Post-acute COVID-19 syndrome negatively impacts health and wellbeing despite less severe acute infection

Abstract

Abstract Introduction One of the noted features of COVID-19 is the spectrum of expressivity in symptoms among those with the disease, ranging from no or mild symptoms that may last a small number of days, to severe and/or longer lasting symptoms. It is emerging that many patients have long lasting symptoms, several months after initial infection with COVID-19. The aim of this research was to characterize post-acute COVID-19 syndrome (PACS). Methods This was a retrospective cross-sectional observational study. Participants were patients recovering from COVID-19 infection, enrolled in Mount Sinai Hospital’s COVID-19 Precision Recovery Program (PRP). Inclusion criteria were confirmed or probable (based on World Health Organization criteria) initial diagnosis of COVID-19; post-acute COVID-19 syndrome (defined as experiencing symptoms > 6 weeks since acute symptom onset) and being currently enrolled in the PRP during the months of July and August 2020. Study survey data were collected using REDCap. Demographic data, COVID-19 clinical data and patient-reported outcomes for breathlessness (Medical Research Council Breathlessness Scale), fatigue and quality of life (EuroQoL 5D-5L) were collected. Results 84 individuals with PACS were included. Symptoms persisted at mean (range) 151 (54 to 255) days. The most prevalent persistent symptoms were fatigue (92%), loss of concentration/memory (74%), weakness (68%), headache (65%) and dizziness (64%). Most participants reported increased levels of disability associated with breathlessness, increased fatigue and reduced quality of life. Conclusions Persistent symptoms following COVID-19 infection are prevalent, debilitating and appear to affect individuals regardless of acute infection severity or prior health status. More detailed research is required in order to identify specific symptom clusters associated with PACS, and to devise effective interventional strategies.