Of the first 179 participants, 44 were hospitalized during their SARS-CoV-2 infection.
Fatigue, shortness of breath, concentration problems, headaches, trouble sleeping, and loss of smell/taste were the most common symptoms reported through 8 months.
Symptoms were generally considered bothersome and often showed fluctuations over time.
Some participants reported experiencing depression, anxiety, and post-traumatic stress, along with challenges in performing daily activities.
The median rating of general health was lower at 4 and 8 months compared to pre-COVID-19 levels.
Two clusters of symptom domains were identified, indicating potential subphenotypes of .
Simplified
BACKGROUND: There is mounting evidence for the presence of postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (), but there is limited information on the spectrum, magnitude, duration, and patterns of these sequelae as well as their influence on quality of life.
METHODS: We assembled a cohort of adults with a documented history of SARS-CoV-2 RNA positivity at ≥2 weeks past onset of coronavirus disease 2019 (COVID-19) symptoms or, if asymptomatic, first positive test. At 4-month intervals, we queried physical and mental health symptoms and quality of life.
RESULTS: Of the first 179 participants enrolled, 10 were asymptomatic during the acute phase of SARS-CoV-2 infection, 125 were symptomatic but not hospitalized, and 44 were symptomatic and hospitalized. During the postacute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping, and anosmia/dysgeusia were most common through 8 months of observation. Symptoms were typically at least somewhat bothersome and sometimes exhibited a waxing-and-waning course. Some participants experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with performance of usual activities. The median visual analogue scale rating of general health was lower at 4 and 8 months compared with pre-COVID-19. Two clusters of symptom domains were identified.
CONCLUSIONS: Many participants report bothersome symptoms following onset of COVID-19 with variable patterns of persistence and impact on quality of life. The substantial variability suggests the existence of multiple subphenotypes of PASC. A rigorous approach to the prospective measurement of symptoms and functional manifestations sets the stage for the next phase of research focusing on the pathophysiologic causes of the various subgroups of PASC.
Key numbers
68 of 111
Participants with symptoms at 8 months
Participants evaluable at 8 months follow-up
54 of 143
Participants reporting no symptoms at late recovery
Participants with complete data at 12–20 weeks follow-up
82
Participants experiencing at least 1 symptom
Participants assessed for symptom clustering in late recovery
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