Patients may continue to experience COVID-19 symptoms after remission

Coronavirus Disease 2019 (COVID-19) is a pandemic that continuously presents new scientific information. Symptoms usually appear 2-14 days after exposure to the virus and include fever or chills, cough, shortness of breath, fatigue, muscle aches, headaches, loss of new taste or smell, sore throat, nasal congestion or runny nose, nausea or Vomiting may be included, and diarrhea.¹ Evidence suggests that the elderly and individuals with underlying disorders are at increased risk of developing severe COVID-19.¹

There is limited evidence that the symptoms of COVID-19 persist even after the infection is gone. However, even several months after the infection, it is reported that symptoms such as persistent loss of taste and smell, tachycardia, chest pain, shortness of breath, excessive fatigue, cognitive impairment, and recurrence of fever still occur. There is.²

Survey results and impact
One study conducted in Italy evaluated persistent symptoms in patients discharged after recovery from COVID-19.^Three Fondazione Polyclinico Universitario Agostino Gemeri IRCCS in Rome, Italy, established post-acute outpatient services for individuals discharged from hospital after recovery from COVID-19. Patients discharged from hospital were free of fever for 3 consecutive days, improved in other symptoms, and had two negative tests for SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), a virus that causes CORS-19. The results were 24 hours apart. In addition, these patients underwent follow-up treatment through a comprehensive health assessment with a detailed medical history and a physical examination with electronically documented information.^Three

Patients were retrospectively asked through a questionnaire about their symptoms during COVID-19 infection and whether they persisted during outpatient visits.^Three Use the scaled EuroQol visual analog to score the patient’s quality of life before COVID-19 and at the outpatient visit from 0 (worst possible health) to 100 (best possible health). did.

The study included 143 patients, with an average age of 56.5 years and 37% were women. Patients were evaluated at the outpatient appointment for an average of 60 days after the onset of the first COVID-19 symptoms. The study found that 87.4% of patients who recovered from COVID-19 still reported at least one symptom, especially fatigue and persistent shortness of breath.^Three At the time of outpatient evaluation, only 12.6% had no COVID-19 symptoms, 32% had one or two symptoms, and 55% had more than two. There were 44.1% of patients who experienced worse quality of life. Many patients still reported fatigue (53.1%), shortness of breath (43.4%), arthralgia (27.3%), and chest pain (21.7%).^Three

This study provides important insights into the longer path to recovery in COVID-19 patients after the infection is gone. Patients should be monitored for symptoms after a discharge by appointment for follow-up appointments or by phone to ensure overall quality of life. Pharmacists can also play an important role in the follow-up process for COVID-19 patients. Study limitations included a small number of study participants, lack of information on the history of symptoms prior to COVID-19 disease, and limited details of severity of symptoms.^Three Further studies are needed to assess persistent COVID-19 symptoms after recovery.

References

1. CDC. Frequently Asked Questions for Coronavirus Disease 2019 (COVID-19). https://www.cdc.gov/coronavirus/2019-ncov/faq.html.. Updated July 3, 2020. Accessed on July 10, 2020.
2. AHA. In the months following infection, many COVID-19 patients are unable to contract the disease. https://www.heart.org/en/news/2020/07/06/months-after-infection-many-covid-19-patients-cant-shake-illness.. Published on July 6, 2020. Accessed on July 10, 2020.
3. Carfi A, Bernabei R, Landi F. Gemelli, COVID-19 Postacute Care Research Group. Persistent symptoms of patients after acute COVID-19. JAMA.. 2020. doi: 10.1001 / jama.2020.12603. Online before printing.