Time to resolution of respiratory and systemic COVID-19 symptoms in community setting

Dinh, Aurélien; Jaulmes, Luc; Dechartres, Agnès; Duran, Clara; Mascitti, Hélène; Lescure, Xavier; Yordanov, Youri; Jourdain, Patrick

OBJECTIVES: During the Coronavirus disease 2019 (COVID-19), symptom course among outpatients is not well known. Our aim was to assess the time to resolution of respiratory and systemic symptoms and their associated factors. METHODS: Cohort study including adult outpatients, managed with Covidom, a telesurveillance solution, with RT-PCR confirmed diagnosis, from March 9(th) 2020 until February 23(rd) 2021. Follow-up was 30 days after symptom onset. RESULTS: Among the 9,667 patients included, mean age was 43.2±14.0 years, and 67.5% were female (n=6,522). Median body mass index (BMI) (IQR) was 25.0 kg/m(2) (22.1-28.8). Main comorbidities were: hypertension (12.9%; n=1247), asthma (11.0%; n=1063), and diabetes mellitus (5.5%; n=527). The most frequent symptom during follow-up was dyspnea (65.1%; n=6,296), followed by tachypnea (49.9%; n=4,821), shivers (45.6%; n=4,410), and fever (36.7%; n=3,550). Median time to resolution of systemic and respiratory symptoms were 3 days (95% CI: 2−4) and 7 days (95% CI: 6−8), respectively. Ultimately, 17.2% (95% CI: 15.7%−18.8%) still presented respiratory symptoms at day 30. Longer time to respiratory symptom resolution was associated with older age, increased BMI, chronic obstructive pulmonary disease (COPD), coronary artery disease, asthma, and heart failure. Regarding systemic symptoms, coronary artery disease, asthma, age above 40 years, and elevated BMI were associated with longer time to resolution. CONCLUSIONS: Time to symptom resolution among outpatients with COVID-19 seemed shorter for systemic than respiratory symptoms. Prolonged respiratory symptoms were common at day 30. Risk factors associated with later resolution included age, cardiovascular and pulmonary diseases.