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In this study, the authors examined data from 206,377 patients exploring the symptoms associated with COVID-19 infection in primary care settings. The most prevalent symptoms in non-hospitalized adult patients with mild disease were cough, fever, myalgia, fatigue, and nasal congestion. In children, the most prevalent were fever, cough, abdominal pain, and fatigue. Disturbances of the sensations of smell and taste were found in up to 10% of the patients starting 3 weeks prior to the diagnosis. In addition, headache and syncope in the 3 weeks prior to the test were associated with a positive result. The clinical course of the infection revealed that individuals with loss of smell and taste tend to have a shorter time to recovery compared with those experiencing shortness of breath, possibly due to the fact that the latter represents severer disease.
This longitudinal study provides a comprehensive evaluation of a large number of patients, highlighting additional information on the natural history of mostly mild cases of COVID-19, which may alert healthcare providers to the possibility of infection.
– Luiz Meirelles, DDS, MS, PhD
This abstract is available on the publisher's site.
As the COVID-19 pandemic progresses, obtaining information on symptoms dynamics is of essence. Here, we extracted data from primary-care electronic health records and nationwide distributed surveys to assess the longitudinal dynamics of symptoms prior to and throughout SARS-CoV-2 infection. Information was available for 206,377 individuals, including 2471 positive cases. The two datasources were discordant, with survey data capturing most of the symptoms more sensitively. The most prevalent symptoms included fever, cough and fatigue. Loss of taste and smell 3 weeks prior to testing, either self-reported or recorded by physicians, were the most discriminative symptoms for COVID-19. Additional discriminative symptoms included self-reported headache and fatigue and a documentation of syncope, rhinorrhea and fever. Children had a significantly shorter disease duration. Several symptoms were reported weeks after recovery. By a unique integration of two datasources, our study shed light on the longitudinal course of symptoms experienced by cases in primary care.