Symptoms Remain After COVID-19 Treatment

July 19, 2020

In a small Italian study, a majority of patients who were hospitalized and recovered from the virus, had lingering symptoms and many had a “worsened quality of life.”

In a small patient study looking at recovered coronavirus 2019 (COVID-19) patients who had been hospitalized, a majority of them said they had lingering symptoms.

Of 143 patients who saw a provider for follow-up assessment care, only 18 (12.6%) were completely free of any COVID-19—related symptoms. However, 32% had 1 or 2 symptoms and 55% had 3 or more. None of the patients involved in the study had fever or any signs or symptoms of acute illness. There was a large range of symptoms with fatigue, dyspnea, joint pain, chest pain, cough, and anosmia being the top lingering symptoms.

The study was published in JAMA.

In their post-care assessments, patients were asked to recount the presence or absence of symptoms during the acute phase of the virus and whether each symptom persisted at the time of the visit. More than 1 symptom could be reported.

In addition, the EuroQol visual analog scale was used to ask patients to score their quality of life from 0 (worst imaginable health) to 100 (best imaginable health) before COVID-19 and at the time of their post-care assessment. A difference of 10 points defined worsened quality of life.

Nearly half of the patients (44%) reported having a “worsened quality of life.”

This is eye-opening and suggests hospitalized patients could be dealing with the effects of the virus after recovery.

All participants had to meet the World Health Organization’s criteria for discontinuation of quarantine, which included not having a fever for 3 days, improvement in other symptoms, and 2 negative test results. At enrollment in the study, real-time reverse transcriptase—polymerase chain reaction for SARS-CoV-2 was performed and patients with a negative test result were included.

While in the hospital, 72.7% of participants had evidence of interstitial pneumonia. The mean length of hospital stay was 13.5 (SD, 9.7) days; 21 patients (15%) received noninvasive ventilation and 7 patients (5%) received invasive ventilation.

“Limitations of the study include the lack of information on symptom history before acute COVID-19 illness and the lack of details on symptom severity,” the authors wrote. “Furthermore, this is a single-center study with a relatively small number of patients and without a control group of patients discharged for other reasons. Patients with community-acquired pneumonia can also have persistent symptoms, suggesting that these findings may not be exclusive to COVID-19.”

“Clinicians and researchers have focused on the acute phase of COVID-19, but continued monitoring after discharge for long-lasting effects is needed,” the investigators concluded.