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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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“A large proportion of patients experience symptoms for many months, even after mild initial infection.(2) Persistent debilitating symptoms include fatigue, breathlessness, muscle”
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Care Dependency in Non-Hospitalized Patients with COVID-19
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“These persistent symptoms should be taken seriously, as these showed a clear association with many clinically relevant outcomes, including a low quality of life [4].”
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“The term “post-acute COVID syndrome / long COVID” defined as persistent symptoms of residual inflammation (recovery phase), organ system disturbance, hospitalization effects or long ventilation (post-intensive care syndrome), co-morbidities, social isolation, stress and anxiety.(9) The fever, cough, sore throat, short…”
BackgroundComparison of Persistent Symptoms After COVID-19 and Other Non-SARS-CoV-2 Infections in Children
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“This wide range could be explained by lack of systematic, long-term follow-ups, with high variability in terms of age, severity of infection, prevalence of pre-existing clinical conditions, and characteristics of the clinical evaluation (since most pediatric studies are based on self- or parent-reported symptom persis…”
BackgroundAssociation of Vaccination with the Persistence of Post-COVID Symptoms
Wisnivesky, J. P., Govindarajulu, U. S., Bagiella, E., Goswami, R., Kale, M., Campbell, K. N., Meliambro, K. A., Chen, Z., Aberg, J. A., & Lin, J. J. (2022) · Journal of General Internal Medicine · doi:10.1007/s11606-022-07465-w · Cited by 90
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“However, current evidence indicates that most children recover after two months.(3,5) Previous studies have used a definition of persistent symptoms following SARS-CoV-2 infection (“long COVID”) including symptoms ranging from 4 to 15 weeks, limiting comparison between studies.”
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“Rehabilitation clinics are offering CBT for these patients based on the claims that these therapies are effective for ME/CFS—a post-infectious illness which can develop after many different infections—as no study into the efficacy of CBT for post-COVID-19 fatigue syndrome has been published.”
BackgroundInfluentialAutoimmunity to annexin A2 predicts mortality among hospitalised COVID-19 patients
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“, fatigue and dyspnoea [31]) are needed, especially in Hong Kong and elsewhere that had less severe disease burden.”
BackgroundCOVID-19: persistence of symptoms and lung alterations after 3–6 months from hospital discharge
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“The first symptoms of long COVID appeared three to four weeks after acute symptom onset [6], and symptoms persisted even after 60 days [8].”
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Prevalence and Predictors of Persistence of COVID-19 Symptoms in Older Adults: A Single-Center Study
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Cardiovascular complications in the Post-Acute COVID-19 syndrome (PACS)
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A multisystem, cardio-renal investigation of post-COVID-19 illness
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Editorial: Long COVID, or Post-COVID Syndrome, and the Global Impact on Health Care
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Health Care Utilization in the 6 Months Following SARS-CoV-2 Infection
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Blood Biomarkers for Detection of Brain Injury in COVID-19 Patients
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“Several studies show that 50-70% of patients after 2 to 6 months still have a variety of symptoms due to SARS-CoV-2 infection [101,102].”
BackgroundLong-term clinical and biochemical residue after COVID-19 recovery
Gameil, M. A., Marzouk, R. E., El-Sebaie, A. H., & Rozaik, S. E. (2021) · Egyptian Liver Journal · doi:10.1186/s43066-021-00144-1 · Cited by 80
“[9] conducted a post-acute COVID-19 comprehensive questionnaire to detect the persistent symptoms after COVID-19 recovery in the follow-up period (14–60 days).”
MethodLoretelli, C., Abdelsalam, A., D’Addio, F., Nasr, M. B., Assi, E., Usuelli, V., Maestroni, A., Seelam, A. J., Ippolito, E., Maggio, S. D., et al. (2021) · JCI Insight · doi:10.1172/jci.insight.146701 · Cited by 81
Racial, ethnic, and sex disparities in the incidence and cognitive symptomology of long COVID-19
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COVID-19—Lessons Learned and Questions Remaining
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“About 60 days after onset of the first COVID-19 symptom, only 13% of the patients previously hospitalized for COVID-19 were completely free of any COVID-19-related symptoms, while 32% had one or two symptoms and 55% had three or more symptoms [4].”
