In addition, 683 participants tested positive for SARS-CoV-2 antibodies (either IgG, IgM, or both).Īmong unrecovered respondents who worked before becoming ill, only 27.3% (95% confidence interval 25.3% to 29.4%) were working as many hours as they were prior to becoming ill at the time of survey, compared to 49.3% (40.8% to 57.9%) of recovered respondents (see Fig. 12d). 54.9% (positive), p < 0.0001 Fisher's exact test, Bonferroni corrected). The loss of smell and taste were the only exceptions (loss of smell: 22.2% (negative) vs 60.8% (positive), p < 0.0001 21.5% loss of taste: 21.5% (negative) vs. 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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