Perception, Prevalence, and Prediction of Severe Infection and Post-acute Sequelae of COVID-19

Dacre R.T. Knight, Bala Munipalli, Ilana I. Logvinov, Meghana G. Halkar, Ghada Mitri, Abd Moain Abu Dabrh, Stephanie L. Hines

Research output: Contribution to journalArticlepeer-review


Background: The aim of the study was to assess, characterize, and describe the prevalence and predicting factors of patient-reported severe coronavirus disease 2019 (COVID-19) infection and post-acute sequelae of COVID-19 (PASC). Methods: We prospectively surveyed patients who received care in our outpatient clinic for COVID-19 from March 13, 2020, through August 17, 2020, and then retrospectively reviewed their electronic health records. We collected data for age, sex, and persistence of symptoms and compared data for hospitalized and nonhospitalized patients. Continuous and categorical variables were summarized, including time from COVID-19 onset, time to resuming normal activities, and length of time away from work. Results: Of those receiving the survey, 437 adult patients with different degrees of severity of COVID-19 illness responded: 77% were between 3 and 6 months from the onset of infection. In total, 34.9% had persistent symptoms, and 11.5% were hospitalized. The most common symptom was fatigue (75.9%), followed by poor sleep quality (60.3%), anosmia (56.8%), dysgeusia (55%), and dyspnea (54.6%). Predicting factors for PASC were female sex and a negative psychological impact of the disease. Age, hospitalization, persistent symptoms, psychological impact (e.g., anxiety and depression), and time missed from work were significantly associated with perception of having severe COVID-19 illness. Hospitalization was not significantly associated with PASC. Conclusions: Over one-third of patients in our study had PASC. Persistent symptoms correlated with severity of disease and were significantly more common for women, for patients who had psychological symptoms (depression and/or anxiety), and for patients reporting inability to resume normal activities.

Original languageEnglish (US)
Pages (from-to)295-304
Number of pages10
JournalAmerican Journal of the Medical Sciences
Issue number4
StatePublished - Apr 2022


  • Epidemiology
  • Fatigue
  • Infectious diseases
  • SARS

ASJC Scopus subject areas

  • General Medicine


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