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Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact

70 Pages Posted: 6 Apr 2021

See all articles by Hannah E. Davis

Hannah E. Davis

University College London - Patient-Led Research Collaborative

Gina S. Assaf

University College London - Patient-Led Research Collaborative

Lisa McCorkell

University College London - Patient-Led Research Collaborative

Hannah Wei

University College London - Patient-Led Research Collaborative

Ryan J. Low

University College London - Patient-Led Research Collaborative

Yochai Re'em

New York-Presbyterian Hospital / Weill Cornell Medicine

Signe Redfield

University College London - Patient-Led Research Collaborative

Jared P. Austin

Oregon Health and Science University

Athena Akrami

University College London - Patient-Led Research Collaborative

More...

Abstract

Growing evidence shows that a significant number of patients with COVID-19 experience prolonged symptoms, known as Long COVID. Few systematic studies exist which investigate this population, and hence, relatively little is known about the range in symptom makeup and severity, expected clinical course, impact on daily functioning, and expected return to baseline health. In this study, we analysed responses from 3762 participants with confirmed (diagnostic/antibody positive, 1020) or suspected (diagnostic/antibody negative or untested, 2742) COVID-19, from 56 countries, with illness duration of at least 28 days. 3608 (96%) reported symptoms beyond 90 days. Prevalence of 205 symptoms in 10 organ systems was estimated in this cohort, with 66 symptoms traced over seven months. Except for loss of smell and taste, the prevalence and trajectory of all symptoms were similar between groups with confirmed and suspected COVID-19. Respondents experienced an average of 14.5 symptoms in an average of 9.08 organ systems. Three clusters of symptoms were identified based on their prevalence over time. The most likely early symptoms were fatigue, dry cough, shortness of breath, headaches, muscle aches, chest tightness, and sore throat. The most frequent symptoms reported after month 6 were fatigue, post-exertional malaise, and cognitive dysfunction. Majority (>85%) experienced relapses, with exercise, physical or mental activity, and stress as the main triggers. 1700 (45.2%) reported requiring a reduced work schedule compared to pre-illness and 839 (22.3%) were not working at the time of survey due to their health conditions.

Funding Statement: All authors contributed voluntarily to this work. The cost of survey hosting (on Qualtrics) was covered from AA research grant (Wellcome Trust/Gatsby Charity via Sainsbury Wellcome Centre, UCL).

Declaration of Interests: All authors have completed the ICMJE uniform disclosure form and declare: no support from any organisation for the submitted work; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years, no other relationships or activities that could appear to have influenced the submitted work.

Ethics Approval Statement: The study was approved by the UCL Research Ethics Committee [16159.002] (London, UK), and Oregon Health and Science University Institutional Review Board (IRB) (Portland, OR, USA), with UCL serving as the primary site. The Weill Cornell Medical College IRB determined non-engagement.

Suggested Citation

Davis, Hannah E. and Assaf, Gina S. and McCorkell, Lisa and Wei, Hannah and Low, Ryan J. and Re'em, Yochai and Redfield, Signe and Austin, Jared P. and Akrami, Athena, Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. Available at SSRN: https://ssrn.com/abstract=3820561 or http://dx.doi.org/10.2139/ssrn.3820561

Hannah E. Davis

University College London - Patient-Led Research Collaborative ( email )

United Kingdom

Gina S. Assaf

University College London - Patient-Led Research Collaborative ( email )

United Kingdom

Lisa McCorkell

University College London - Patient-Led Research Collaborative

United Kingdom

Hannah Wei

University College London - Patient-Led Research Collaborative

United Kingdom

Ryan J. Low

University College London - Patient-Led Research Collaborative

Gower Street
London, WC1E 6BT
United Kingdom

Yochai Re'em

New York-Presbyterian Hospital / Weill Cornell Medicine

1300 York Avenue
New York, NY 10065
United States

Signe Redfield

University College London - Patient-Led Research Collaborative ( email )

United Kingdom

Jared P. Austin

Oregon Health and Science University

United States

Athena Akrami (Contact Author)

University College London - Patient-Led Research Collaborative ( email )

United Kingdom

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