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COVID-19 can mean weeks-long illness, even in young adults and those without chronic conditions who have mild illness and are receiving outpatient treatment, according to today’s survey results. Weekly Morbidity and Mortality Report from the Centers for Disease Control and Prevention (CDC).
Mark W. Tenforde, MD, PhD, for the CDC-COVID-19 response team, and colleagues conducted a multistate telephone survey of symptomatic adults who tested positive for SARS-CoV-2. The researchers found that 35% had not returned to their usual state of well-being when they were interviewed 2 to 3 weeks after the test.
Among the 270 of 274 people interviewed for whom there were data on return to health, 175 (65%) reported that they had returned to the reference health status on average 7 days from the date of the test.
Among the 274 symptomatic outpatients, the median number of symptoms was seven. Fatigue (71%), cough (61%), and headache (61%) were the most commonly reported symptoms.
Prolonged disease is well described in hospitalized adults with severe COVID-19, especially among the older adult population, but little is known about other groups.
The proportion that had not recovered health differed according to age: 26% of those interviewed between 18 and 34 years, 32% of those between 35 and 49 years old and 47% of those who were at least 50 years old reported that they did not they had recovered their usual state of health. (P = .010) within 14 to 21 days after receiving positive test results.
Among respondents ages 18-34 who did not have a chronic medical condition, 19% (nine of 48) reported not having returned to their usual health status during that time.
Public health messages targeting younger adults, a group that is not expected to be sick for weeks with mild illness, is particularly important, the authors write.
Kyle Annen, DO, medical director of patient blood transfusion and management services at Children’s Hospital Colorado and an assistant professor of pathology at the University of Colorado at Denver, said Medscape Medical News An important message is that late recovery (symptoms of fatigue, cough, and shortness of breath) was evident in almost a quarter of 18- to 34-year-olds and in one-third of 35-49 year-olds who were not. sick enough to require hospitalization.
“This should affect the perception that it is a mild illness in the young adult population and encourage them to comply with the recommendations for social distancing, masking and handwashing,” he said.
He noted that recovery time of more than 2 weeks will affect work and school performance, especially prolonged fatigue. This was one of the prominent symptoms reported to be slowly dissipating.
“I think the most interesting point in this study is that of the underlying conditions; psychiatric conditions were significantly correlated with prolonged recovery. I don’t think many people think of depression and anxiety as an underlying medical condition regarding the risk of COVID-19 “This could have a potential impact, as depression and anxiety rates are likely to increase as COVID-19 continues,” he said.
Buddy Creech, MD, MPH said Medscape Medical News“It is important to realize that the spectrum of disease with COVID is broad, including mild disease, severe disease, and long-term disease. This report helps us understand some of the risk factors for people with long-term symptoms and can allow us to refine even more clearly how we prioritize vaccine treatment and administration, once available.
“It also highlights the challenge of dealing with this virus. Not only do symptoms vary widely, but also the incubation period, duration of symptoms, and residual symptoms that sometimes occur. Clearly, there is still much to understand about this virus. “, said.
The interviews were conducted from April 15 to June 25 with a random sample of adults at least 18 years of age who had received a first positive result for SARS-CoV-2 at an outpatient visit in one of the 14 US academic health systems in 13 states.
Annen and Creech have disclosed no relevant financial relationships.
Morb Mortal Wkly Rev. Published online July 24, 2020. Full text
Marcia Frellick is a Chicago-based freelance journalist. She has previously written for the Chicago Tribune and Nurse.com and was an editor at the Chicago Sun-Times, Cincinnati Enquirer, and St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.
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