Lingering symptoms in non-hospitalized patients with COVID-19 – a prospective survey study of symptom expression and effects on mental health in Germany

Abstract

Abstract Background The infection rates with SARS-CoV 2 virus, known since 2019, are currently significantly weakened in their dynamics. Nevertheless, COVID 19 is still a common disease, which in most cases is overcome quite well and can be treated by the general practitioner. Despite an initially uncomplicated disease progression, the long-term consequences can be considerable. Symptoms persisting over a period of more than 12 weeks after infection are summarized as Post-COVID (PC) syndrome. The aim of this study is to document the symptom expression in PC patients in the outpatient setting, with a major focus on limitations in daily life and consequences for mental health. Methods This survey is part of a prospective European collaborative study with the German cohort having been slightly extended and evaluated separately. Data collection was performed by telephone interviews of adult SARS CoV 2 positive patients using standardized questionnaires (38 open and 6 closed questions). After an inclusion interview, follow-up interviews were conducted every 4 weeks over a period of 6 months. Participants were recruited in collaboration with the local health department (Würzburg, Germany). Results Sixty participants were recruited in April and May 2021. After 12 weeks (PC cutoff), 48% still reported symptoms related to SARS-CoV-2 infection. The most commonly reported symptoms were fatigue (33%), cognitive impairment (27%), and breathing problems (23%). One-quarter of respondents reported impaired functioning, with the most common daily limitations being sports (28%), work (25%), and social life (15%). At 6 months, 22% of respondents experienced anxiety and 12% reported depressive symptoms. Overall, 40% of respondents were concerned that their health would deteriorate again or not fully normalize because of COVID-19. Over two-thirds (70%) visited a physician during the course of the study because of COVID-19, 74% of whom visited their general practitioner. Conclusion PC in the outpatient setting is a common, difficult and multidimensional condition. In addition to physical symptoms, limitations in mental health and activities of daily life are particularly apparent. PC is not yet fully understood in its complexity and poses long-term challenges, particularly for outpatient care. Routine screening for psychosocial comorbidities can help to offer supportive measures to prevent chronification and/or somatization.