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About:
Longitudinal symptom dynamics of COVID-19 infection in primary care
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research paper
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Academic Article
research paper
schema:ScholarlyArticle
isDefinedBy
Covid-on-the-Web dataset
title
Longitudinal symptom dynamics of COVID-19 infection in primary care
Creator
Segal, Eran
Keshet, Ayya
Rossman, Hagai
Shilo, Smadar
Barer, Yael
Chodick, Gabriel
Kalkstein, Nir
Marcus, Karni
Mizrahi, Barak
Segal,
Shalev, Varda
Zohar, Anat
Ama Shamir-Stein, Na
source
MedRxiv
abstract
Importance: Data regarding the clinical characteristics of COVID-19 infection is rapidly accumulating. However, most studies thus far are based on hospitalized patients and lack longitudinal follow up. As the majority of COVID-19 cases are not hospitalized, prospective studies of symptoms in the population presenting to primary care are needed. Objective: To assess the longitudinal dynamic of clinical symptoms in non-hospitalized individuals prior to and throughout the diagnosis of SARS-CoV-2 infection. Design, Setting, and Participants: From 1/3/2020 to 07/06/2020, information on symptoms from either surveys or primary care visits was available for 206,377 individuals, including 2,471 who tested positive for COVID-19. Data were extracted from electronic health records (EHR) of the second largest Health Maintenance Organization in Israel, consisting of both results of PCR tests and symptoms recorded by primary care physicians, and linked longitudinal self reported symptoms. Exposures: Diagnosis of COVID-19 disease was made by PCR testing for SARS-CoV-2 from nasopharyngeal swabs. Main Outcomes and Measures: Longitudinal prevalence of clinical symptoms Results: In adults, the most prevalent symptoms recorded in EHR were cough (11.6%), fever (10.3%), and myalgia (7.7%) and the most prevalent self-reported symptoms were cough (21%), fatigue (19%) and rhinorrhea and/or nasal congestion (17%). In children, the most prevalent symptoms recorded in the EHR were fever (7%), cough (5.5%) and abdominal pain (2.4%). Emotional disturbances were documented in 15.9% of the positive adults and 4.2% of the children. Loss of taste and smell, either self-reported or documented by a physician, 3 weeks prior to testing, were the most discriminative symptoms in adults (OR =11.18 and OR=5.47 respectively). Additional symptoms included self reported confusion (OR =4.02), and fatigue (OR = 1.73) and a documentation of syncope, rhinorrhea (OR = 2.09 for both ) and fever (OR= 1.62 ) by a physician. Mean time to recovery was 23.5 +- 9.9 days. Children had a significantly shorter disease duration (21.7 +- 8.8 days, p-value=0.01). Several symptoms, including fatigue, myalgia, runny nose and shortness of breath were reported weeks after recovery. Conclusions and Relevance: As the COVID-19 pandemic progresses rapidly worldwide, obtaining accurate information on symptoms and their progression is of essence. Our study shed light on the full clinical spectrum of symptoms experienced by infected individuals in primary care, and may alert physicians for the possibility of COVID-19 infection.
has issue date
2020-07-14
(
xsd:dateTime
)
bibo:doi
10.1101/2020.07.13.20151795
has license
medrxiv
sha1sum (hex)
c92482c2ad9f8ad2f6ae1d5b5bb38e466805f3da
schema:url
https://doi.org/10.1101/2020.07.13.20151795
resource representing a document's title
Longitudinal symptom dynamics of COVID-19 infection in primary care
resource representing a document's body
covid:c92482c2ad9f8ad2f6ae1d5b5bb38e466805f3da#body_text
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named entity 'primary care'
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named entity 'COVID'
named entity 'epidemiological'
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named entity 'symptom'
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named entity 'clinical symptoms'
named entity 'medRxiv'
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named entity 'COVID-19 testing'
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named entity 'CC-BY-NC-ND 4.0'
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named entity 'chest discomfort'
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named entity 'PCR test'
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