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Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?

Yvonne M.J. Goërtz, Maarten Van Herck, Jeannet M. Delbressine, Anouk W. Vaes, Roy Meys, Felipe V.C. Machado, Sarah Houben-Wilke, Chris Burtin, Rein Posthuma, Frits M.E. Franssen, Nicole van Loon, Bita Hajian, Yvonne Spies, Herman Vijlbrief, Alex J. van ’t Hul, Daisy J.A. Janssen, Martijn A. Spruit
ERJ Open Research 2020; DOI: 10.1183/23120541.00542-2020
Yvonne M.J. Goërtz
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
9shared first author
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Maarten Van Herck
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
4REVAL – Rehabilitation Research Center, BIOMED – Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
9shared first author
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Jeannet M. Delbressine
1Department of Research and Development, Ciro, Horn, the Netherlands
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Anouk W. Vaes
1Department of Research and Development, Ciro, Horn, the Netherlands
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Roy Meys
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Felipe V.C. Machado
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Sarah Houben-Wilke
1Department of Research and Development, Ciro, Horn, the Netherlands
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Chris Burtin
4REVAL – Rehabilitation Research Center, BIOMED – Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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Rein Posthuma
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Frits M.E. Franssen
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Nicole van Loon
1Department of Research and Development, Ciro, Horn, the Netherlands
5Department of Internal Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Bita Hajian
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
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Yvonne Spies
6Lung Foundation Netherlands, Amersfoort, the Netherlands
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Herman Vijlbrief
6Lung Foundation Netherlands, Amersfoort, the Netherlands
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Alex J. van ’t Hul
7Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, the Netherlands
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Daisy J.A. Janssen
1Department of Research and Development, Ciro, Horn, the Netherlands
8Department of Health Services Research, Care and Public Health Research Institute, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Martijn A. Spruit
1Department of Research and Development, Ciro, Horn, the Netherlands
2Nutrim School of Nutrition and Translational Research in Metabolism, Maastricht, the Netherlands
3Department of Respiratory Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, the Netherlands
4REVAL – Rehabilitation Research Center, BIOMED – Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Diepenbeek, Belgium
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Abstract

Background Many patients with COVID-19 do not require hospitalisation, let alone have undergone COVID-19 testing. There is anecdotal evidence that patients with “mild” COVID-19 may complain about persistent symptoms, even weeks after the infection. This suggests that symptoms during the infection may not resolve spontaneously. The objective of this study was to assess whether multiple relevant symptoms recover following the onset of symptoms in hospitalised and non-hospitalised patients with COVID-19.

Methods 2113 members of two Facebook groups for coronavirus patients with persistent complaints in The Netherlands and Belgium, and from a panel of people who registered at a website of the Lung Foundation Netherlands, were assessed for demographics, pre-existing comorbidities, health status, date of symptoms onset, COVID-19 diagnosis, healthcare utilisation, and the presence of 29 symptoms at the time of the onset of symptoms (retrospectively) and at follow-up (79±17 days after symptoms onset).

Results 112 hospitalised patients and 2001 non-hospitalised patients (confirmed COVID-19, n=345; symptom-based COVID-19, n=882; and suspected COVID-19, n=774) were analysed. The median number of symptoms during the infection reduced significantly over time (14 (11–17) versus6 (4–9), p<0.001). Fatigue and dyspnoea were the most prevalent symptoms during the infection and at follow-up (fatigue: 95% versus 87%; dyspnoea: 90% versus 71%).

Conclusion In previously hospitalised and non-hospitalised patients with confirmed or suspected COVID-19, multiple symptoms are present about 3 months after symptoms onset. This suggests the presence of a “post-COVID-19 syndrome” and highlights the unmet healthcare needs in a subgroup of patients with “mild” or “severe” COVID-19.

Footnotes

This manuscript has recently been accepted for publication in the ERJ Open Research. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJOR online. Please open or download the PDF to view this article.

Conflict of interest: Dr. Goërtz has nothing to disclose.

Conflict of interest: Dr. Van Herck has nothing to disclose.

Conflict of interest: Dr. Delbressine has nothing to disclose.

Conflict of interest: Dr. Vaes has nothing to disclose.

Conflict of interest: Dr. Meys has nothing to disclose.

Conflict of interest: Dr. Machado has nothing to disclose.

Conflict of interest: Dr. Houben-Wilke has nothing to disclose.

Conflict of interest: Dr. Burtin has nothing to disclose.

Conflict of interest: Dr. Posthuma has nothing to disclose.

Conflict of interest: Dr. Franssen reports personal fees from GlaxoSmithKline, personal fees from Chiesi, personal fees from Boehringer Inghelheim, grants and personal fees from AstraZeneca, grants and personal fees from Novartis, personal fees from TEVA, outside the submitted work.

Conflict of interest: Dr. van Loon has nothing to disclose.

Conflict of interest: Dr. Hajian has nothing to disclose.

Conflict of interest: Dr. Spies has nothing to disclose.

Conflict of interest: Dr. Vijlbrief has nothing to disclose.

Conflict of interest: Dr. van ’t Hul has nothing to disclose.

Conflict of interest: D.J.A. Janssen reports speaker fees from Novartis, Boehringer Ingelheim and AstraZeneca, outside the submitted work.

Conflict of interest: Dr. Spruit reports grants from Lung Foundation Netherlands, grants from Stichting Astma Bestrijding, grants and personal fees from Boehringer Inghelheim, grants and personal fees from AstraZeneca, outside the submitted work.

This is a PDF-only article. Please click on the PDF link above to read it.

  • Received July 30, 2020.
  • Accepted August 13, 2020.
  • Copyright ©ERS 2020
http://creativecommons.org/licenses/by-nc/4.0/

This article is open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?
Yvonne M.J. Goërtz, Maarten Van Herck, Jeannet M. Delbressine, Anouk W. Vaes, Roy Meys, Felipe V.C. Machado, Sarah Houben-Wilke, Chris Burtin, Rein Posthuma, Frits M.E. Franssen, Nicole van Loon, Bita Hajian, Yvonne Spies, Herman Vijlbrief, Alex J. van ’t Hul, Daisy J.A. Janssen, Martijn A. Spruit
ERJ Open Research Jan 2020, 00542-2020; DOI: 10.1183/23120541.00542-2020

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Persistent symptoms 3 months after a SARS-CoV-2 infection: the post-COVID-19 syndrome?
Yvonne M.J. Goërtz, Maarten Van Herck, Jeannet M. Delbressine, Anouk W. Vaes, Roy Meys, Felipe V.C. Machado, Sarah Houben-Wilke, Chris Burtin, Rein Posthuma, Frits M.E. Franssen, Nicole van Loon, Bita Hajian, Yvonne Spies, Herman Vijlbrief, Alex J. van ’t Hul, Daisy J.A. Janssen, Martijn A. Spruit
ERJ Open Research Jan 2020, 00542-2020; DOI: 10.1183/23120541.00542-2020
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