Prevalence of Symptoms ≤12 Months After Acute Illness, by COVID-19 Testing Status Among Adults - United States, December 2020-March 2023

Abstract

To further the understanding of post-COVID conditions, and provide a more nuanced description of symptom progression, resolution, emergence, and reemergence after SARS-CoV-2 infection or COVID-like illness, analysts examined data from the Innovative Support for Patients with SARS-CoV-2 Infections Registry (INSPIRE), a prospective multicenter cohort study. This report includes analysis of data on self-reported symptoms collected from 1,296 adults with COVID-like illness who were tested for SARS-CoV-2 using a Food and Drug Administration-approved polymerase chain reaction or antigen test at the time of enrollment and reported symptoms at 3-month intervals for 12 months. Prevalence of any symptom decreased substantially between baseline and the 3-month follow-up, from 98.4% to 48.2% for persons who received a positive SARS-CoV-2 test results (COVID test-positive participants) and from 88.2% to 36.6% for persons who received negative SARS-CoV-2 test results (COVID test-negative participants). Persistent symptoms decreased through 12 months; no difference between the groups was observed at 12 months (prevalence among COVID test-positive and COVID test-negative participants = 18.3% and 16.1%, respectively; p>0.05). Both groups reported symptoms that emerged or reemerged at 6, 9, and 12 months. Thus, these symptoms are not unique to COVID-19 or to post-COVID conditions. Awareness that symptoms might persist for up to 12 months, and that many symptoms might emerge or reemerge in the year after COVID-like illness, can assist health care providers in understanding the clinical signs and symptoms associated with post-COVID-like conditions.

FIGURE

Self-reported prevalence of emerging and reemerging symptoms,^,, by symptom category during 12 months among adults with an acute COVID-like illness with no evidence of new or reinfection by SARS-CoV-2 test result status — Innovative Support for Patients with SARS-CoV-2 Infections Registry, United States, December 2020–March 2023 Abbreviation: HEENT = head, ears, eyes, nose, and throat. * Symptom categories were any symptom (one or more symptoms), HEENT (headache, runny nose, loss of smell, loss of taste, sore throat, and loss of hair), constitutional (tired, chills, feeling hot, fever, and shakes), pulmonary (cough, shortness of breath, and wheezing), musculoskeletal (aches and joint pains), gastrointestinal (diarrhea, nausea or vomiting, and abdominal pain), cardiovascular (chest pain and palpitations), cognitive difficulties (forgetfulness/memory problems, difficulty thinking, or difficulty concentrating), and extreme fatigue (fatigue severity score ≥25). ^† Emerging symptoms were symptoms present at a given time point but not at the previous time point, including symptoms that resolved and reemerged after an absence. ^§ https://www.cdc.gov/me-cfs/pdfs/wichita-data-access/symptom-inventory-doc.pdf ^¶ Point prevalence at each time point is presented for the COVID test result–positive and COVID test result–negative groups for each symptom category. ** Without evidence of reinfection.