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Persistent Symptoms in Patients After Acute COVID-19
Open accessAbstract
case rate of 587 per 100 000.The crude COVID-19 death rate in prisons was 39 deaths per 100 000 prisoners, which was higher than the US population rate of 29 deaths per 100 000 (Table).However, individuals aged 65 years or older comprised a smaller share of the prison population than of the US population (3% vs 16%, respectively) and accounted for 81% of COVID-19 deaths in the US population.The Table provides a standardized calculation showing that the adjusted death rate in the prison population was 3.0 times higher than would be expected if the age and sex distributions of the US and prison populations were equal.The Figure displays the daily trends in cumulative, confirmed cases of COVID-19 in state and federal prisons and the US population from March 31, 2020, to June 6, 2020.The COVID-19 case rate was initially lower in prisons but surpassed the US population on April 14, 2020.The mean daily case growth rate was 8.3% per day in prisons and 3.4% per day in the US population.Discussion | COVID-19 case rates have been substantially higher and escalating much more rapidly in prisons than in the US population.One limitation of the study is that it relied on officially reported data, which may be subject to inaccuracies and reporting delays, but are the only data available.Comprehensive data on testing rates were not available, and testing rates in both prisons and the overall population were uneven, with many facilities testing no prisoners or only symptomatic persons.2,5 Mass testing in select prisons revealed wide COVID-19 outbreaks, with infection rates exceeding 65% in several facilities. 2 Reported case rates for prisoners therefore likely understated the true prevalence of COVID-19 in prisons.A second limitation is that departments of corrections generally did not report demographic data on decedents, and therefore we could not adjust death rates to account for race/ ethnicity and comorbidity.This study focused on prisons but did not include jails or other detention facilities where there have been notable COVID-19 outbreaks.Although some facilities did engage in efforts to control outbreaks, the findings suggest that overall, COVID-19 in US prisons is unlikely to be contained without implementation of more effective infection control.
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“Nevertheless, what emerges from preliminary data is the negative impact of long COVID on quality of life and its effects on patient work ability and social relationships [1,4,19].”
From Female gender is associated with long COVID syndrome: a prospective cohort study (2022) · cites this paper as [4]
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“The high incidence of long COVID within our cohort was similar to that previously reported: more than half of patients reported symptoms lasting more than 2 months after symptom onset [4,5,16,18,19].”
From Female gender is associated with long COVID syndrome: a prospective cohort study (2022) · cites this paper as [4]
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“exploring health status from the patient perspective have mainly evaluated the presence or absence of persistent symptoms, without more sophisticated or comprehensive analyses.(3)”
BackgroundLong Covid-19: Proposed Primary Care Clinical Guidelines for Diagnosis and Disease Management
Sisó‐Almirall, A., Brito‐Zerón, P., Conangla, L., Kostov, B., Moragas, A., Mestres, J., Sellarès, J., Galindo, G., Morera, R., Basora, J., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18084350 · Cited by 216
Post-Discharge Health Status and Symptoms in Patients with Severe COVID-19
Weerahandi, H. M., Hochman, K. A., Simon, E., Blaum, C. S., Chodosh, J., Duan, E., Garry, K., Kahan, T. F., Karmen-Tuohy, S., Karpel, H. C., et al. (2021) · Journal of General Internal Medicine · doi:10.1007/s11606-020-06338-4 · Cited by 214
The Conundrum of ‘Long-COVID-19ʹ: A Narrative Review
Garg, M. K., Maralakunte, M., Garg, S., Dhooria, S., Sehgal, I. S., Bhalla, A. S., Vijayvergiya, R., Grover, S., Bhatia, V., Jagia, P., et al. (2021) · International Journal of General Medicine · doi:10.2147/ijgm.s316708 · Cited by 219
Frontera, J. A., Yang, D., Lewis, A. K., Patel, P. S., Medicherla, C. B., Arena, V., Fang, T., Andino, A., Snyder, T. E., Madhavan, M., et al. (2021) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2021.117486 · Cited by 214
Post COVID-19 pulmonary fibrosis; a meta-analysis study
Amin, B. J. H., Kakamad, F. H., Ahmed, G. S., Ahmed, S. F., Abdullah, H. O., Mohammed, S. H., Mikael, T. M., Salih, R. Q. M., Ali, R. K., Salh, A. M., et al. (2022) · Annals of Medicine and Surgery · doi:10.1016/j.amsu.2022.103590 · Cited by 207
“Even though it has been reported that most COVID-19 cases will fully recover after the infection, various new studies estimate that nearly 70–80% of the patients will continue to suffer from a wide range of short- or long-term post-infectious complications, especially in severe COVID-19 cases [9,10].”
