![]() The primary difference between these two groups was the time elapsed between symptom onset and testing, with a median of 6 days for those who tested positive and 43 days for those who tested negative ( p 0.05 Fisher's exact test, Bonferroni corrected). A general progression from early to late symptoms can also be seen in the heatmap of normalized time courses ( Fig. 6 & Supplemental Figure S3), which have been sorted by similarity in shape (see Methods).Īmong respondents who received a diagnostic test (RT-PCR or antigen) for SARS-CoV-2 at any point during their illness, 1730 tested negative and 600 tested positive. All clusters contained symptoms from multiple organ systems, and Cluster 3 contained symptoms from all but one organ system (pulmonary/respiratory symptoms). Their probability may plateau (like constipation), decrease slightly (like post-exertional malaise and fatigue), or increase slightly in the later months (like tinnitus, hearing loss, muscle spasms, and tremors). Cluster 3 consists of symptoms most likely to increase sharply in the first two months. Cluster 2 consists of symptoms with a relatively stable probability over time. Cluster 1 consists of symptoms that are most likely to occur early in the illness, reaching a high point in the first two or three weeks, then decreasing in probability over time. changes in relative amplitude over time, ignoring their overall prevalence, see Methods). ![]() Symptoms were clustered in three groups ( Fig. 6), according to the shapes of their time courses (i.e. Participants experienced an average of 55.9+/- 25.5 (mean+/-STD) symptoms during their illness. The top three most debilitating symptoms listed by patients were: 1) fatigue ( n>2652), 2) breathing issues ( n>2242), and 3) cognitive dysfunction ( n>1274). Musculoskeletal, cardiovascular, gastrointestinal, pulmonary, and neuropsychiatric symptoms were prevalent in >85% of participants (further detail in Supplemental Tables S5-S21). Almost all participants experienced systemic (99.7%, 95% confidence interval 99.49% to 99.84%), and HEENT (100%) symptoms. Table 3 summarizes these prevalence estimates for 18 categories (nine non-neuropsychiatric organ systems: systemic, reproductive/genitourinary/endocrine, cardiovascular, musculoskeletal, immunological and autoimmune, HEENT, pulmonary, gastrointestinal and dermatologic in Fig. 2, and nine neuropsychiatric sub-groups: cognitive dysfunction, speech and language, memory, headaches, smell and taste, sleep, emotion and mood, hallucinations, sensorimotor in Fig. 3, see Appendix F Table S6-S23 for raw data). Overall symptom prevalence in 10 organ systems was estimated for a total of 203 symptoms (see Methods, Appendix A for list of symptoms). Except for loss of smell and taste, the prevalence and trajectory of all symptoms were similar between groups with confirmed and suspected COVID-19. Cognitive dysfunction or memory issues were common across all age groups (~88%). 1700 respondents (45.2%) required a reduced work schedule compared to pre-illness, and an additional 839 (22.3%) were not working at the time of survey due to illness. 86.7% (85.6% to 92.5%) of unrecovered respondents were experiencing fatigue at the time of survey, compared to 44.7% (38.5% to 50.5%) of recovered respondents. 85.9% of participants (95% CI, 84.8% to 87.0%) experienced relapses, primarily triggered by exercise, physical or mental activity, and stress. Symptoms varied in their prevalence over time, and we identified three symptom clusters, each with a characteristic temporal profile. The most frequent symptoms after month 6 were fatigue, post-exertional malaise, and cognitive dysfunction. During their illness, participants experienced an average of 55.9+/- 25.5 (mean+/-STD) symptoms, across an average of 9.1 organ systems. The Lancet Regional Health – Western Pacificįor the majority of respondents (>91%), the time to recovery exceeded 35 weeks.The Lancet Regional Health – Southeast Asia.The Lancet Gastroenterology & Hepatology.
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