4.5 Article

Clinical characteristics and symptom duration among outpatients with COVID-19

Journal

AMERICAN JOURNAL OF INFECTION CONTROL
Volume 50, Issue 4, Pages 383-389

Publisher

MOSBY-ELSEVIER
DOI: 10.1016/j.ajic.2021.10.039

Keywords

Coronavirus infections; Risk factors; Ambulatory care; Recovery of function; Outpatients statistics and numerical data

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This retrospective cohort study examined the symptom duration among COVID-19 patients who did not require hospitalization, with results showing that lower respiratory symptoms and neurological symptoms at disease onset were associated with prolonged symptom duration. The median symptom duration for outpatients was found to be 15 days, with over 25% of patients experiencing symptoms for longer than 21 days.
Background: Approximately 80% of people with COVID-19 do not require hospitalization. Studies examining the outpatient experience have not tracked symptoms to resolution leading to unknown expected symptom duration. Our objectives were to (1) determine symptom duration among patients with COVID-19 who do not require hospitalization and (2) identify potential risk factors associated with prolonged symptom duration.Design: This is a retrospective cohort study conducted across an academic healthcare system including adult patients with laboratory-confirmed SARS-CoV-2 infection between March 18th and April 28th, 2020 who were not hospitalized. Symptom duration encompassed time from patient-reported symptom onset as documented in the chart until documented symptom resolution. We calculated the median symptom duration and tested if demographics, comorbidities, or reported symptoms were associated with symptom duration.Key results: Of 294 patients meeting inclusion criteria, 178 (60.5%) had documented symptom resolution. The median [interquartile range (IQR)] symptom duration for included patients was 15 (8-24) days. No associations were found between comorbidities and symptom duration. Factors associated with prolonged symptom duration were presence vs lack of lower respiratory symptoms [median (IQR) 16.5 (10.75-33.5) vs 14.5 (7-21.75) days respectively, P < .001] and neurologic symptoms [median (IQR) 17 (9-28) vs 9.5 (4-17) days, P < .001] at disease onset.Conclusions: The median symptom duration in outpatients is 15 days and over 25% of patients have symptoms longer than 21 days.(c) 2021 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

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