Acute and persistent symptoms in non-hospitalized PCR-confirmed COVID-19 patients
Bliddal, S., Banasik, K., Pedersen, O. B., Nissen, J., Cantwell, L., Schwinn, M., Tulstrup, M., Westergaard, D., Ullum, H., Brunak, S., et al. (2021) · Scientific Reports · doi:10.1038/s41598-021-92045-x · Cited by 211
The Neurological Manifestations of Post-Acute Sequelae of SARS-CoV-2 Infection
Moghimi, N., Napoli, M. D., Biller, J., Siegler, J. E., Shekhar, R., McCullough, L. D., Harkins, M. S., Hong, E., Alaouieh, D., Mansueto, G., et al. (2021) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-021-01130-1 · Cited by 202
Postacute COVID-19: An Overview and Approach to Classification
Amenta, E. M., Spallone, A., Rodriguez‐Barradas, M. C., Sahly, H. M. E., Atmar, R. L., & Kulkarni, P. A. (2020) · Open Forum Infectious Diseases · doi:10.1093/ofid/ofaa509 · Cited by 201
“Carfi et al report persistent symptoms in 143 patients evaluated after hospitalization due to COVID-19 (Table 1) [6].”
BackgroundPeripheral Nervous System Manifestations Associated with COVID-19
Andalib, S., Biller, J., Napoli, M. D., Moghimi, N., McCullough, L. D., Rubiños, C., Nobleza, C. O., Azarpazhooh, M. R., Catanese, L., Elicer, I., et al. (2021) · Current Neurology and Neuroscience Reports · doi:10.1007/s11910-021-01102-5 · Cited by 198
Ghosn, J., Piroth, L., Épaulard, O., Turnier, P. L., Mentré, F., Bachelet, D., & Laouenan, C. (2021) · Clinical Microbiology and Infection · doi:10.1016/j.cmi.2021.03.012 · Cited by 190
“Recently, persistent COVID-19 symptoms have been reported up to 3 months after discharge [3,4].”
A systematic review and meta-analysis of long COVID symptoms
Natarajan, A., Shetty, A., Delanerolle, G., Zeng, Y., Zhang, Y., Raymont, V., Rathod, S., Halabi, S., Elliot, K., Shi, J. Q., et al. (2023) · Systematic Reviews · doi:10.1186/s13643-023-02250-0 · Cited by 190
“As SARS-CoV-2 survivors continue to share their experiences, clinical researchers hypothesize the continuation of complex symptomatologies for a longer period of time than initially anticipated [3].”
BackgroundPlasma Markers of Disrupted Gut Permeability in Severe COVID-19 Patients
Giron, L. B., Dweep, H., Yin, X., Wang, H., Damra, M., Goldman, A. R., Gorman, N., Palmer, C. S., Tang, H., Shaikh, M. W., et al. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.686240 · Cited by 194
COVID-19 sequelae in adults aged less than 50 years: A systematic review
Willi, S., Lüthold, R. V., Hunt, A., Hänggi, N. V., Sejdiu, D., Scaff, C., Bender, N., Staub, K., & Schlagenhauf, P. (2021) · Travel Medicine and Infectious Disease · doi:10.1016/j.tmaid.2021.101995 · Cited by 193
“Breathlessness or shortness of breath was reported by four out of six, ranging from 39 to 74% [7,8,10,11].”
