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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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“Persistent symptoms were more frequent with increasing age of the patients (Carvalho-Schneider et al., 2021).”
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“According to our study, and reported in the existing literature [10,20,23,24], long COVID symptoms in CYP resemble those described in adults [19,42,43], including fatigue, dyspnea, brain fog, myalgia, headache, chest pain, and tachycardia.”
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Utilizing CNN-LSTM techniques for the enhancement of medical systems
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Long COVID and Physical Therapy: A Systematic Review
Sánchez-García, J. C., Reinoso‐Cobo, A., Piqueras-Sola, B., Cortés‐Martín, J., Menor-Rodríguez, M. J., Alabau‐Dasi, R., & Rodríguez-Blanque, R. (2023) · Diseases · doi:10.3390/diseases11040163 · Cited by 44
“One prevalent symptom in long COVID is often referred to as “brain fog”, where individuals may experience difficulties in concentration, memory, and executive function [4,5].”
BackgroundMao, K., Tan, Q., Ma, Y., Wang, S., Zhong, H., Liao, Y., Huang, Q., Xiao, W., Xia, H., Tan, X., et al. (2021) · Cell Death and Disease · doi:10.1038/s41419-021-03816-3 · Cited by 43
Goldhaber, N. H., Kohn, J. N., Ogan, W. S., Sitapati, A. M., Longhurst, C., Wang, A. Y., Lee, S., Hong, S., & Horton, L. E. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph192416841 · Cited by 43
Exertional intolerance and dyspnea with preserved lung function: an emerging long COVID phenotype?
Lam, G. Y., Befus, A. D., Damant, R. W., Ferrara, G., Fuhr, D. P., Stickland, M. K., Varughese, R. A., Wong, E. Y. L., & Smith, M. P. (2021) · Respiratory Research · doi:10.1186/s12931-021-01814-9 · Cited by 42
“In COVID-19 survivors of severe acute infections, the majority were found to have persistent fatigue, breathlessness or significant burden of psychological distress and reduced health-related quality of life at 1–2 months post discharge [6, 7], while 63% still reported persistent fatigue or muscle weakness at 6 months…”
BackgroundAlba, G. A., Ziehr, D. R., Rouvina, J. N., Hariri, L. P., Knipe, R. S., Medoff, B. D., Hibbert, K. A., Kowal, A., Hoenstine, C., Ginns, L. C., et al. (2021) · EClinicalMedicine · doi:10.1016/j.eclinm.2021.101066 · Cited by 44
“Dyspnea and exercise intolerance are among the most commonly reported symptoms in patients with PASC [1-5], but the underlying physiological abnormalities causing these symptoms are unknown.”
Norrefalk, J., Borg, K., & Bilevičiūtė-Ljungar, I. (2021) · Journal of Rehabilitation Medicine · doi:10.2340/jrm.v53.188 · Cited by 41
Luo, X., Gandhi, P., Storey, S., & Huang, K. (2021) · IEEE Journal of Biomedical and Health Informatics · doi:10.1109/jbhi.2021.3123192 · Cited by 44
18F-FDG-PET Imaging for Post-COVID-19 Brain and Skeletal Muscle Alterations
Rudroff, T., Workman, C. D., & Ponto, L. L. B. (2021) · Viruses · doi:10.3390/v13112283 · Cited by 44
“Studies have also shown that PASC can impact children, young adults, and those who only had mild COVID-19 symptoms and did not require respiratory support or hospitalization [15,28].”
BackgroundFajar, J. K., Ilmawan, M., Mamada, S. S., Mutiawati, E., Husnah, M., Yusuf, H., Nainu, F., Sirinam, S., Keam, S., Ophinni, Y., et al. (2021) · Narra J · doi:10.52225/narra.v1i3.48 · Cited by 39
“The prevalence of persistent neuromuscular symptoms was calculated from 14 studies for fatigue [33, 47-59], 7 studies for anosmia [48-50, 52-54, 60], 7 studies for headache [48-50, 52, 54, 55, 57] and myalgia [48-50, 52, 55, 56, 58], and 4 studies for joint pain [47, 48, 50, 58].”
