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Post–COVID-19 Condition and Core Symptoms
Quick Takes
- Post–COVID-19 condition might occur in approximately one out of eight people with COVID-19 in the general population.
- Core symptoms of post–COVID-19 condition include chest pain, difficulties with breathing, lump in throat, pain when breathing, painful muscles, heavy arms or legs, ageusia or anosmia, feeling hot and cold alternately, tingling extremities, and general tiredness.
- This analysis presents a starting point for core symptoms that could define post–COVID-19 condition, offer an improved working definition of post–COVID-19 condition, and may provide a reliable prevalence estimate of post-COVID condition in the population.
Study Questions:
What is the nature, prevalence, and severity of long-term symptoms related to coronavirus disease 2019 (COVID-19), while correcting for symptoms present before severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and controlling for the symptom dynamics in the population without infection?
Methods:
The investigators collected data within Lifelines, a multidisciplinary, prospective, population-based, observational cohort study examining the health and health-related behaviors of people living in the north of the Netherlands. All Lifelines participants aged 18 years or older received invitations to digital COVID-19 questionnaires. Longitudinal dynamics of 23 somatic symptoms surrounding COVID-19 diagnoses (due to SARS-CoV-2 alpha [B.1.1.7] variant or previous variants) were assessed using 24 repeated measurements between March 31, 2020, and August 2, 2021. Participants with COVID-19 (a positive SARS-CoV-2 test or a physician’s diagnosis of COVID-19) were matched by age, sex, and time to COVID-19–negative controls. Authors recorded symptom severity before and after COVID-19 in participants with COVID-19 and compared that with matched controls.
Results:
A total of 76,422 participants (mean age 53.7 years [standard deviation 12.9 years], 46,329 [60.8%] were female) completed a total of 883,973 questionnaires. Of these, 4,231 (5.5%) participants had COVID-19 and were matched to 8,462 controls. Persistent symptoms in COVID-19–positive participants at 90-150 days after COVID-19 compared with before COVID-19 and compared with matched controls included chest pain, difficulties with breathing, pain when breathing, painful muscles, ageusia or anosmia, tingling extremities, lump in throat, feeling hot and cold alternately, heavy arms or legs, and general tiredness. In 12.7% of patients, these symptoms could be attributed to COVID-19, as 381 (21.4%) of 1,782 COVID-19–positive participants versus 361 (8.7%) of 4,130 COVID-19–negative controls had at least one of these core symptoms substantially increased to at least moderate severity at 90-150 days after COVID-19 diagnosis or matched time point.
Conclusions:
The authors reported that 12.7% of patients with COVID-19 in the general population will experience persistent somatic symptoms after COVID-19.
Perspective:
This study reported that post–COVID-19 condition might occur in approximately one out of eight people with COVID-19 in the general population. Furthermore, core symptoms of post–COVID-19 condition include chest pain, difficulties with breathing, lump in throat, pain when breathing, painful muscles, heavy arms or legs, ageusia or anosmia, feeling hot and cold alternately, tingling extremities, and general tiredness and have the highest discriminative ability to distinguish between post–COVID-19 condition and non-COVID-19–related symptoms. This analysis presents a starting point for core symptoms that could define post–COVID-19 condition, offer an improved working definition of post–COVID-19 condition, and may potentially provide a reliable prevalence estimate of post-COVID condition in the general population. Finally, additional studies that distinguish potential mechanisms driving post–COVID-19-related symptomatology are required.
Clinical Topics: COVID-19 Hub, Prevention
Keywords: Ageusia, Anosmia, Chest Pain, COVID-19, COVID-19 Testing, Fatigue, Health Behavior, Medically Unexplained Symptoms, Muscles, Pharynx, Primary Prevention, SARS-CoV-2
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