The most common persistent symptoms in patients with COVID-19 who were evaluated in the Internal Medicine polyclinic

Objectives: To identify continuing symptoms of individuals in the post-COVID period. To begin with our study was planned to research the most common persistent symptoms in the post-COVID period, and additionally to research whether or not there were differences between the most frequent initial symptoms in the 1st, 2nd and 3rd waves of the pandemic. Methods: Cases attending the internal medicine clinic infected with COVID-19 who were minimum 120 days past the infection were included in the study. The study was shaped by responses of cases to open-ended questions. Results: From a total of 2,802 clinical attendances, 1,005 cases were included in the study. Of cases, 9.3% required clinical monitoring and 1.7% required intensive care during infection. The mean number of persistent symptoms was 1.38, with the most common persistent symptoms being 11.2% fatigue/tiredness, 6.1% shortness of breath, and 4.6% back and low back pain. Mean number of initial symptoms was 1.63, with the most common initial symptoms being 21.2% fatigue, 19.4% fever and 19.1% headache. Persistent chest pain was most common among those infected in the 1st wave, while there were no other significant differences observed between pandemic waves. Conclusions: The most common persistent symptoms were consistent with the general literature data; however, our condition of minimum 120 days past infection allowed a range of symptoms to ameliorate. Our results are more realistic in this way. A range of rare persistent symptoms emerging in our results were not encountered in the literature, while our study is unique as there is no other study comparing pandemic periods.

Keywords:

COVID-19 persistent symptom, post-COVID-19,

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1. Chan JF, Yuan S, Kok KH, To KK, Chu H, Yang J, et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 2020;395:514-23.
2. Perlman S. Another decade, another coronavirus. N Engl J Med 2020;382:760-2.
3. DiToro A, Bozzani A, Tavazzi G, Urtis M, Giuliani L, Pizzoccheri R, et al. Long COVID: long-term effects. Eur Heart J Suppl 2021;23(Suppl E):E1-5.
4. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, het al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-9.
5. Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603-5.
6. Mandal S, Barnett J, Brill SE, Brown JS, Denneny EK, Hare SS, et al; ARC Study Group. Long-COVID: a cross-sectional study of persistings ymptoms, biomarker and imaging abnormalities following hospitalization for COVID-19. Thorax 2021;76:396-8.
7. Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: a cross-sectional evaluation. J Med Virol 2021;93:1013-22.
8. Wang X, Xu H, Jiang H, Wang L, Lu C, Wei X, et al. The clinical features and outcomes of discharged coronavirus disease 2019 patients: a prospective cohort study. QJM 2020;113:657-65.
9. Tenforde MW, Kim SS, Lindsell CJ. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate healthcare systems network - United States, March-June 2020. MMWR Morb Mortal Wkly Rep 2020;69:993-8.
10. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet 2021;397:220-32.
11. Petersen MS, Kristiansen MF, Hanusson KD, Danielsen ME, ÁSteig B, Gaini S, et al. Long COVID in the Faroe Islands - a longitudinal study among non-hospitalized patients. Clin Infect Dis 2021;73:e4058-63.
12. Karaarslan F, Güneri FD, Kardeş S. Long COVID: rheumatologic/musculoskeletal symptoms in hospitalized COVID-19 survivors at 3 and 6 months. Clin Rheumatol 2022;41:289-96.
13. Kayaaslan B, Eser F, Kalem AK, Kaya G, Kaplan B, Kacar D, et al. Post-COVID syndrome: a single-center questionnaire study on 1007 participants recovered from COVID-19. J Med Virol 2021;93:6566-74.
14. Georgieva I, Lepping P, Bozev V, Lickiewicz J, Pekara J, Wikman S, et al. Prevalence, new incidence, course, and risk factors of PTSD, depression, anxiety, and panic disorder during the Covid-19 pandemic in 11 countries. Healthcare (Basel) 2021;9:664.
15. Lui DTW, Lee CH, Chow WS, Lee ACH, Tam AR, Fong CHY, et al. Insights from a prospective follow-up of thyroid function and autoimmunity among COVID-19 survivors. Endocrinol Metab (Seoul) 2021;36:582-9.
16. Parks AL, Auerbach AD, Schnipper JL, Anstey JE, Sterken DG, Hecht TEH, et al; Hospital Medicine Reengineering Network (HOMERuN). COVID-19 coagulopathy and thrombosis: analysis of hospital protocols in response to the rapidly evolving pandemic. Thromb Res 2020;196:355-8.
17. Oktar D, Çam C, Zencirci SA, Aygar H, Dağtekin G, Pala SÇ, et al. [Evaluation of the relationship of chronic disease, multimorbidity and quality of life at primary healthcare centers]. Turk J Public Health 2021;19:116-28. [Article in Turkish]
18. Paudel SS. A meta-analysis of 2019 novel coronavirus patient clinical characteristics and comorbidities. ResearchSquare 2020. 10.21203/rs.3.rs-21831/v1 [Accessed April 18, 2020].
19. Yang J, Zheng Y, Gou X, Pu K, Chen Z, Guo Q, et al. Prevalence of comorbidities in the novel Wuhan coronavirus (COVID-19) infection: a systematic review and meta-analysis. Int J Infect Dis 2020;94:91-5.
20. Zhou F, Yu T, Du R, Fan G, Liu F, Liu Z, et al. Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054-62.
21. Fang X, Li S, Yu H, Wang P, Zhang Y, Chen Z, et al. Epidemiological, comorbidity factors with severity and prognosis of COVID-19: a systematic review and meta-analysis. Aging (Albany NY) 2020;12:12493-503.
22. Thanh HN, Van TN, Thu HNT, Van BN, Thanh BD, Thu HPT, et al. Outbreak investigation for COVID-19 in northern Vietnam. Lancet Infect Dis 2020;20:553-558