One Third of Outpatients With COVID-19 Are Unwell Weeks Later

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July 24, 2020 – COVID-19 can mean illness lasting several weeks, even in young adults and people without chronic illness who have mild illness and are treated on an outpatient basis, according to today’s survey results ‘hui Morbidity and Mortality Weekly Report from the Centers for Disease Control and Prevention (CDC).

Mark W. Tenforde, MD, PhD, for the CDC-COVID-19 Response Team, and colleagues conducted a multi-state telephone survey of symptomatic adults who tested positive for SARS-CoV-2 . The researchers found that 35% had not returned to their usual state of well-being when questioned 2-3 weeks after the test.

Of the 270 out of 274 respondents for whom there was data on health recovery, 175 (65%) said they returned to baseline health on average 7 days after the test date .

Among the 274 symptomatic ambulatory patients, the median number of symptoms was seven. Fatigue (71%), cough (61%) and headache (61%) were the most frequently reported symptoms.

Prolonged illness is well described in adults hospitalized with severe COVID-19, particularly among the older adult population, but little is known about other groups.

The proportion of those who had not returned to health differed by age: 26% of respondents aged 18 to 34, 32% of those aged 35 to 49 and 47% of those at least 50-year-olds declared that they had not recovered their usual state of health (P = 0.010) within 14-21 days of receiving positive test results.

Among respondents aged 18 to 34 who did not have a chronic condition, 19% (nine of 48) said they did not return to their usual state of health during this time.

Public health messages targeting young adults, a group who shouldn’t be sick for weeks with mild illness, are especially important, the authors write.

Kyle Annen, DO, medical director of transfusion services and patient blood management at Colorado Children’s Hospital and assistant professor of pathology at the University of Colorado at Denver, said Medscape Medical News that an important message is that late recovery (symptoms of fatigue, cough and shortness of breath) was evident in almost a quarter of 18-34 year olds and a third of 35-49 year olds who were not sick enough to require hospitalization.


“This should have an impact on the perception that this is a mild illness in young adults and encourage them to comply with recommendations for social distancing, masking and hand washing,” she said. declared.

A recovery time of more than 2 weeks will affect performance at work and school, especially prolonged fatigue, she noted. This was one of the main symptoms that have been reported to slowly go away.

“I think the most interesting point in this study is the underlying conditions; the psychiatric conditions were significantly correlated with prolonged recovery. I don’t think many people consider depression and anxiety to be a medical condition. as it relates to the risk of COVID-19. This could potentially have an impact, as rates of depression and anxiety will likely increase as COVID-19 continues, ”she said.

Buddy Creech, MD, MPH, said Medscape Medical News, “It is important to understand that the spectrum of illnesses associated with COVID is wide, including mild illness, serious illness and prolonged illness. This report helps us understand some of the risk factors for people with prolonged symptoms. and can allow us to even more clearly refine how we prioritize the treatment and administration of vaccines, once available.

“It also highlights the challenge of tackling this virus. Not only do the symptoms vary widely, but the incubation period, symptom duration, and residual symptoms that sometimes occur as well. Obviously, there is still a lot to be done. understand. about this virus, ”he said.

Interviews were conducted from April 15 to June 25 with a random sample of adults aged 18 or older who had received a first positive test result for SARS-CoV-2 during an outpatient visit to the one of 14 US university health systems in 13 states. .

Annen and Creech did not disclose any relevant financial relationship.

Morb Mortal Wkly Rev. Published online July 24, 2020. Full text

Marcia Frellick is a Chicago-based freelance journalist. She has previously written for the Chicago Tribune and and was an editor for the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

Medscape Medical News

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