• Max Augustin, Philipp Schommers, Melanie Stecher, Felix Dewald, Lutz Gieselmann, Henning Gruell, Carola Horn, Kanika Vanshylla, CristanzianoVeronica DiVDInstitute of Virology, Faculty of Medicine and University Hospital of Cologne, University of Cologne, 50935 Cologne, Germany., Luise Osebold, Maria Roventa, Toqeer Riaz, Nikolai Tschernoster, Janine Altmueller, Leonard Rose, Susanne Salomon, Vanessa Priesner, Jan Christoffer Luers, Christian Albus, Stephan Rosenkranz, Birgit Gathof, Gerd Fätkenheuer, Michael Hallek, Florian Klein, Isabelle Suárez, and Clara Lehmann.
• Department I of Internal Medicine, Medical Faculty and University Hospital Cologne, University of Cologne, 50937 Cologne, Germany.
• Lancet Reg Health Eur. 2021 Jul 1; 6: 100122.

BackgroundWhile the leading symptoms during coronavirus disease 2019 (COVID-19) are acute and the majority of patients fully recover, a significant fraction of patients now increasingly experience long-term health consequences. However, most data available focus on health-related events after severe infection and hospitalisation. We present a longitudinal, prospective analysis of health consequences in patients who initially presented with no or minor symptoms of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) infection. Hence, we focus on mild COVID-19 in non-hospitalised patients.Methods958 Patients with confirmed SARS-CoV-2 infection were observed from April 6th to December 2nd 2020 for long-term symptoms and SARS-CoV-2 antibodies. We identified anosmia, ageusia, fatigue or shortness of breath as most common, persisting symptoms at month 4 and 7 and summarised presence of such long-term health consequences as post-COVID syndrome (PCS). Predictors of long-term symptoms were assessed using an uni- and multivariable logistic regression model.FindingsWe observed 442 and 353 patients over four and seven months after symptom onset, respectively. Four months post SARS-CoV-2 infection, 8•6% (38/442) of patients presented with shortness of breath, 12•4% (55/442) with anosmia, 11•1% (49/442) with ageusia and 9•7% (43/442) with fatigue. At least one of these characteristic symptoms was present in 27•8% (123/442) and 34•8% (123/353) at month 4 and 7 post-infection, respectively. A lower baseline level of SARS-CoV-2 IgG, anosmia and diarrhoea during acute COVID-19 were associated with higher risk to develop long-term symptoms.InterpretationThe on-going presence of either shortness of breath, anosmia, ageusia or fatigue as long-lasting symptoms even in non-hospitalised patients was observed at four and seven months post-infection and summarised as post-COVID syndrome (PCS). The continued assessment of patients with PCS will become a major task to define and mitigate the socioeconomic and medical long-term effects of COVID-19.FundingCOVIM:"NaFoUniMedCovid19"(FKZ: 01KX2021).© 2021 The Authors.

This article appears in the collection: What is Long COVID?.

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