MethodLocal anesthetics as a therapeutic tool for post COVID-19 patients: A case report
Vinyes, D., Muñoz-Sellart, M., & Caballero, T. G. (2022) · Medicine · doi:10.1097/md.0000000000029358 · Cited by 43
Iqbal, N. T., Khan, H., Khalid, A., Mahmood, S. F., Nasir, N., Khanum, I., de Siqueira, I. C., & Voorhis, W. C. V. (2025) · Molecular Medicine · doi:10.1186/s10020-024-00986-6 · Cited by 49
Secuelas médicas de la COVID-19
Peramo-Álvarez, F. P., Zúñiga, M. Á. L., & López‐Ruz, M. Á. (2021) · Medicina Clínica · doi:10.1016/j.medcli.2021.04.023 · Cited by 55
Islam, A., Bashir, M. S., Joyce, K. W., Rashid, H., Laher, I., & Elshazly, S. A. (2021) · Molecules · doi:10.3390/molecules26165004 · Cited by 47
Rossato, M. S., Brilli, E., Ferri, N., Giordano, G., & Tarantino, G. (2021) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2021.08.031 · Cited by 48
“[6] confirmed that the main symptom found in 53.”
Beaudry, R. I., Brotto, A. R., Varughese, R. A., de Waal, S., Fuhr, D. P., Damant, R. W., Ferrara, G., Lam, G. Y., Smith, M. P., & Stickland, M. K. (2022) · Frontiers in Physiology · doi:10.3389/fphys.2022.917886 · Cited by 47
“…of individuals hospitalized as a result of COVID19 and 53% of individuals with mild initial illness experience symptoms 3-month after infection; these individuals are colloquially known as COVID Long-Haulers (Long-CoV) (Carfì et al., 2020; Petersen et al., 2020; World Health Organization, 2021).”
BackgroundRisk of Cardiovascular Events After COVID-19
Tereshchenko, L. G., Bishop, A., Fisher-Campbell, N., Levene, J., Morris, C. C., Patel, H., Beeson, E. A., Blank, J. A., Bradner, J. N., Coblens, M., et al. (2022) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2022.06.023 · Cited by 43
Buonsenso, D., Valentini, P., Rose, C. D., Pata, D., Sinatti, D., Speziale, D., Ricci, R., Carfì, A., Landi, F., Ferrari, V., et al. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25280 · Cited by 42
Self-citationThe complex combination of COVID-19 and diabetes: pleiotropic changes in glucose metabolism
Mahrooz, A., Muscogiuri, G., Buzzetti, R., & Maddaloni, E. (2021) · Endocrine · doi:10.1007/s12020-021-02729-7 · Cited by 42
“Based on study results, 87% of patients who had recovered from COVID-19 experienced persistence of at least one symptom (a mean of 60 days after onset of the first COVID-19 symptom), particularly dyspnea and fatigue [39].”
BackgroundSun, G., Cui, Q., Garcia, G., Wang, C., Zhang, M., Arumugaswami, V., Riggs, A. D., & Shi, Y. (2021) · Scientific Reports · doi:10.1038/s41598-021-96462-w · Cited by 44
Stoian, A., Stoian, M., Bajkó, Z., Maier, S., Andone, S. R., Cioflinc, R. A., Moțățăianu, A., Bărcuţean, L., & Bălașa, R. (2022) · Biomedicines · doi:10.3390/biomedicines10040774 · Cited by 42
Abdel‐Moneim, A., Radwan, M. A., & Yousef, A. I. (2022) · Current Medical Research and Opinion · doi:10.1080/03007995.2022.2078081 · Cited by 45
Musculoskeletal complications in long COVID-19: A systematic review
Swarnakar, R., Jenifa, S., & Wadhwa, S. (2022) · World Journal of Virology · doi:10.5501/wjv.v11.i6.485 · Cited by 45
Dagher, H., Chaftari, A., Subbiah, I. M., Malek, A. E., Jiang, Y., Lamie, P. M., Granwehr, B. P., John, T. M., Guevara, E. Y., Borjan, J., et al. (2023) · eLife · doi:10.7554/elife.81182 · Cited by 41
Pain Management in the Post-COVID Era—An Update: A Narrative Review
El-Tallawy, S. N., Perglozzi, J. V., Ahmed, R. S., Kaki, A. M., Nagiub, M. S., LeQuang, J. A., & Hadarah, M. M. (2023) · Pain and Therapy · doi:10.1007/s40122-023-00486-1 · Cited by 45
Acute and Post-Acute COVID-19 Cardiovascular Complications: A Comprehensive Review
Kole, C., Stefanou, Ε., Karvelas, N., Schizas, D., & Toutouzas, K. P. (2023) · Cardiovascular Drugs and Therapy · doi:10.1007/s10557-023-07465-w · Cited by 58
“%) at 6-month follow-up [16–18] and chest pain at ~20% and 5% at 60-day and 6-month follow-up in the post-acute COVID-19 period, respectively [19].”
