Wu Yunfu, Wang Mingming, Lv Xing, Chen Jie, Song Liqiang
Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Air Force Medical University, Xi'an, China.
J Thorac Dis. 2025 Mar 31;17(3):1593-1604. doi: 10.21037/jtd-24-1244. Epub 2025 Mar 18.
After the cessation of the dynamic zero-coronavirus disease 2019 (COVID-19) policy in China, a large number of people were infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) without being hospitalized, but few studies investigated the symptoms of this population. In this study, we aimed to describe the symptom characteristics of this population and to provide information for further understanding of COVID-19.
An online nationwide anonymous survey questionnaire on symptoms was conducted through WeChat to probe participants infected with SARS-CoV-2 between December 2022 and January 2023. In order to guarantee the promptness of data collection while maximizing the coverage of diverse populations, we opted for the convenient sampling method. Demographic information, incidence and severity of main symptoms, and vaccination status were collected in the questionnaire. Descriptive analysis was utilized to elucidate the epidemiological characteristics of the overall population; comparative analysis was conducted to highlight the differences in symptom variations among distinct subgroups.
A total of 4,836 valid questionnaires were collected, with 64.8% testing positive for COVID-19 and 35.2% exhibiting symptoms but not having undergone testing. Among the COVID-19-positive respondents, 64.3% (n=2,016) were female, with a median age of 39.0 (33.0, 47.0) years, and 95.8% (n=3,002) had received multiple vaccine doses. The prevalent comorbidities included allergic rhinitis (10.1%), hypertension (6.1%), and diabetes (3.5%). The most frequently reported symptoms were fever (n=2,941, 93.9%), fatigue (n=2,871, 91.6%), expectoration (n=2,847, 90.8%), nasal congestion (n=2,735, 87.2%), and myalgia (n=2,712, 86.5%). Vaccinated individuals, non-smokers, and males exhibited significantly higher rates of respiratory symptoms. Myalgia (35.3%), fatigue (31.5%), and sore throat (30.9%) were the symptoms with the highest incidence of severe occurrence, and this varied between age groups. Except for sneezing, age of 60 years or older was negatively correlated with severe manifestations for all symptoms. Conversely, smoking was positively associated with severe symptoms for nearly all conditions.
The study highlights common systemic and respiratory symptoms among non-hospitalized COVID-19 patients in China, varying by gender, age, and underlying diseases. These findings are clinically important for early identification, diagnosis, treatment evaluation, and global management of COVID-19.
在中国实施的新型冠状病毒肺炎（COVID-19）动态清零政策结束后，大量人群感染了严重急性呼吸综合征冠状病毒2（SARS-CoV-2）但未住院治疗，然而针对这部分人群症状的研究较少。在本研究中，我们旨在描述这部分人群的症状特征，并为进一步了解COVID-19提供信息。
通过微信开展了一项全国性的在线匿名症状调查问卷，以调查2022年12月至2023年1月期间感染SARS-CoV-2的参与者。为了确保数据收集的及时性并最大程度覆盖不同人群，我们选择了便利抽样方法。问卷中收集了人口统计学信息、主要症状的发生率和严重程度以及疫苗接种状况。采用描述性分析来阐明总体人群的流行病学特征；进行比较分析以突出不同亚组之间症状变化的差异。
共收集到4836份有效问卷，其中64.8%的COVID-19检测呈阳性，35.2%有症状但未进行检测。在COVID-19检测呈阳性的受访者中，64.3%（n = 2016）为女性，中位年龄为39.0（33.0，47.0）岁，95.8%（n = 3002）接种过多剂疫苗。常见的合并症包括过敏性鼻炎（10.1%）、高血压（6.1%）和糖尿病（3.5%）。最常报告的症状为发热（n = 2941，93.9%）、乏力（n = 2871，91.6%）、咳痰（n = 2847，90.8%）、鼻塞（n = 2735，87.2%）和肌痛（n = 2712，86.5%）。接种疫苗者、非吸烟者和男性出现呼吸道症状的比例显著更高。肌痛（35.3%）、乏力（31.5%）和咽痛（30.9%）是严重症状发生率最高的症状，且在不同年龄组中有所不同。除打喷嚏外，60岁及以上年龄与所有症状的严重表现呈负相关。相反，吸烟与几乎所有症状的严重程度呈正相关。
该研究突出了中国非住院COVID-19患者常见的全身和呼吸道症状，这些症状因性别、年龄和基础疾病而异。这些发现对于COVID-19的早期识别、诊断、治疗评估和全球管理具有重要临床意义。
