BACKGROUND: As the coronavirus disease 2019 (COVID-19) pandemic continues and millions remain vulnerable to infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), attention has turned to characterizing post-acute sequelae of SARS-CoV-2 infection (PASC). METHODS: From April 21 to December 31, 2020, we assembled a cohort of consecutive volunteers who a) had documented history of SARS-CoV-2 RNA-positivity; b) were ≥ 2 weeks past onset of COVID-19 symptoms or, if asymptomatic, first test for SARS-CoV-2; and c) were able to travel to our site in San Francisco. Participants learned about the study by being identified on medical center-based registries and being notified or by responding to advertisements. At 4-month intervals, we asked participants about physical symptoms that were new or worse compared to the period prior to COVID-19, mental health symptoms and quality of life. We described 4 time periods: 1) acute illness (0-3 weeks), 2) early recovery (3-10 weeks), 3) late recovery 1 (12-20 weeks), and 4) late recovery 2 (28-36 weeks). Blood and oral specimens were collected at each visit. RESULTS: We have, to date, enrolled 179 adults. During acute SARS-CoV-2 infection, 10 had been asymptomatic, 125 symptomatic but not hospitalized, and 44 symptomatic and hospitalized. In the acute phase, the most common symptoms were fatigue, fever, myalgia, cough and anosmia/dysgeusia. During the post-acute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping and anosmia/dysgeusia were the most commonly reported symptoms, but a variety of others were endorsed by at least some participants. Some experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with ambulation and performance of usual activities. The median visual analogue scale value rating of general health was lower at 4 and 8 months (80, interquartile range [IQR]: 70-90; and 80, IQR 75-90) compared to prior to COVID-19 (85; IQR 75-90). Biospecimens were collected at nearly 600 participant-visits. CONCLUSION: Among a cohort of participants enrolled in the post-acute phase of SARS-CoV-2 infection, we found many with persistent physical symptoms through 8 months following onset of COVID-19 with an impact on self-rated overall health. The presence of participants with and without symptoms and ample biological specimens will facilitate study of PASC pathogenesis. Similar evaluations in a population-representative sample will be needed to estimate the population-level prevalence of PASC.
BACKGROUND: As the coronavirus disease 2019 (COVID-19) pandemic continues and millions remain vulnerable to infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), attention has turned to characterizing post-acute sequelae of SARS-CoV-2 infection (PASC). METHODS: From April 21 to December 31, 2020, we assembled a cohort of consecutive volunteers who a) had documented history of SARS-CoV-2 RNA-positivity; b) were ≥ 2 weeks past onset of COVID-19 symptoms or, if asymptomatic, first test for SARS-CoV-2; and c) were able to travel to our site in San Francisco. Participants learned about the study by being identified on medical center-based registries and being notified or by responding to advertisements. At 4-month intervals, we asked participants about physical symptoms that were new or worse compared to the period prior to COVID-19, mental health symptoms and quality of life. We described 4 time periods: 1) acute illness (0-3 weeks), 2) early recovery (3-10 weeks), 3) late recovery 1 (12-20 weeks), and 4) late recovery 2 (28-36 weeks). Blood and oral specimens were collected at each visit. RESULTS: We have, to date, enrolled 179 adults. During acute SARS-CoV-2 infection, 10 had been asymptomatic, 125 symptomatic but not hospitalized, and 44 symptomatic and hospitalized. In the acute phase, the most common symptoms were fatigue, fever, myalgia, cough and anosmia/dysgeusia. During the post-acute phase, fatigue, shortness of breath, concentration problems, headaches, trouble sleeping and anosmia/dysgeusia were the most commonly reported symptoms, but a variety of others were endorsed by at least some participants. Some experienced symptoms of depression, anxiety, and post-traumatic stress, as well as difficulties with ambulation and performance of usual activities. The median visual analogue scale value rating of general health was lower at 4 and 8 months (80, interquartile range [IQR]: 70-90; and 80, IQR 75-90) compared to prior to COVID-19 (85; IQR 75-90). Biospecimens were collected at nearly 600 participant-visits. CONCLUSION: Among a cohort of participants enrolled in the post-acute phase of SARS-CoV-2 infection, we found many with persistent physical symptoms through 8 months following onset of COVID-19 with an impact on self-rated overall health. The presence of participants with and without symptoms and ample biological specimens will facilitate study of PASC pathogenesis. Similar evaluations in a population-representative sample will be needed to estimate the population-level prevalence of PASC.
Authors: Safiya Richardson; Jamie S Hirsch; Mangala Narasimhan; James M Crawford; Thomas McGinn; Karina W Davidson; Douglas P Barnaby; Lance B Becker; John D Chelico; Stuart L Cohen; Jennifer Cookingham; Kevin Coppa; Michael A Diefenbach; Andrew J Dominello; Joan Duer-Hefele; Louise Falzon; Jordan Gitlin; Negin Hajizadeh; Tiffany G Harvin; David A Hirschwerk; Eun Ji Kim; Zachary M Kozel; Lyndonna M Marrast; Jazmin N Mogavero; Gabrielle A Osorio; Michael Qiu; Theodoros P Zanos Journal: JAMA Date: 2020-05-26 Impact factor: 56.272
Authors: Kurt Kroenke; Tara W Strine; Robert L Spitzer; Janet B W Williams; Joyce T Berry; Ali H Mokdad Journal: J Affect Disord Date: 2008-08-27 Impact factor: 4.839
Authors: Christian Gaebler; Zijun Wang; Julio C C Lorenzi; Frauke Muecksch; Shlomo Finkin; Minami Tokuyama; Alice Cho; Mila Jankovic; Dennis Schaefer-Babajew; Thiago Y Oliveira; Melissa Cipolla; Charlotte Viant; Christopher O Barnes; Yaron Bram; Gaëlle Breton; Thomas Hägglöf; Pilar Mendoza; Arlene Hurley; Martina Turroja; Kristie Gordon; Katrina G Millard; Victor Ramos; Fabian Schmidt; Yiska Weisblum; Divya Jha; Michael Tankelevich; Gustavo Martinez-Delgado; Jim Yee; Roshni Patel; Juan Dizon; Cecille Unson-O'Brien; Irina Shimeliovich; Davide F Robbiani; Zhen Zhao; Anna Gazumyan; Robert E Schwartz; Theodora Hatziioannou; Pamela J Bjorkman; Saurabh Mehandru; Paul D Bieniasz; Marina Caskey; Michel C Nussenzweig Journal: Nature Date: 2021-01-18 Impact factor: 69.504
Authors: George Goshua; Alexander B Pine; Matthew L Meizlish; C-Hong Chang; Hanming Zhang; Parveen Bahel; Audrey Baluha; Noffar Bar; Robert D Bona; Adrienne J Burns; Charles S Dela Cruz; Anne Dumont; Stephanie Halene; John Hwa; Jonathan Koff; Hope Menninger; Natalia Neparidze; Christina Price; Jonathan M Siner; Christopher Tormey; Henry M Rinder; Hyung J Chun; Alfred I Lee Journal: Lancet Haematol Date: 2020-06-30 Impact factor: 18.959
Authors: Yu Zuo; Shanea K Estes; Ramadan A Ali; Alex A Gandhi; Srilakshmi Yalavarthi; Hui Shi; Gautam Sule; Kelsey Gockman; Jacqueline A Madison; Melanie Zuo; Vinita Yadav; Jintao Wang; Wrenn Woodard; Sean P Lezak; Njira L Lugogo; Stephanie A Smith; James H Morrissey; Yogendra Kanthi; Jason S Knight Journal: Sci Transl Med Date: 2020-11-02 Impact factor: 17.956