Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study

Max Augustin, MD; Philipp Schommers, M.D. PhD.; Melanie Stecher, Ph.D.; Felix Dewald, M.D.; Lutz Gieselmann, M.D.; Henning Gruell, M.D.; Carola Horn, M.D.; Kanika Vanshylla, Ph.D.; Veronica Di Cristanziano, M.D.; Luise Osebold; Maria Roventa; Toqeer Riaz; Nikolai Tschernoster, M.Sc; Janine Altmueller, M.D.; Leonard Rose, M.D.; Susanne Salomon, Ph.D.; Vanessa Priesner, M.D.; Jan Christoffer Luers, Prof.; Christian Albus, Prof.; Stephan Rosenkranz, Prof.; Birgit Gathof, Prof.; Gerd Fätkenheuer, Prof.; Michael Hallek, Prof.; Florian Klein, Prof.; Isabelle Suárez, M.D.; Clara Lehmann, Prof.

The Lancet Regional Health. Europe (Jul 2021)

Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study

Max Augustin, MD,
Philipp Schommers, M.D. PhD.,
Melanie Stecher, Ph.D.,
Felix Dewald, M.D.,
Lutz Gieselmann, M.D.,
Henning Gruell, M.D.,
Carola Horn, M.D.,
Kanika Vanshylla, Ph.D.,
Veronica Di Cristanziano, M.D.,
Luise Osebold,
Maria Roventa,
Toqeer Riaz,
Nikolai Tschernoster, M.Sc,
Janine Altmueller, M.D.,
Leonard Rose, M.D.,
Susanne Salomon, Ph.D.,
Vanessa Priesner, M.D.,
Jan Christoffer Luers, Prof.,
Christian Albus, Prof.,
Stephan Rosenkranz, Prof.,
Birgit Gathof, Prof.,
Gerd Fätkenheuer, Prof.,
Michael Hallek, Prof.,
Florian Klein, Prof.,
Isabelle Suárez, M.D.,
Clara Lehmann, Prof.

Affiliations

Max Augustin, MD: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany
Philipp Schommers, M.D. PhD.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany; Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Melanie Stecher, Ph.D.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany
Felix Dewald, M.D.: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Lutz Gieselmann, M.D.: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Henning Gruell, M.D.: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Carola Horn, M.D.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany
Kanika Vanshylla, Ph.D.: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Veronica Di Cristanziano, M.D.: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Luise Osebold: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Maria Roventa: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Toqeer Riaz: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Nikolai Tschernoster, M.Sc: Cologne Center for Genomics and West German Genome Center, University of Cologne, 50931 Cologne, Germany
Janine Altmueller, M.D.: Cologne Center for Genomics and West German Genome Center, University of Cologne, 50931 Cologne, Germany
Leonard Rose, M.D.: Institute of Transfusion Medicine, University Hospital Cologne, 50937 Cologne, Germany
Susanne Salomon, Ph.D.: Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Vanessa Priesner, M.D.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany
Jan Christoffer Luers, Prof.: Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Cologne, Cologne, Germany
Christian Albus, Prof.: Department of Psychosomatics and Psychotherapy, University Hospital Cologne, 50937, Cologne, Germany
Stephan Rosenkranz, Prof.: Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany; Department III of Internal Medicine, University Hospital Cologne, 50937 Cologne, Germany; Cologne Cardiovascular Research Center (CCRC) and Heart Center, University Hospital Cologne, 50937 Cologne, Germany
Birgit Gathof, Prof.: Institute of Transfusion Medicine, University Hospital Cologne, 50937 Cologne, Germany
Gerd Fätkenheuer, Prof.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany
Michael Hallek, Prof.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), Department I of Internal Medicine, University of Cologne, Cologne, Germany; Center of Integrated Oncology Aachen Bonn Cologne Düsseldorf, University of Cologne, Cologne, Germany
Florian Klein, Prof.: Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany; Institute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany
Isabelle Suárez, M.D.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany
Clara Lehmann, Prof.: Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany; Center for Molecular Medicine Cologne (CMMC), 50937 Cologne, Germany; German Center for Infection Research (DZIF), Bonn-Cologne, Germany; Corresponding author at: University Hospital Cologne, Uniklinik Koln, Kerpener Str 62, 50674 Cologne, NRW, Germany.

Journal volume & issue: Vol. 6
p. 100122

Abstract

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Background: While the leading symptoms during coronavirus disease 2019 (COVID-19) are acute and the majority of patients fully recover, a significant fraction of patients now increasingly experience long-term health consequences. However, most data available focus on health-related events after severe infection and hospitalisation. We present a longitudinal, prospective analysis of health consequences in patients who initially presented with no or minor symptoms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. Hence, we focus on mild COVID-19 in non-hospitalised patients. Methods: 958 Patients with confirmed SARS-CoV-2 infection were observed from April 6th to December 2nd 2020 for long-term symptoms and SARS-CoV-2 antibodies. We identified anosmia, ageusia, fatigue or shortness of breath as most common, persisting symptoms at month 4 and 7 and summarised presence of such long-term health consequences as post-COVID syndrome (PCS). Predictors of long-term symptoms were assessed using an uni- and multivariable logistic regression model. Findings: We observed 442 and 353 patients over four and seven months after symptom onset, respectively. Four months post SARS-CoV-2 infection, 8•6% (38/442) of patients presented with shortness of breath, 12•4% (55/442) with anosmia, 11•1% (49/442) with ageusia and 9•7% (43/442) with fatigue. At least one of these characteristic symptoms was present in 27•8% (123/442) and 34•8% (123/353) at month 4 and 7 post-infection, respectively. A lower baseline level of SARS-CoV-2 IgG, anosmia and diarrhoea during acute COVID-19 were associated with higher risk to develop long-term symptoms. Interpretation: The on-going presence of either shortness of breath, anosmia, ageusia or fatigue as long-lasting symptoms even in non-hospitalised patients was observed at four and seven months post-infection and summarised as post-COVID syndrome (PCS). The continued assessment of patients with PCS will become a major task to define and mitigate the socioeconomic and medical long-term effects of COVID-19. Funding: COVIM:“NaFoUniMedCovid19”(FKZ: 01KX2021)

Published in The Lancet Regional Health. Europe

ISSN: 2666-7762 (Online)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Medicine: Public aspects of medicine
Website: https://www.thelancet.com/journals/lanepe/home

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