Clinical characterization of dysautonomia in long COVID-19 patients
Barizien, N., Guen, M. L., Russel, S., Touche, P., Huang, F., & Vallée, A. (2021) · Scientific Reports · doi:10.1038/s41598-021-93546-5 · Cited by 185
Huang, Y., Pinto, M. D., Borelli, J. L., Mehrabadi, M. A., Abrahim, H. L., Dutt, N. D., Lambert, N., Nurmi, E. L., Chakraborty, R., Rahmani, A. M., et al. (2022) · Clinical Nursing Research · doi:10.1177/10547738221125632 · Cited by 220
Cares-Marambio, K., Montenegro-Jiménez, Y., Torres‐Castro, R., Vera‐Uribe, R., Torralba, Y., Alsina‐Restoy, X., Vasconcello‐Castillo, L., & Vilaró, J. (2021) · Chronic Respiratory Disease · doi:10.1177/14799731211002240 · Cited by 176
Post-viral effects of COVID-19 in the olfactory system and their implications
Xydakis, M. S., Albers, M. W., Holbrook, E. H., Lyon, D. M., Shih, R., Frasnelli, J., Pagenstecher, A., Kupke, A., Enquist, L. W., & Perlman, S. M. (2021) · The Lancet Neurology · doi:10.1016/s1474-4422(21)00182-4 · Cited by 195
Psychiatric morbidity and protracted symptoms after COVID-19
Poyraz, B., Poyraz, C., Olğun, Y., Gürel, Ö., Alkan, S., Özdemir, Y., Balkan, I., & Karaali, R. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113604 · Cited by 147
Post-acute sequelae of COVID-19 in a non-hospitalized cohort: Results from the Arizona CoVHORT
Bell, M. L., Catalfamo, C. J., Farland, L. V., Ernst, K. C., Jacobs, E. T., Klimentidis, Y. C., Jehn, M., & Pogreba-Brown, K. (2021) · PLoS ONE · doi:10.1371/journal.pone.0254347 · Cited by 181
A review of cytokine-based pathophysiology of Long COVID symptoms
Low, R. N., Low, R. J., & Akrami, A. (2023) · Frontiers in Medicine · doi:10.3389/fmed.2023.1011936 · Cited by 205
Pediatric long-COVID: an overlooked phenomenon?
Brackel, C. L. H., Lap, C. R., Buddingh, E. P., van Houten, M. A., van der Sande, L. J. T. M., Langereis, E. J., Bannier, M. A. G. E., Pijnenburg, M. W. H., Hashimoto, S., & Terheggen‐Lagro, S. W. J. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25521 · Cited by 163
Hoagland, D. A., Møller, R., Uhl, S. A., Oishi, K., Frere, J. J., Golynker, I., Horiuchi, S., Panis, M., Blanco-Melo, D., Sachs, D. M., et al. (2021) · Immunity · doi:10.1016/j.immuni.2021.01.017 · Cited by 177
Post-infection cognitive impairments in a cohort of elderly patients with COVID-19.
Liu, Y.-H., Wang, Y.-R., Wang, Q.-H., Chen, Y., Chen, X., Li, Y., Cen, Y., Xu, C., Hu, T., Liu, X.-D., et al. (2021) · Molecular Neurodegeneration · doi:10.1186/s13024-021-00469-w · Cited by 171
Sandmann, F., Davies, N. G. M., Vassall, A., Edmunds, W. J., Jit, M., Sun, F. Y., Villabona‐Arenas, C. J., Nightingale, E., Showering, A., Knight, G. M., et al. (2021) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(21)00079-7 · Cited by 179
Cardiopulmonary exercise capacity and limitations 3 months after COVID-19 hospitalisation
Skjørten, I., Ankerstjerne, O. A. W., Trebinjac, D., Brønstad, E., Rasch-Halvorsen, Ø., Einvik, G., Lerum, T. V., Stavem, K., Edvardsen, A., & Ingul, C. B. (2021) · European Respiratory Journal · doi:10.1183/13993003.00996-2021 · Cited by 177
Jacobson, K. B., Rao, M., Bonilla, H. F., Subramanian, A. K., Hack, I., Madrigal, M., Singh, U., Jagannathan, P., & Grant, P. (2021) · Clinical Infectious Diseases · doi:10.1093/cid/ciab103 · Cited by 190
Pulmonary function and functional capacity in COVID-19 survivors with persistent dyspnoea
