Chopra Neha, Chowdhury Mohit, Singh Anupam K, Ma Khan, Kumar Arvind, Ranjan Piyush, Desai Devashish, Wig Naveet
Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
Department of Medicine, Santosh Medical College, Delhi NCR, India.
Drug Discov Ther. 2021;15(3):156-161. doi: 10.5582/ddt.2021.01014.
A variable proportion of patients develop persistent/prolonged symptoms of Coronavirus Disease 2019 (COVID-19) infection (long COVID). We aimed to study the clinical predictors of persistent symptoms in patients with mild COVID-19 at 30 days post discharge (long COVID-19). We also tried to identify symptom clusters among mild COVID-19 patients. Fifty-seven patients admitted at a tertiary care centre after a positive RT-PCR report over a period of 2 months, were enrolled in the study. Details of presentation, history of illness, laboratory investigations and disease outcomes were recorded from documented medical records and discharge slip. The patients were contacted (telephonically) at 30 days after discharge and enquired regarding persistent symptoms, if any. Follow up data at 30 days post-discharge was available for 53 patients. Among them, the most common persistent symptom was fatigue (22.6%), followed by cough (9.4%) and myalgias (7.5%). There was a significant association of persistent symptoms with diarrhoea at presentation [OR 14.26 (95% CI 2.30-142.47; p = 0.009] and gap between symptom onset and admission [OR 1.40 (95% CI 1.08-1.93; p = 0.020] on multivariate logistic regression analysis. On cluster analysis, three phenotypes of mild COVID-19 were identified, which may have implications on monitoring and management. There appears to be a positive association of diarrhoea as a presenting manifestation and gap between symptom onset and admission with the persistence of symptoms classified as long COVID-19, even in mild illness. We also identified multiple phenotypes of mild COVID-19 illness, which warrant further exploration.
可变比例的患者会出现2019冠状病毒病（COVID-19）感染的持续/延长症状（长新冠）。我们旨在研究轻度COVID-19患者出院后30天持续症状（长新冠-19）的临床预测因素。我们还试图识别轻度COVID-19患者中的症状群。在2个月期间，一家三级护理中心收治的57例RT-PCR报告呈阳性的患者被纳入研究。从记录的病历和出院小结中记录了临床表现、病史、实验室检查和疾病转归的详细信息。出院后30天通过电话联系患者，询问是否有持续症状。53例患者有出院后30天的随访数据。其中，最常见的持续症状是疲劳（22.6%），其次是咳嗽（9.4%）和肌痛（7.5%）。多因素逻辑回归分析显示，持续症状与就诊时腹泻[比值比14.26（95%置信区间2.30-142.47；p = 0.009）]以及症状出现与入院之间的间隔[比值比1.40（95%置信区间1.08-1.93；p = 0.020）]存在显著关联。通过聚类分析，识别出了轻度COVID-19的三种表型，这可能对监测和管理有影响。即使在轻症中，腹泻作为就诊表现以及症状出现与入院之间的间隔与归类为长新冠-19的症状持续存在之间似乎也存在正相关。我们还识别出了轻度COVID-19疾病的多种表型，需要进一步探索。
