COVID-19 symptom severity and duration among outpatients, July 2021-May 2023: The PROTECT observational study.

<h4>Introduction</h4>With the emergence of new SARS-CoV-2 variants has come significant variations in disease manifestation, severity, and duration in non-hospitalized infected patients. To characterize symptom patterns and risk factors associated with symptom severity and duration, COVI...

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Main Authors: Bhavya Vashi, Kristen Pettrone, Claire S Wilson, Josh G Chenoweth, Joost Brandsma, Melissa K Gregory, Pavol Genzor, Deborah A Striegel, Richard E Rothman, Bhakti Hansoti, Gideon D Avornu, Breana McBryde, Lauren Reynolds Zimmerman, Christopher W Woods, Elizabeth A Petzold, Jessica Cowden, Sorachai Nitayaphan, Worapong Nasomsong, Danielle V Clark
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2025-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0314518
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Summary:<h4>Introduction</h4>With the emergence of new SARS-CoV-2 variants has come significant variations in disease manifestation, severity, and duration in non-hospitalized infected patients. To characterize symptom patterns and risk factors associated with symptom severity and duration, COVID-19 and influenza-like illness (ILI) outpatients and their contacts were enrolled at two sites in the United States of America and one site in Thailand.<h4>Methods</h4>COVID-19 infection was confirmed at enrollment with a positive antigen or PCR test. Baseline demographics and medical histories were collected from participants at enrollment and daily self-reported symptom questionnaires were obtained to assess symptom severity and duration. Risk factors associated with symptom severity and duration were determined by multivariate logistic regression and Cox proportional hazards model.<h4>Results</h4>Two hundred and forty one participants meeting the eligibility criteria were enrolled, including 174 confirmed COVID-19 cases (9% Delta and 90% Omicron), 33 ILI cases, and 34 healthy contacts. COVID-19 participants had a shorter median symptom duration of 9.0 (95% CI, 8.0-11.0) days than ILI participants. Infection with the Delta variant resulted in a longer symptom alleviation period compared to infection with the Omicron variant. The most commonly reported symptoms among COVID-19 participants were reported in the nasal and chest/respiratory domains of the FLU-PRO Plus. Participants infected with the Delta variant reported more symptoms overall, with significantly more symptoms affecting eyes and senses reported. 55% of SARS-CoV-2-positive participants reached a negative N1 Ct value by the day 14 study time point. No risk factors for moderate to severe symptoms were identified in this outpatient cohort. Male sex was associated with a shorter symptom duration.<h4>Conclusion</h4>Symptom manifestation varied among Delta and Omicron variants. Few risk factors were identified for increased symptom severity or duration.
ISSN:1932-6203