THE 2019 CORONAVIRUS DISEASE EVOLUTION (COVID-19) SYMPTOMS IN THE FIRST TWELVE MONTHS OF THE ILLNESS
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Keywords
symptoms, evolution, long-term COVID
Abstract
Background: There aren't much reliable long-term data on the symptoms of COVID-19 (coronavirus disease 2019). For up to a year from the start of the illness, we assessed the onset, severity, and recovery of symptoms over the whole range of disease severity.
Method:. Amsterdam, Netherlands-based RECoVERED Study is a prospective cohort study. Following a diagnosis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by the local public health agency and hospitals, participants who were at least 18 years old were enlisted. Patients completed standardized symptom questionnaires at enrollment, one week and one month later, and then every month after that. In accordance with World Health Organization (WHO) guidelines, clinical severity was determined. Using Kaplan-Meier techniques, the length of time from the start of the disease to the resolution of symptoms was compared by clinical severity. We examined for factors that affect recovery time using multivariable Cox
Results. Between 11 May 2020 and 1 May 2021, 342 COVID-19 patients (192 [56%] male) were enrolled, of whom 99/342 (29%) had mild, 145/342 (42%) moderate, 56/342 (16%) severe, and 42/342 (12%) critical disease. The proportion of participants who reported at least 1 persistent symptom at 12 weeks after illness onset was greater in those with severe/critical disease (86.7% [95% confidence interval {CI} = 76.5–92.7%]) compared to those with mild or moderate disease (30.7% [95% CI = 21.1–40.9%] and63.8% [95% CI = 54.8–71.5%], respectively). At 12 months after illness onset, two-fifths of participants (40.7% [95% CI = 34.2–7.1])continued to report ≥1 symptom. Recovery was slower in female compared to male participants (adjusted hazard ratio [aHR] 0.65 [95% CI = .47–.92]) and those with a body mass index [BMI] ≥30kg/m2 compared to BMI <25kg/m2 (hazard ratio [HR] 0.62 [95%CI = .39–.97]).
Conclusions. A year after the start of the illness, COVID-19 symptoms persisted, even in some people with minor cases. The biggest predictors of the rate of symptom improvement were female sex and fat.
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Ramy Abdallah
A Internal Medicine Consultant, Saudi Arabia.
Marwa Alharbi
King Abdulaziz University, Saudi Arabia.
Ammar Katib
Fakeeh College of Medical Science, Saudi Arabia.
Khadijah Hawsawi
Fakeeh College of Medical Science, Saudi Arabia.
Lujain Madani
Fakeeh College of Medical Science, Saudi Arabia.
Amjad Aldadi
Ibn Sina Collage, Saudi Arabia.