BackgroundPost-acute sequelae of SARS-CoV-2 infection: Caring for the ‘long-haulers’
Vehar, S. J., Boushra, M. N., Ntiamoah, P., & Biehl, M. (2021) · Cleveland Clinic Journal of Medicine · doi:10.3949/ccjm.88a.21010 · Cited by 86
CO-ResNet: Optimized ResNet model for COVID-19 diagnosis from X-ray images
Bharati, S., Podder, P., Mondal, M. R. H., & Prasath, V. B. S. (2021) · International Journal of Hybrid Intelligent Systems · doi:10.3233/his-210008 · Cited by 79
“Several common symptoms like cough, fever, dyspnea, sore throat, pneumonia, etc., are associated with it [3].”
BackgroundZheng, B., Daines, L., Han, Q., Hurst, J. R., Pfeffer, P., Shankar‐Hari, M., Elneima, O., Walker, S., Brown, J., Siddiqui, S., et al. (2022) · European Respiratory Review · doi:10.1183/16000617.0071-2022 · Cited by 80
Wong, M. C. S., Huang, J., Wong, Y. Y., Wong, G. L., Yip, T. C., Chan, N. Y., Chau, S. W. H., Ng, S. C., Wing, Y. K., & Chan, F. K. L. (2023) · JMIR Public Health and Surveillance · doi:10.2196/42315 · Cited by 84
Boesl, F., Audebert, H. J., Endres, M., Prüß, H., & Franke, C. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.738405 · Cited by 78
Long COVID-19 and Postural Orthostatic Tachycardia Syndrome- Is Dysautonomia to Be Blamed?
Chadda, K. R., Blakey, E. E., Huang, C. L.-H., & Jeevaratnam, K. (2022) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2022.860198 · Cited by 76
Hallek, M. J., Adorjan, K., Behrends, U., Ertl, G., Suttorp, N., & Lehmann, C. (2023) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2022.0409 · Cited by 92
Kuodi, P., Gorelik, Y., Gausi, B., Bernstine, T., & Edelstein, M. L. (2023) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2023.05.003 · Cited by 78
Generic and Respiratory-Specific Quality of Life in Non-Hospitalized Patients with COVID-19
Meys, R., Delbressine, J. M., Goërtz, Y. M. J., Vaes, A. W., Machado, F. V. C., Herck, M. V., Burtin, C., Posthuma, R., Spaetgens, B., Franssen, F. M. E., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9123993 · Cited by 78
“To date, only a few studies, focused on hospitalized patients, demonstrated a negative impact of (suspected) COVID-19 symptoms on generic quality of life [6,7].”
BackgroundLong COVID from rheumatology perspective — a narrative review
Sapkota, H. R., & Nune, A. (2021) · Clinical Rheumatology · doi:10.1007/s10067-021-06001-1 · Cited by 82
Complexity and Challenges of the Clinical Diagnosis and Management of Long COVID
O’Hare, A. M., Vig, E. K., Iwashyna, T. J., Fox, A., Taylor, J. S., Viglianti, E. M., Butler, C. R., Vranas, K. C., Helfand, M., Tuepker, A., et al. (2022) · JAMA Network Open · doi:10.1001/jamanetworkopen.2022.40332 · Cited by 80
Neurological Sequelae in Patients with COVID-19: A Histopathological Perspective
Fisicaro, F., Napoli, M. D., Liberto, A., Fanella, M., Stasio, F. D., Pennisi, M., Bella, R., Lanza, G., & Mansueto, G. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18041415 · Cited by 78
Immunofibrotic drivers of impaired lung function in postacute sequelae of SARS-CoV-2 infection
Chun, H. J., Coutavas, E. E., Pine, A. B., Lee, A. I., Yu, V., Shallow, M., Giovacchini, C. X., Mathews, A. M., Stephenson, B., Que, L. G., et al. (2021) · JCI Insight · doi:10.1172/jci.insight.148476 · Cited by 75
Fernández‐de‐las‐Peñas, C., Gómez‐Mayordomo, V., Cuadrado, M. L., Palacios‐Ceña, D., Florêncio, L. L., Peral, Á. L. G., García‐Azorín, D., Hernández‐Barrera, V., & Arendt‐Nielsen, L. (2021) · Cephalalgia · doi:10.1177/03331024211020404 · Cited by 85
Long COVID: long-term effects?