Role of Endothelium in Cardiovascular Sequelae of Long COVID
Santoro, L., Zaccone, V., Falsetti, L., Ruggieri, V., Danese, M., Miro, C., Giorgio, A. D., Nesci, A., D’Alessandro, A., Moroncini, G., et al. (2023) · Biomedicines · doi:10.3390/biomedicines11082239 · Cited by 45
Delayed Symptoms in Patients Recovered from COVID-19
Moradian, S. T., Parandeh, A., Khalili, R., & KARIMI, L. K. (2020) · Iranian Journal of Public Health · doi:10.18502/ijph.v49i11.4729 · Cited by 42
“1% of patient with COVID-19 one month after infection (18).”
BackgroundEmerging Neurological and Psychobiological Aspects of COVID-19 Infection
Tancheva, L. P., Petralia, M. C., Miteva, S., Dragomanova, S., Solak, A., Kalfin, R. E., Lazarova, M. I., Yarkov, D., Ciurleo, R., Cavalli, E., et al. (2020) · Brain Sciences · doi:10.3390/brainsci10110852 · Cited by 43
Lewnard, J. A., Mora, A. M., Nkwocha, O., Kogut, K. R., Rauch, S. A., Morga, N., Hernandez, S., Wong, M. P., Huen, K., Andrejko, K. L., et al. (2021) · Emerging infectious diseases · doi:10.3201/eid2705.204949 · Cited by 41
Chen, S., Klaus Prettner, A., Kühn, M., & Bloom, D. E. (2021) · The Journal of the Economics of Ageing · doi:10.1016/j.jeoa.2021.100328 · Cited by 42
“However, many of those who get infected may not recover fully,(Carfì et al., 2020) which would suggest that our estimates are conservative.”
InfluentialLifestyle Adjustments in Long-COVID Management: Potential Benefits of Plant-Based Diets
Storz, M. A. (2021) · Current Nutrition Reports · doi:10.1007/s13668-021-00369-x · Cited by 45
Immuno-Thrombotic Complications of COVID-19: Implications for Timing of Surgery and Anticoagulation
Bunch, C. M., Moore, E. E., Moore, H. B., Neal, M. D., Thomas, A. V., Zackariya, N., Zhao, J. C., Zackariya, S. K., Brenner, T. J., Berquist, M., et al. (2022) · Frontiers in Surgery · doi:10.3389/fsurg.2022.889999 · Cited by 43
“fatigue are common in patients with convalescent COVID-19 (12, 13, 18, 19).”
BackgroundWillis, C., & Chalder, T. (2021) · Journal of Mental Health · doi:10.1080/09638237.2021.1875418 · Cited by 45
“Validated, generic measures such as the PHQ15 (Kroenke et al., 2002) can capture a range of somatic symptoms and measures of fatigue (Cella & Chalder, 2010) could track fluctuations in specific symptoms.”
BackgroundPost-COVID syndrome: A reflection and opinion paper
Bouza, E., Cantón, R., Ramos, P. D. L., Botella, A. G., García‐Lledó, A., Gómez‐Pavón, J., del Castillo, J. M. G., Hernández‐Sampelayo, T., Delgado, M. C. M., Martín‐Sánchez, F. J., et al. (2021) · Revista Española de Quimioterapia · doi:10.37201/req/023.2021 · Cited by 44
The relationship between chronic immune response and neurodegenerative damage in long COVID-19
Elizalde-Díaz, J. P., Miranda-Narváez, C. L., Martínez‐Lazcano, J. C., & Martínez‐Martínez, E. (2022) · Frontiers in Immunology · doi:10.3389/fimmu.2022.1039427 · Cited by 43
“Interestingly nervous system seems particularly affected after COVID-19 disease (9, 10).”
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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