Dynamics of symptoms in outpatients with SARS-CoV2 infection

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Background. COVID-19 has had a huge impact on the health and economy of the world. While most people with COVID-19 illness recover fully, others continue to experience chronic symptoms, including autonomic manifestations. Meeting the needs of Long-COVID patients requires a significant investment of resources and funding for both clinical care and research. It is imperative to act during this window of opportunity in hopes of reducing or decreasing the symptom burden for these patients.

Objective. Evaluation of the prevailing symptoms and their dynamics in patients with a new coronavirus infection in the acute and subacute periods of the disease.

Methods. The study analyzed the questionnaires of 113 patients followed-up on an outpatient basis in several clinics in Belgorod. The authors] questionnaire was a survey in which, on a 10-point scale, the patient had to indicate the intensity of the sign (symptom, symptom complex) in the acute stage (the first 4 weeks of the disease) and the degree of intensity of symptoms more than 3 weeks after the initial visit (subacute period of the disease, or the beginning of “post-Covid syndrome”).

Results. The results of our survey showed that in the acute phase of COVID-19, asthenovegetative syndrome, manifested by weakness and fatigue (96%); thermoregulation disorders (95%); impaired perception of taste and smell (72%) were most often observed. At the same time, in the “subacute” phase (the beginning of the “post-COVID syndrome”), in addition to asthenovegetative syndrome (82%), tachycardia (67%) and emotional and mental disorders, asthenia (63%) came to the fore.

Conclusion. The study, conducted at the height of the pandemic, allowed the authors to identify the leading symptoms of the acute and subacute (early post-Covid) phases of the new coronavirus infection. Trends in the dynamics of symptoms have been identified, which makes it possible to more accurately select approaches to the treatment of such patients at different periods of the disease.

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作者简介

Roman Bontsevich

Mari State University; Belgorod State National Research University; Kazan State Medical Academy – Branch Campus of the Russian Medical Academy of Continuous Professional Education

编辑信件的主要联系方式.
Email: bontsevich@bsu.edu.ru
ORCID iD: 0000-0002-9328-3905

Cand. Sci. (Med.), General Practitioner, Pulmonologist, Clinical Pharmacologist, Associate Professor at the Department of Internal Medicine No. 2, Associate Professor at the Department of Pharmacology and Clinical Pharmacology, Associate Professor at the Department of Clinical Pharmacology and Pharmacotherapy

俄罗斯联邦, Yoshkar-Ola, Republic of Mari El; Belgorod; Kazan

Zh. Zhdanova

Belgorod State National Research University; Medical Center OOO “Doctor Polskaya Polyclinic of Pediatric Neurology”

Email: bontsevich@bsu.edu.ru
ORCID iD: 0000-0002-5874-1763
俄罗斯联邦, Belgorod; Belgorod

A. Ryabchikova

Belgorod State National Research University

Email: bontsevich@bsu.edu.ru
ORCID iD: 0009-0004-8585-6234
俄罗斯联邦, Belgorod

L. Solovyova

Multidisciplinary Polyclinic “Harmony of Health” “MAKSBelmed” LLC

Email: bontsevich@bsu.edu.ru
ORCID iD: 0000-0002-7495-0258
俄罗斯联邦, Belgorod

Ya. Vovk

Medical center “SM-Clinic”

Email: bontsevich@bsu.edu.ru
ORCID iD: 0000-0002-7741-9745
俄罗斯联邦, Moscow

Z. Dauletova

Diagnostic center “Generation”; Clinical Diagnostic Center “Medicine 31”

Email: bontsevich@bsu.edu.ru
ORCID iD: 0009-0002-5776-5533
俄罗斯联邦, Belgorod; Belgorod

T. Ponomarenko

Belgorod State National Research University

Email: bontsevich@bsu.edu.ru
ORCID iD: 0009-0007-4056-0765
俄罗斯联邦, Belgorod

M. Maksimov

Kazan State Medical Academy – Branch Campus of the Russian Medical Academy of Continuous Professional Education; Russian Medical Academy of Continuous Professional Education; Pirogov Russian National Research Medical University

Email: bontsevich@bsu.edu.ru
ORCID iD: 0000-0002-8979-8084
俄罗斯联邦, Kazan; Moscow; Moscow

