue, or shortness of breath at the time of testing, 43%, 35%, and 29%, respectively, continued to experience these symptoms at the time of the interview. These findings indicate that COVID-19 can result in prolonged illness even among persons with milder outpatient illness, including young adults. Effective public health messaging targeting these groups is warranted. Preventative measures, including social distancing, frequent handwashing, and the consistent and correct use of face coverings in public, should be strongly encouraged to slow the spread of SARS-CoV-2.

Environmental health · Family medicine · Health care · Medical record · National Health Interview Survey · Population · Psychiatry · Psychological intervention · Public health · Telephone interview · COVID-19 and Mental Health · COVID-19 Clinical Research Studies · Internal Medicine · Long-Term Effects of COVID-19 · Medicine · Gerontology

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