Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020

Details

• Personal Author:
  Tenforde, Mark W. ; Kim, Sara S. ; Lindsell, Christopher J. ; Rose, Erica Billig ; Shapiro, Nathan I. ; Files, D. Clark ; Gibbs, Kevin W. ; Erickson, Heidi L. ; Steingrub, Jay S. ; Smithline, Howard A. ; Gong, Michelle N. ; Aboodi, Michael S. ; Exline, Matthew C. ; Henning, Daniel J. ; Wilson, Jennifer G. ; Khan, Akram ; Qadir, Nida ; Brown, Samuel M. ; Peltan, Ithan D. ; Rice, Todd W. ; Hager, David N. ; Ginde, Adit A. ; Stubblefield, William B. ; Patel, Manish M. ; Self, Wesley H. ; Feldstein, Leora R.
• Corporate Authors:
  IVY Network Investigators. ; CDC COVID-19 Response Team. ; Oak Ridge Institute for Science and Education. ; Vanderbilt University Medical Center. ; Beth Israel Deaconess Medical Center. ; Wake Forest University Baptist Medical Center. ; Hennepin County Medical Center. ; Baystate Medical Center. ; Montefiore Medical Center and Albert Einstein College of Medicine. ; Ohio State University. Wexner Medical Center. ; University of Washington Medical Center,. ; Stanford University Medical Center.
• Description:
  What is already known about this topic? Relatively little is known about the clinical course of COVID-19 and return to baseline health for persons with milder, outpatient illness.
  
  What is added by this report? In a multistate telephone survey of symptomatic adults who had a positive outpatient test result for SARS-CoV-2 infection, 35% had not returned to their usual state of health when interviewed 2–3 weeks after tTesting. Among persons aged 18–34 years with no chronic medical conditions, one in five had not returned to their usual state of health.
  
  What are the implications for public health practice? COVID-19 can result in prolonged illness, even among young adults without underlying chronic medical conditions. Effective public health messaging targeting these groups is warranted.
  
  Prolonged symptom duration and disability are common in adults hospitalized with severe coronaVirus disease 2019 (COVID-19). Characterizing return to baseline health among outpatients with milder COVID-19 illness is important for understanding the full spectrum of COVID-19–associated illness and tailoring public health messaging, interventions, and policy. During April 15–June 25, 2020, telephone interviews were conducted with a random sample of adults aged ≥18 years who had a first positive reverse transcription–polymerase chain reaction (RT-PCR) test for SARS-CoV-2, the Virus that causes COVID-19, at an outpatient visit at one of 14 U.S. academic health care systems in 13 states. Interviews were conducted 14–21 days after the test date. Respondents were asked about demographic characteristics, baseline chronic medical conditions, symptoms present at the time of tTesting, whether those symptoms had resolved by the interview date, and whether they had returned to their usual state of health at the time of interview. Among 292 respondents, 94% (274) reported experiencing one or more symptoms at the time of tTesting; 35% of these symptomatic respondents reported not having returned to their usual state of health by the date of the interview (median = 16 days from tTesting date), including 26% among those aged 18–34 years, 32% among those aged 35–49 years, and 47% among those aged ≥50 years. Among respondents reporting cough, fatigue, or shortness of breath at the time of tTesting, 43%, 35%, and 29%, respectively, continued to experience these symptoms at the time of the interview. These findings indicate that COVID-19 can result in prolonged illness even among persons with milder outpatient illness, including young adults. Effective public health messaging targeting these groups is warranted. Preventative measures, including social distancing, frequent handwashing, and the consistent and correct use of face coverings in public, should be strongly encouraged to slow the spread of SARS-CoV-2.
  
  Suggested citation for this article: Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. MMWR Morb Mortal Wkly Rep. ePub: 24 July 2020.
  
  mm6930e1.htm?s_cid=mm6930e1_w
  
  mm6930e1-H.pdf
  
  
• Content Notes:
  Return to Usual State of Health -- Resolution of Symptoms and Duration -- Discussion.
• Subjects:
  CoronaVirus Infections COVID-19 Pneumonia, Viral Symptom Assessment Treatment Outcome
• Source:
  MMWR: Morbidity and Mortality Weekly Report 2020; v. 69 Early Release
• Series:
  Weekly Report: Morbidity and Mortality Weekly Report (MMWR)
• ISSN:
  0149-2195 (print) ; 1545-861X (digital)
• Document Type:
  Journal Article
• Place as Subject:
  United States
• Pages in Document:
  7 pdf pages
• Volume:
  69
• Collection(s):
  Morbidity and Mortality Weekly Report (MMWR)
• Main Document Checksum:
  urn:sha-512:c2148c4fc9d486ec8372b17fa064c70cd49fe3f039b7bc693256639180adb08b9bb28bfd5a665771e28fecf3360932d54a147f1666c6cd2007354ace1d72dab0
• Download URL:
  https://stacks.cdc.gov/view/cdc/91044/cdc_91044_DS1.pdf
• File Type:
  [PDF - 667.48 KB ]