Prevalence and factors associated with symptom persistence: A prospective study of 429 mild COVID-19 outpatients - 01/12/21

Doi : 10.1016/j.idnow.2021.11.003

A. Faycal ^a,⁎ , A.L. Ndoadoumgue ^b, B. Sellem ^a, C. Blanc ^a,^b, Y. Dudoit ^a,^b, L. Schneider ^a,^b, R. Tubiana ^a,^b, M.-A. Valantin ^a,^b, S. Seang ^a,^b, R. Palich ^a,^b, A. Bleibtreu ^a, G. Monsel ^a, N. Godefroy ^a, O. Itani ^a, O. Paccoud ^a, V. Pourcher ^a,^b, E. Caumes ^a,^b, N. Ktorza ^a, A. Chermak ^a, B. Abdi ^b,^c, L. Assoumou ^b, C. Katlama ^a,^b
for the
COVIDOM-19 PSL research group
^a Service de maladies infectieuses et tropicales, hôpitaux universitaires Pitié-Salpêtrière Charles-Foix, AP–HP, 75013 Paris, France
^b Inserm 1136, institut Pierre-Louis d’épidémiologie et de santé publique, Sorbonne université, 75013 Paris, France
^c Laboratoire de virologie, hôpitaux universitaires Pitié-Salpêtrière, AP–HP, Paris, France

^⁎Corresponding author.

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En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Wednesday 01 December 2021
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Highlights

•	The clinical presentation of patients with mild COVID-19 varies with age and gender.
•	Median time to recovery from mild COVID-19 was 27 days.
•	The probability of complete recovery was 56.3% at 1 month and 85.6% at 2 months.
•	Four independent factors were associated with symptom persistence at 1 month: female sex, age>40, ageusia, and a low cycle threshold.
•	Persistent symptoms were mainly asthenia, ageusia, anosmia, and dyspnea.

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Abstract

Introduction

Persistent symptoms have recently emerged as a clinical issue in COVID-19. We aimed to assess the prevalence and risk factors in symptomatic non-hospitalized individuals with mild COVID-19.

Methods

We performed a prospective cohort study of symptomatic COVID-19 outpatients, from March to May 2020, with weekly phone calls from clinical onset until day 30 and up to day 60 in case of persistent symptoms. The main outcomes were the proportion of patients with complete recovery at day 30 and day 60 and factors associated with persistent symptoms.

Results

We enrolled 429 individuals mostly women (72.5%) and healthcare workers (72.5%), with a median age of 41.6 years [IQR 30–51.5]. Symptoms included: cough (69.7%), asthenia (68.8%), anosmia (64.8%), headaches (64.6%), myalgia (62.7%), gastrointestinal symptoms (61.8%), fever (61.5%), and ageusia (60.8%). Mean duration of disease was 27 days (95%CI: 25–29). The rate of persistent symptoms was 46.8% at day 30 and 6.5% at day 60 consisting in asthenia (32.6%), anosmia (32.6%), and ageusia (30.4%). The probability of complete recovery was 56.3% (95%CI: 51.7–61.1) at day 30 and 85.6% (95%CI: 81.2–89.4) at day 60. Factors associated with persistent symptoms were age>40 (HR 0.61), female sex (HR 0.70), low cycle threshold (HR 0.78), and ageusia (HR 0.59).

Conclusions

COVID-19 – even in its mild presentation – led to persistent symptoms (up to one month) in nearly half of individuals. Identification of risk factors such as age, gender, ageusia and viral load is crucial for clinical management and argues for the development of antiviral agents.

El texto completo de este artículo está disponible en PDF.

Keywords : COVID-19, Mild COVID-19, Persistent COVID-19 symptoms, SARS-CoV-2 RT-PCR