Cortés-Telles, A., López-Romero, S., Figueroa‐Hurtado, E., Pou-Aguilar, Y. N., Wong, A. W., Milne, K. M., Ryerson, C. J., & Guenette, J. A. (2021) · Respiratory Physiology & Neurobiology · doi:10.1016/j.resp.2021.103644 · Cited by 175
Al‐Hakeim, H. K., Al-Rubaye, H. T., Al-Hadrawi, D. S., Almulla, A. F., & Maes, M. H. J. (2022) · Molecular Psychiatry · doi:10.1038/s41380-022-01836-9 · Cited by 169
Epidemiology and organ specific sequelae of post-acute COVID19: A narrative review
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Notarbartolo, S., Ranzani, V., Bandera, A., Gruarin, P., Bevilacqua, V., Putignano, A. R., Gobbini, A., Galeota, E., Manara, C., Bombaci, M., et al. (2021) · Science Immunology · doi:10.1126/sciimmunol.abg5021 · Cited by 173
Hyperinflammatory Immune Response and COVID-19: A Double Edged Sword
Tan, L. Y., Komarasamy, T. V., & Balasubramaniam, V. R. M. T. (2021) · Frontiers in Immunology · doi:10.3389/fimmu.2021.742941 · Cited by 184
“Symptoms reported in descending frequency include fatigues, dyspnea, joint pain, chest pain, cough, anosmia, sicca syndrome, rhinitis, red eyes, dysgeusia, headache, sputum secretion, appetite loss, sore throat, vertigo, myalgia and diarrhea (67).”
BackgroundSukocheva, O. A., Maksoud, R., Beeraka, N. M., Madhunapantula, S. V., Sinelnikov, M. Y., Nikolenko, V. N., Неганова, М. Е., Klochkov, S. G., Kamal, M. A., Staines, D., et al. (2021) · Journal of Advanced Research · doi:10.1016/j.jare.2021.11.013 · Cited by 182
“Persistence of dyspnoea and neuropsychological symptoms were registered in 35% of non-hospitalized and 87% of hospitalized COVID-19 patients [5,6].”
InfluentialD'Cruz, R. F., Waller, M. D., Perrin, F., Periselneris, J. N., Norton, S., Smith, L., Patrick, T., Walder, D., Heitmann, A., Lee, K. N., et al. (2020) · ERJ Open Research · doi:10.1183/23120541.00655-2020 · Cited by 173
Rass, V., Beer, R., Schiefecker, A. J., Kofler, M., Lindner, A., Mahlknecht, P., Heim, B., Limmert, V., Sahanic, S., Pizzini, A., et al. (2021) · European Journal of Neurology · doi:10.1111/ene.14803 · Cited by 185
Metadata
- Authors
- Carfì, A., Bernabei, R., Landi, F., & for the Gemelli Against COVID-19 Post-Acute Care Study Group
- Affiliations
- Agostino Gemelli University Polyclinic (IT)
- Corresponding author
- Carfì, Angelo
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2020-08-11
- Volume
- 324
- Issue
- 6
- Pages
- 603
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC7349096
- OpenAlex
- W3041493976
- Cited by
- 4,561
- References
- 7
- Citations by year
- 2026: 139 · 2025: 292 · 2024: 495 · 2023: 827 · 2022: 1183 · 2021: 1373 · 2020: 245
- FWCI
- 393.49
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- University of Pennsylvania
- Topics
- Health Sciences › Medicine › Clinical Neurology › Long-Term Effects of COVID-19
- Health Sciences › Medicine › Infectious Diseases › COVID-19 Clinical Research Studies
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- COVID-19 pandemic, long COVID, post-acute symptoms, prisoners, prison population, COVID-19 mortality, COVID-19 case rates, infection control, jails, detention centers, COVID-19 outbreak
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Chest Pain, Dyspnea, Fatigue, Female, Follow-Up Studies, Humans, Italy, Male, Middle Aged, Pneumonia, Viral, Coronavirus Infections, Arthralgia, Pandemics, Symptom Assessment
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