Toro, A. D., Bozzani, A., Tavazzi, G., Urtis, M., Giuliani, L., Pizzoccheri, R., Aliberti, F., Fergnani, V., & Arbustini, E. (2021) · European Heart Journal Supplements · doi:10.1093/eurheartj/suab080 · Cited by 86
The COVID ‐19 pandemic and its consequences for chronic pain: a narrative review
Shanthanna, H., Nelson, A. M., Kissoon, N. R., & Narouze, S. (2022) · Anaesthesia · doi:10.1111/anae.15801 · Cited by 77
“studies [22] and as the primary outcome in some [23, 24].”
BackgroundResultMetabolomic and immune alterations in long COVID patients with chronic fatigue syndrome
Saito, S., Shahbaz, S., Luo, X., Osman, M. S., Redmond, D., Tervaert, J. W. C., Li, L., & Elahi, S. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1341843 · Cited by 84
“Recent studies and surveys conducted by patient groups indicate that 50 to 80% of patients continue to have bothersome symptoms three months after the onset of COVID-19 disease even after tests no longer detect the virus in their body (7, 10, 11).”
BackgroundSivan, M., Halpin, S. J., Hollingworth, L., Snook, N., Hickman, K., & Clifton, I. (2020) · Journal of Rehabilitation Medicine · doi:10.2340/16501977-2727 · Cited by 75
“The shortand long-term sequelae for survivors (including those discharged from hospital care) are currently unknown, but reports are starting to emerge on their symptoms and needs (5, 6).”
BackgroundImmunopathology of galectin-3: an increasingly promising target in COVID-19
Caniglia, J. L., Asuthkar, S., Tsung, A. J., Guda, M. R., & Velpula, K. K. (2020) · F1000Research · doi:10.12688/f1000research.25979.1 · Cited by 75
The COVID-19 Disease Burden in Germany in 2020
Rommel, A., von der Lippe, E., Plaß, D., Ziese, T., Diercke, M., der Heiden, M. A., Haller, S., & Wengler, A. (2021) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.m2021.0147 · Cited by 75
Oral Symptoms Associated with COVID-19 and Their Pathogenic Mechanisms: A Literature Review
Tsuchiya, H. (2021) · Dentistry Journal · doi:10.3390/dj9030032 · Cited by 76
Musculoskeletal symptoms and related factors in postacute COVID‐19 patients
Bakılan, F., Gökmen, İ. G., Ortanca, B., Uçan, A., Güvenç, Ş. E., Mutlu, F., Gökmen, H. M., & Ekim, A. A. (2021) · International Journal of Clinical Practice · doi:10.1111/ijcp.14734 · Cited by 79
Postacute Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection
Jiang, D. H., Roy, D. J., Gu, B., Hassett, L. C., & McCoy, R. G. (2021) · JACC Basic to Translational Science · doi:10.1016/j.jacbts.2021.07.002 · Cited by 77
“Symptoms frequently last 60 to 70 days after initial diagnosis or even longer (8,131,132).”
BackgroundInfluentialvan Campen, C. M. C., Rowe, P. C., & Visser, F. C. (2021) · Medicina · doi:10.3390/medicina58010028 · Cited by 72
“From the early stages of the SARS-CoV-2 virus pandemic, it has become clear that affected subjects can experience long-lasting, exhausting fatigue accompanied by postexertional malaise (PEM), cognitive dysfunction, and an early-onset symptoms of orthostatic intolerance [1,2].”
BackgroundFunctional outcomes in the inpatient rehabilitation setting following severe COVID-19 infection
Olezene, C. S., Hansen, E., Steere, H. K., Giacino, J. T., Polich, G. R., Borg‐Stein, J., ZAFONTE, R. D., & Schneider, J. C. (2021) · PLoS ONE · doi:10.1371/journal.pone.0248824 · Cited by 76
“It has been shown that a large proportion of patients have persistent symptoms that impact quality of life [12].”
