tetano
Editor, Senior Moderator
Open Forum Infect Dis
. 2021 Mar 1;8(3)
fab090.
doi: 10.1093/ofid/ofab090. eCollection 2021 Mar.
Acute Symptoms of Mild to Moderate COVID-19 Are Highly Heterogeneous Across Individuals and Over Time
Thomas L Rodebaugh[SUP] 1 [/SUP], Madelyn R Frumkin[SUP] 1 [/SUP], Angela M Reiersen[SUP] 2 [/SUP], Eric J Lenze[SUP] 2 [/SUP], Michael S Avidan[SUP] 3 [/SUP], J Philip Miller[SUP] 4 [/SUP], Jay F Piccirillo[SUP] 5 [/SUP], Charles F Zorumski[SUP] 2 [/SUP], Caline Mattar[SUP] 6 [/SUP]
Affiliations
Abstract
Background: The symptoms of coronavirus disease 2019 (COVID-19) appear to be heterogenous, and the typical course of these symptoms is unknown. Our objectives were to characterize the common trajectories of COVID-19 symptoms and to assess how symptom course predicts other symptom changes as well as clinical deterioration.
Methods: One hundred sixty-two participants with acute COVID-19 responded to surveys up to 31 times for up to 17 days. Several statistical methods were used to characterize the temporal dynamics of these symptoms. Because 9 participants showed clinical deterioration, we explored whether these participants showed any differences in symptom profiles.
Results: Trajectories varied greatly between individuals, with many having persistently severe symptoms or developing new symptoms several days after being diagnosed. A typical trajectory was for a symptom to improve at a decremental rate, with most symptoms still persisting to some degree at the end of the reporting period. The pattern of symptoms over time suggested a fluctuating course for many patients. Participants who showed clinical deterioration were more likely to present with higher reports of severity of cough and diarrhea.
Conclusions: The course of symptoms during the initial weeks of COVID-19 is highly heterogeneous and is neither predictable nor easily characterized using typical survey methods. This has implications for clinical care and early-treatment clinical trials. Additional research is needed to determine whether the decelerating improvement pattern seen in our data is related to the phenomenon of patients reporting long-term symptoms and whether higher symptoms of diarrhea in early illness presages deterioration.
Keywords: COVID-19; cough; humans; severe acute respiratory syndrome coronavirus 2; smell; taste.
. 2021 Mar 1;8(3)
fab090.doi: 10.1093/ofid/ofab090. eCollection 2021 Mar.
Acute Symptoms of Mild to Moderate COVID-19 Are Highly Heterogeneous Across Individuals and Over Time
Thomas L Rodebaugh[SUP] 1 [/SUP], Madelyn R Frumkin[SUP] 1 [/SUP], Angela M Reiersen[SUP] 2 [/SUP], Eric J Lenze[SUP] 2 [/SUP], Michael S Avidan[SUP] 3 [/SUP], J Philip Miller[SUP] 4 [/SUP], Jay F Piccirillo[SUP] 5 [/SUP], Charles F Zorumski[SUP] 2 [/SUP], Caline Mattar[SUP] 6 [/SUP]
Affiliations
- PMID: 33796601
- PMCID: PMC7989225
- DOI: 10.1093/ofid/ofab090
Abstract
Background: The symptoms of coronavirus disease 2019 (COVID-19) appear to be heterogenous, and the typical course of these symptoms is unknown. Our objectives were to characterize the common trajectories of COVID-19 symptoms and to assess how symptom course predicts other symptom changes as well as clinical deterioration.
Methods: One hundred sixty-two participants with acute COVID-19 responded to surveys up to 31 times for up to 17 days. Several statistical methods were used to characterize the temporal dynamics of these symptoms. Because 9 participants showed clinical deterioration, we explored whether these participants showed any differences in symptom profiles.
Results: Trajectories varied greatly between individuals, with many having persistently severe symptoms or developing new symptoms several days after being diagnosed. A typical trajectory was for a symptom to improve at a decremental rate, with most symptoms still persisting to some degree at the end of the reporting period. The pattern of symptoms over time suggested a fluctuating course for many patients. Participants who showed clinical deterioration were more likely to present with higher reports of severity of cough and diarrhea.
Conclusions: The course of symptoms during the initial weeks of COVID-19 is highly heterogeneous and is neither predictable nor easily characterized using typical survey methods. This has implications for clinical care and early-treatment clinical trials. Additional research is needed to determine whether the decelerating improvement pattern seen in our data is related to the phenomenon of patients reporting long-term symptoms and whether higher symptoms of diarrhea in early illness presages deterioration.
Keywords: COVID-19; cough; humans; severe acute respiratory syndrome coronavirus 2; smell; taste.