Prevalence of Symptoms More Than Seven Months After Diagnosis of Symptomatic COVID-19 in an Outpatient Setting

Ann Intern Med. 2021 Sep;174(9):1252-1260. doi: 10.7326/M21-0878. Epub 2021 Jul 6.


Background: With millions of SARS-CoV-2 infections worldwide, increasing numbers of patients are coming forward with long-term clinical effects of the disease lasting several weeks to months.

Objective: To characterize symptoms 7 to 9 months after diagnosis of COVID-19.

Design: Self-reported surveys and semistructured telephone interviews at enrollment and 30 to 45 days and 7 to 9 months from diagnosis.

Setting: From 18 March to 15 May 2020, symptomatic persons who tested positive for SARS-CoV-2 at the Geneva University Hospitals were followed by CoviCare, a virtual, clinical, outpatient follow-up program. Persons were contacted again at 30 to 45 days and 7 to 9 months from diagnosis.

Participants: Persons who were a part of the CoviCare program from 18 March to 15 May 2020.

Measurements: A standardized interview of symptoms consistent with COVID-19, with grading of intensity.

Results: Of the 629 participants in the study who completed the baseline interviews, 410 completed follow-up at 7 to 9 months after COVID-19 diagnosis; 39.0% reported residual symptoms. Fatigue (20.7%) was the most common symptom reported, followed by loss of taste or smell (16.8%), dyspnea (11.7%), and headache (10.0%).

Limitation: Limitations include generalizability and missing data for 34.8% of participants.

Conclusion: Residual symptoms after SARS-CoV-2 infection are common among otherwise young and healthy persons followed in an outpatient setting. These findings contribute to the recognition of long-term effects in a disease mostly counted by its death toll to date by promoting communication on postacute sequelae of SARS-CoV-2 and encouraging physicians to continue long-term monitoring of their patients.

Primary funding source: None.

MeSH terms

  • Adolescent
  • Adult
  • Ambulatory Care*
  • COVID-19 / complications*
  • COVID-19 / diagnosis*
  • COVID-19 / epidemiology
  • Dyspnea / virology
  • Fatigue / virology
  • Female
  • Headache / virology
  • Health Surveys / methods
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Olfaction Disorders / virology
  • Post-Acute COVID-19 Syndrome
  • Prevalence
  • SARS-CoV-2
  • Self Report
  • Telephone
  • Time Factors
  • Young Adult