Post‑COVID‑19 Syndrome in Outpatients: a Cohort Study

• DOI: 10.1007/s11606-021-07242-1
• Publication Date: 2022-03-22T18:23:17Z
• Authors: Florian Desgranges; Eliana Tadini; Aline Munting; Jean Regina; Paraskevas Filipp...; Benjamin Viala; Eleftherios Karac...; Véronique Suttels; David Haefliger; Eleftheria Kampouri; Mathias Van Singer; Jonathan Tschopp; Laurence Rochat S...; Siméon Schaad; Thomas Brahier; Olivier Hugli; Yolanda Mueller; Alexandre Gouveia; Onya Opota; Pierre-Nicolas Ca...; Benoît Guery; Matthaios Papadim...; Noémie Boillat-Bl...
• Keywords: Adult; SARS-CoV-2; COVID-19; Cohort Studies; Young Adult; 03 medical and health sciences; Post-Acute COVID-19 Syndrome; 0302 clinical medicine; Outpatients; Humans; Female; Prospective Studies; Original Research

After mild COVID-19, some outpatients experience persistent symptoms. However, data are scarce and prospective studies are urgently needed.To characterize the post-COVID-19 syndrome after mild COVID-19 and identify predictors.Outpatients with symptoms suggestive of COVID-19 with (1) PCR-confirmed COVID-19 (COVID-positive) or (2) SARS-CoV-2 negative PCR (COVID-negative).Monocentric cohort study with prospective phone interview between more than 3 months to 10 months after initial visit to the emergency department and outpatient clinics.Data of the initial visits were extracted from the electronic medical file. Predefined persistent symptoms were assessed through a structured phone interview. Associations between long-term symptoms and PCR results, as well as predictors of persistent symptoms among COVID-positive, were evaluated by multivariate logistic regression adjusted for age, gender, smoking, comorbidities, and timing of the survey.The study population consisted of 418 COVID-positive and 89 COVID-negative patients, mostly young adults (median age of 41 versus 36 years in COVID-positive and COVID-negative, respectively; p = 0.020) and healthcare workers (67% versus 82%; p = 0.006). Median time between the initial visit and the phone survey was 150 days in COVID-positive and 242 days in COVID-negative patients. Persistent symptoms were reported by 223 (53%) COVID-positive and 33 (37%) COVID-negative patients (p = 0.006) and proportions were stable among the periods of the phone interviews. Overall, 21% COVID-positive and 15% COVID-negative patients (p = 0.182) attended care for this purpose. Four surveyed symptoms were independently associated with COVID-19: fatigue (adjusted odds ratio 2.14, 95% CI 1.04-4.41), smell/taste disorder (26.5, 3.46-202), dyspnea (2.81, 1.10-7.16), and memory impairment (5.71, 1.53-21.3). Among COVID-positive, female gender (1.67, 1.09-2.56) and overweight/obesity (1.67, 1.10-2.56) were predictors of persistent symptoms.More than half of COVID-positive outpatients report persistent symptoms up to 10 months after a mild disease. Only 4 of 14 symptoms were associated with COVID-19 status. The symptoms and predictors of the post-COVID-19 syndrome need further characterization as this condition places a significant burden on society.