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. 2021 Jun 17;11(1):12775.
doi: 10.1038/s41598-021-91270-8.

Persistent symptoms and lab abnormalities in patients who recovered from COVID-19

Julian Varghese  1 , Sarah Sandmann  2 , Kevin Ochs  3 , Inga-Marie Schrempf  3 , Christopher Frömmel  3 , Martin Dugas  2   4 , Hartmut H Schmidt #  3 , Richard Vollenberg #  3 , Phil-Robin Tepasse #  3
Affiliations

Persistent symptoms and lab abnormalities in patients who recovered from COVID-19

Julian Varghese et al. Sci Rep. .

Abstract

With increasing numbers of patients recovering from COVID-19, there is increasing evidence for persistent symptoms and the need for follow-up studies. This retrospective study included patients without comorbidities, who recovered from COVID-19 and attended an outpatient clinic at a university hospital for follow-up care and potential convalescent plasma donation. Network analysis was applied to visualize symptom combinations and persistent symptoms. Comprehensive lab-testing was ascertained at each follow-up to analyze differences regarding patients with vs without persistent symptoms. 116 patients were included, age range was 18-69 years (median: 41) with follow-ups ranging from 22 to 102 days. The three most frequent persistent symptoms were Fatigue (54%), Dyspnea (29%) and Anosmia (25%). Lymphopenia was present in 13 of 112 (12%) cases. Five of 35 cases (14%) had Lymphopenia in the later follow-up range of 80-102 days. Serum IgA concentration was the only lab parameter with significant difference between patients with vs without persistent symptoms with reduced serum IgA concentrations in the patient cohort of persistent symptoms (p = 0.0219). Moreover, subgroup analyses showed that patients with lymphopenia experienced more frequently persistent symptoms. In conclusion, lymphopenia persisted in a noticeable percentage of recovered patients. Patients with persistent symptoms had significantly lower serum IgA levels. Furthermore, our data provides evidence that lymphopenia is associated with persistence of COVID-19 symptoms.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Inclusion of study population.
Figure 2
Figure 2
Follow-up day and symptom duration for each patient. Grey horizontal line represents threshold for persistent symptoms (28 days). Five patients were asymptomatic (symptom start and end at day 0).
Figure 3
Figure 3
Network analyses of symptom nodes. Node size and node number correspond to the number of patients having that onset symptom. The number in parentheses corresponds to persistent symptoms, which is also indicated by the redness of the symptom node. Thickness of grey edges corresponds co-occurrence of onset symptoms.
Figure 4
Figure 4
Absolute lymphocyte count over time. Dashed line represents lab-specific lower limit (1.26 × 109/L).
See this image and copyright information in PMC

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