With a growing number of COVID-19 patients reporting lingering symptoms and complications, healthcare leaders are scrambling to gather data and seek patterns that could help providers better understand COVID long-haulers and supply effective interventions. A volunteer-led study aimed to document the symptom profile and timeline in patients with long COVID, including the impact on their daily activities and their return to baseline health.* 

What they looked for

The study consisted of a web-based survey of suspected and confirmed COVID-19 patients who got sick before June 2020 and whose illness lasted longer than 28 days. The survey forms were disseminated throughout online COVID-19 support groups and social media platforms.

Respondents who completed the survey included 3,762 patients from 56 countries:

• 27% received a laboratory-confirmed diagnosis of COVID-19.
• 8.4% reported being hospitalized.
• 96% reported symptoms that lasted more than 90 days.

What they discovered  

Approximately 205 symptoms across 10 organ systems (an average of 9.08) were reported, with 66 of the symptoms traced over seven months. 

After six months, respondents most frequently reported that they were still experiencing: 

• Fatigue (77.7%)
• Post-exertional malaise (72.2%)
• Cognitive dysfunction (55.4%)

These were also the three most commonly reported symptoms overall. For those who recovered in fewer than 90 days, the average number of symptoms (11.4) peaked during the second week, and for those who did not recover in 90 days, the average number of symptoms (17.2) peaked during the second month.  

Respondents with symptoms lingering beyond six months experienced an average of 13.8 symptoms during month seven, which included the following:

• 85.9% experienced relapses, with the primary catalysts being exercise, physical or mental activity, and stress. 
• 86.7% of unrecovered respondents were experiencing fatigue at the time of the survey, compared with 44.7% of recovered respondents. 
• 45.2% required a reduced work schedule compared to pre-illness.  
• 22.3% were not working at the time of the survey due to their health conditions.

Conclusions 

Patients with long COVID report significant prolonged multisystem effects and disability worldwide. Most survey respondents had not returned to previous work levels by the end of six months from illness onset. After seven months, many respondents had still not recovered from all their symptoms and “continue to experience significant symptom burden,” as stated in the study.

As stated on the medRxiv website, “This article is a preprint and has not been peer-reviewed. It reports new medical research that has yet to be evaluated and so should not be used to guide clinical practice.”

*Davis, H. E., Assaf, G. S., McCorkell, L., Wei, H., et al. (2020, Dec. 27). Characterizing Long COVID in an International Cohort: 7 Months of Symptoms and Their Impact. medRxiv. https://www.medrxiv.org/content/10.1101/2020.12.24.20248802v2 

Much about the novel coronavirus, i.e., COVID-19, is still not fully understood. As research progresses and our knowledge of the virus increases, information can change rapidly. We strive to update all of our articles as quickly as possible, but there may occasionally be some lag between scientific developments and our revisions.