Post-COVID syndrome: Turning convalescence into illness? - Authors' reply.

We have carefully read the reply letter by Doctores Cozzi, Amaddeo and Barbi [1] to our research paper titled “Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study” [2] and note that a disruptive event such as the pandemic can promote the development of somatoform symptoms in predisposed individuals. We agree that there is a danger in seeking health care that somatoform symptoms may instead be exacerbated, with the risk of convalescence becoming illness.

Convalescence from COVID-19 can take a lengthy course over months resulting in great societal and economic consequences. We found anosmia, ageusia, shortness of breath and fatigue to be the most common persisting symptom up to 7 months after symptom onset. Here, specific symptoms face nonspecific symptoms, physical health faces mental health. Especially with regard to fatigue, a holistic approach is necessary to reduce bias. It is undisputed that the aggravating circumstances such as social distancing and frequently changing narratives pose a particular challenge in terms of mental health and coping strategies. This is precisely when it is important to perceive patient impressions, to put them into perspective and to examine them in a multidisciplinary manner, as we did with 958 SARS-CoV-2 convalescents. It is important to emphasize that all post-COVID symptoms reported were newly emerged and resulted in restrictions of everyday life. Thus, a differentiated and critical anamnesis is essential to assess the symptoms in order to finally make the clinical diagnosis of a post-COVID syndrome and furthermore to provide support and offer solutions with the aim of shortening time of convalescence.

Taken together, we don't think critically evaluating and labelling health consequences after viral illness is about turning convalescence into illness but rather about labelling illness to accelerate convalescence.

Author contribution

MA an CL contributed to all aspects of the Letter.

Declaration of Competing Interests

MA and CL have nothing to disclose.