参考

  1. Centers for Disease Control and Prevention COVID-19. Cases, Data and Surveillance. URL: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates
  2. World Health Organization Coronavirus disease (COVID-19) weekly epidemiological update and weekly operational update. URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports
  3. Mahase E. Covid-19: What do we know about ‘long Covid’? BMJ. 2020;370:m2815. doi: 10.1136/bmj.m2815.
  4. COVID-19 rapid guideline: managing the long-term effects of COVID-19. NICE guideline [NG188]. URL: https://www.nice.org.uk/guidance/ng188 (accessed 18.12.2020).
  5. Carfi A., Bernabei R., Landi F., Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020;324(6):603–5. doi: 10.1001/jama.2020.12603.
  6. Wong A.W., Shah A.S., Johnston J.C., et al. Patient-reported outcome measures after COVID-19: a prospective cohort study. Eur. Respir. J. 2020;56 (5):2003276. doi: 10.1183/13993003.03276-2020.
  7. Garrigues E., Janvier P., Kherabi Y., et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81 (6):e4–6. doi: 10.1016/j.jinf.2020.08.029.
  8. Rosales-Castillo A., Garcia de Los Rios C., Mediavilla Garcia J.D. Persistent symptoms after acute COVID-19 infection: importance of follow-up. Med Clin (Barc). 2021;156(1):35–6. English, Spanish. doi: 10.1016/j.medcli.2020.08.001.
  9. Mandal S., Barnett J., Brill S.E., et al. ARC Study Group. ‘Long-COVID’: a cross-sectional study of persisting symptoms, biomarker and imaging abnormalities following hospitalisation for COVID-19. Thorax. 2021;76:396–98. doi: 10.1136/thoraxjnl-2020-215818.
  10. Huang C., Huang L., Wang Y., et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397(10270):220–32. doi: 10.1016/S0140-6736(20)32656-8.
  11. Halpin S.J., McIvor C., Whyatt G., et al. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021;93(2):1013–22. doi: 10.1002/jmv.26368.
  12. The prevalence of long COVID symptoms and COVID-19 complications. URL: https://www.ons.gov.uk/news/statementsandletters/theprevalenceoflongcovidsymptomsandcovid19complications.
  13. Al-Aly Z., Xie Y., Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature. 2021;594(7862):259–64. doi: 10.1038/s41586-021-03553-9.
  14. Cares-Marambio K., Montenegro-Jimйnez Y., Torres-Castro R., et al. Prevalence of potential respiratory symptoms in survivors of hospital admission after coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis. Chron Respir. Dis. 2021;18:14799731211002240. doi: 10.1177/14799731211002240.
  15. Бонцевич Р.А., Котлярова В.К., Букач О.А. и др. Анализ подходов к лечению и эффективность применения программы поддержки принятия решений в поликлинической практике в период Ковид-пандемии. Медицинский совет. 2023;17(4):77–85. [Boncevich R.A., Kotlyarova V.K., Bukach O.A., et al. Analysis of treatment approaches and the effectiveness of using a decision support program in outpatient practice during the Covid pandemic. Meditsinskii Sovet. 2023;17(4):77–85. (In Russ.)]. doi: 10.21518/ms2023-016.
  16. Бонцевич Р.А., Заева А.А., Гаврилов П.В. Случай ведения пациента с длительным персистированием постковидного синдрома и наличием грубых интерстициальных изменений в легких. Актуальные проблемы медицины. 2023;46(1):23–37. [Boncevich R.A., Zaeva A.A., Gavrilov P.V. A case of managing a patient with long-term persistence of post-Covid syndrome and the presence of gross interstitial changes in the lungs. Aktual’nye problemy meditsiny. 2023;46(1):23–37. (In Russ.)]. doi: 10.52575/2687-0940-2023-46-1-23-37.
  17. Gupta A., Madhavan M.V., Sehgal K., et al. Extrapulmonary manifestations of COVID-19. Nat. Med. 2020;26(7):1017–32. doi: 10.1038/s41591-020-0968-3.
  18. Li H., Liu L., Zhang D., et al. SARS-CoV-2 and viral sepsis: observations and hypotheses. Lancet. 2020;395(10235):1517–20. doi: 10.1016/S0140-6736(20)30920-X.
  19. Xu X., Chen P., Wang J., et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Sci China Life Sci. 2020;63(3):457–60. doi: 10.1007/s11427-020-1637-5.
  20. Amraei R., Yin W., Napoleon M.A., et al. CD209L/L-SIGN and CD209/DC-SIGN act as receptors for SARS-CoV-2. bioRxiv [Preprint]. 2021 Jun 14:2020.06.22.165803. doi: 10.1101/2020.06.22.165803. Update in: ACS Cent. Sci. 2021;7(7):1156–65.
  21. Verdecchia P., Cavallini C., Spanevello A., Angeli F. The pivotal link between ACE2 deficiency and SARS-CoV-2 infection. Eur J Intern Med. 2020;76:14–20. doi: 10.1016/j.ejim.2020.04.037.
  22. Bontsevich R., Vinyukov V., Subina T., et al. The frequency of prescribing antimicrobial drugs in the initial therapy of COVID-19 at the outpatient stage. Eur Respir J. 2021;58(Suppl. 65):PA3675. doi: 10.1183/13993003.congress-2021.PA3675».
  23. Bontsevich R., Vovk Ya., Solovyova L. COVID-19: treatment of early chronic COVID syndrome. Eur Respir J. 2021;58(Suppl. 65):PA3674. doi: 10.1183/13993003.congress-2021.PA3674».
  24. Bontsevich R., Vovk Ya., Solovyova L. Practical experience in optimizing Covid-19 therapy in an outpatient setting. Eur Respir J. 2021;58(Suppl. 65):PA3677. doi: 10.1183/13993003.congress-2021.PA3677».
  25. Wadman M., Couzin-Frankel J., Kaiser J., Matacic C. A rampage through the body. Science. 2020;368(6489):356–60. doi: 10.1126/science.368.6489.356.
  26. Рекомендации по ведению больных с коронавирусной инфекцией COVID-19 в острой фазе и при постковидном синдроме в амбулаторных условиях. Под ред. П.А. Воробьева. Проблемы стандартизации в здравоохранении. 2021;7–8:3–96. [Recommendations for the management of patients with coronavirus infection COVID-19 in the acute phase and in postcovirus syndrome in outpatient settings. Ed. by P.A. Vorobyov. Problemy standartizatsii v zdravookhranenii. 2021;7–8:3–96. (In Russ.)]. doi: 10.26347/1607-2502202107-08003-096.

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2. Fig. 1. Dynamics of symptom intensity in the acute phase of coronavirus infection (n=113)

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3. Fig. 2. Dynamics of symptom intensity in the subacute (early postcovid) phase of coronavirus infection (n=113)

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4. Fig. 3. Dynamics of the intensity of symptoms in the acute and subacute phases of coronavirus infection, as well as recalculation to the condition of the same frequency of occurrence of the sign in the acute and subacute periods (n=113)

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