BackgroundNormal Adrenal and Thyroid Function in Patients Who Survive COVID-19 Infection
Clarke, S. A., Phylactou, M., Patel, B., Mills, E., Muzi, B., Izzi‐Engbeaya, C. N., Choudhury, S., Khoo, B. C. E., Meeran, K. M., Comninos, A. N., et al. (2021) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/clinem/dgab349 · Cited by 74
COVID-19 and RA share an SPP1 myeloid pathway that drives PD-L1+ neutrophils and CD14+ monocytes
MacDonald, L., Alivernini, S., Tolusso, B., Elmesmari, A., Somma, D., Perniola, S., Paglionico, A., Petricca, L., Bosello, S. L., Carfì, A., et al. (2021) · JCI Insight · doi:10.1172/jci.insight.147413 · Cited by 72
“In addition, the immune mechanisms of long-lasting clinical sequelae (26) described in convalescent COVID-19 patients are unresolved, hindering development of effective treatments and biomarkers of disease trajectory.”
BackgroundInfluentialSelf-citationScherlinger, M., Felten, R., Gallais, F., Nazon, C., Chatelus, E., Pijnenburg, L., Mengin, A. C., Gras, A., Vidailhet, P., Arnould-Michel, R., et al. (2021) · Infectious Diseases and Therapy · doi:10.1007/s40121-021-00484-w · Cited by 82
Beckmann, N. D., Comella, P., Cheng, E., Lepow, L., Beckmann, A. G., Tyler, S. R., Mouskas, K., Simons, N. W., Hoffman, G. E., Francoeur, N. J., et al. (2021) · Nature Communications · doi:10.1038/s41467-021-24981-1 · Cited by 71
Post-acute COVID-19 syndrome and kidney diseases: what do we know?
Çöpür, S., Berkkan, M., Basile, C., Tuttle, K. R., & Kanbay, M. (2022) · Journal of Nephrology · doi:10.1007/s40620-022-01296-y · Cited by 76
“Similar rates of mortality, re-hospitalization and persistent symptoms have also been reported in some European studies [13, 14].”
ResultAsthma Phenotypes, Associated Comorbidities, and Long-Term Symptoms in COVID-19
Eggert, L. E., He, Z., Collins, W. J., Lee, A., Dhondalay, G. K., Jiang, S. Y., Fitzpatrick, J., Snow, T. T., Pinsky, B. A., Artandi, M. K., et al. (2021) · Allergy · doi:10.1111/all.14972 · Cited by 73
Symptoms, Pulmonary Function, and Functional Capacity Four Months after COVID-19
Abdallah, S. J., Voduc, N., Corrales‐Medina, V., McGuinty, M., Pratt, A., Chopra, A., Law, A., Garuba, H. A., Thavorn, K., Reid, R. E. R., et al. (2021) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202012-1489rl · Cited by 73
Fernández‐de‐las‐Peñas, C., Rodríguez‐Jiménez, J., Fuensalida‐Novo, S., Palacios‐Ceña, M., Gómez‐Mayordomo, V., Florêncio, L. L., Hernández‐Barrera, V., & Arendt‐Nielsen, L. (2021) · Pain · doi:10.1097/j.pain.0000000000002306 · Cited by 76
Pistarini, C., Fiabane, E., Houdayer, E., Vassallo, C., Manera, M. R., & Alemanno, F. (2021) · Frontiers in Neurology · doi:10.3389/fneur.2021.643646 · Cited by 76
“The term “long COVID” has been recently introduced to include those patients still suffering from various symptoms weeks or months after the end of infection (36, 37).”
BackgroundTsai, Y., Vogt, T. M., & Zhou, F. (2021) · Annals of Internal Medicine · doi:10.7326/m21-1102 · Cited by 72
SARS-CoV-2: is there neuroinvasion?
McQuaid, C., Brady, M., & Deane, R. (2021) · Fluids and Barriers of the CNS · doi:10.1186/s12987-021-00267-y · Cited by 72
The Nutrition-COVID-19 Interplay: a Review
Antwi, J., Appiah, B., Oluwakuse, B., & Abu, B. A. Z. (2021) · Current Nutrition Reports · doi:10.1007/s13668-021-00380-2 · Cited by 83
Long-COVID diagnosis: From diagnostic to advanced AI-driven models
Cau, R., Faa, G., Nardi, V., Balestrieri, A., Puig, J., Suri, J. S., Sanfilippo, R., & Saba, L. (2022) · European Journal of Radiology · doi:10.1016/j.ejrad.2022.110164 · Cited by 75
“Thus, the authors reported a worsening of the quality of life in 44,1 % of patients [7].”
Background
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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