The Symptom Experience and Functioning of Non-Hospitalized COVID-19 Patients Within the First 20 days

Clin Nurs Res. 2023 Mar;32(3):608-617. doi: 10.1177/10547738231155729. Epub 2023 Feb 17.


The adverse physical, psychological, and mental health consequences associated with COVID-19 illness are well-documented. However, how specific symptoms change over time and how COVID-19 affects one's day-to-day activities of daily living (ADL), Quality of Life (QoL), sleep quality, and fatigue severity are not well described. This longitudinal and descriptive study examined the changes in COVID-19 symptoms, ADL, QoL, sleep quality, and fatigue severity within the first 20 days. A convenience sample (n = 41) of non-hospitalized SARS-CoV-2 positive patients were recruited and followed for 20 days. Participants completed self-report measures: COVID-19 symptoms, ADL, QoL, sleep quality, and fatigue severity at days: 1, 10, and 20 following a diagnosis. Findings revealed that symptoms decreased over 20 days (p < .001). In parallel with the decrease in symptoms, QoL and ADL improved over 20 days (p < .05). However, sleep quality and fatigue severity did not improve within 20 days (p > .05). Our findings contribute to the growing evidence that COVID-19 symptoms can linger, especially fatigue and sleep quality, that affect overall day-to-day functioning for at least 20 days after diagnosis. To mitigate the effect of COVID-19 on QOL and ADL, findings underscore the need for clinicians to work collaboratively with patients to develop a symptom management plan for a variety of symptoms including fatigue and sleep quality. Beginning to repurpose existing self-management strategies for the longer term COVID-19 symptoms could be beneficial and help to optimize patient outcomes. Future work should examine these variables over a longer timeframe and among different samples of non-hospitalized patients.

Keywords: COVID-19; activities of daily living; fatigue; quality of life; sleep quality.

MeSH terms

  • Activities of Daily Living
  • COVID-19* / epidemiology
  • Fatigue
  • Humans
  • Quality of Life*
  • SARS-CoV-2