Survivors of Covid-19: Testing, Symptoms, Severity, and Post-Exposure Conditions among New Yorkers

Collette M. Brown^1, , Latoya Callender^{1, 2}, Peter C. Nwakeze¹, Donna M. Dyke¹, Dexter C. Forde¹, Ronette A. Campbell¹, Joy Wilcox¹, Phronie Jackson² and Su-yan L. Barrow¹

¹School of Allied Health Professions, Monroe College, Bronx, NY, USA

²College of Agriculture, Urban Sustainability and Environmental Sciences, Health Nursing, and Nutrition Department, University of the District of Columbia, Washington, DC, USA

Cite this paper

Collette M. Brown, Latoya Callender, Peter C. Nwakeze, Donna M. Dyke, Dexter C. Forde, Ronette A. Campbell, Joy Wilcox, Phronie Jackson and Su-yan L. Barrow. Survivors of Covid-19: Testing, Symptoms, Severity, and Post-Exposure Conditions among New Yorkers. American Journal of Public Health Research. 2021; 9(5):215-221. doi: 10.12691/AJPHR-9-5-5

Abstract

The novel Coronavirus Disease 2019 (COVID-19) is a pandemic of great public health and clinical concern due to its high rate of infectivity, and subsequent morbidity and mortality. The objectives of the study were to 1) assess individual experiences with testing and symptoms of COVID-19 infection; 2) determine the extent to which individuals experienced COVID-19 post-exposure symptoms; and 3) determine if an association exists between pre-existing conditions and severity of COVID-19 symptoms with post-exposure symptoms. One hundred and twenty-one (N= 121) New York State residents who had COVID-19 symptoms and were tested positive for the virus participated in this study. The survey was created in Qualtrics, and the link was posted online (Facebook, Twitter, Snap Chat), and sent to New Yorkers via email and WhatsApp to gather data. Data were exported from Excel spreadsheet to Statistical Package for the Social Sciences (SPSS), version 25, where Chi-Square tests were conducted. Results indicated that most of the participants were between ages 18-35 (54.5%), African Americans (50.4%), non- Hispanic (65%), female (69.4%), had less than a college degree (51%), and made an income in 2019 of less than $55,000 per year (62%). Eighty-seven (approximately 73%) of the participants reported that getting access to testing was easy/very easy. More than one-half reported that they experienced fatigue (66.9%), lack of energy (61.2%), headache (57.9%), muscle ache (53.7%), cough (50.4%), and loss of smell (50.4%) while infected with COVID-19. Participants who experienced symptoms described their most bothersome symptom as severe (37%), followed by mild (33%), and moderate (27%). There was a statistically significant relationship between severity of symptoms and post-exposure problems experienced by participants (X² = 13.69; df = 2; p = .001); as well as between pre-existing conditions and post-exposure problems experienced by participants (X² = 10.53; df = 1; p = .001). Information from this study could benefit public health practitioners and clinicians by improving their knowledge about COVID-19 and its impacts on survivors.

Keywords

symptoms of COVID-19, severity of symptoms of COVID-19, COVID-19 testing, long haulers, lingering symptoms, COVID-19 and pre-existing conditions

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	World Health Organization, “Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19),” (2020a). [Online]. Available: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf. [Accessed July 14, 2020].
[2]	John Hopkins University, “COVID-19 data in motion: Monday, July 5, 2021.” Available: https://coronavirus.jhu.edu [Accessed Jul. 5, 2021].
[3]	Ahmad, FB., Anderson, RN, “The leading causes of death in the US for 2020,”. JAMA, 325(18), 1829-1830. Mar.2021.
[4]	Centers for Disease Control and Prevention, “Discontinuation of transmission-based precautions and disposition of patients with COVID-19 in healthcare settings (Interim Guidance),” 2020. Available: https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html.
[5]	Cevik, M., Tate, M., Lloyd, O., Maraolo, A., Schafers, J., Ho, A, “SARS-CoV-2, SARS-CoV, and MERS-CoV viral load dynamics, duration of viral shedding, and infectiousness: A systematic review and meta-analysis,” The Lancet Microbe, 2021, 2(1), E13-E22.
[6]	World Health Organization, “Coronavirus,” 2021a. [Online]. Available: https://www.who.int/health-topics/coronavirus#tab=tab_1.
[7]	Oduro-Mensah, E, Tetteh, J, Adomako, I, Adjei-Mensah, E, Owoo, C, Yawson, AO, Oliver-Commey, JA, et al., “Clinical features of COVID-19 in Ghana: Symptomatology, illness severity and comorbid non-communicable diseases,” 2020. Ghana Medical Journal 54(4): 23-32.
[8]	Khalil. R., Abdullah, N., Qaddoura, D., Alash, R, “Survey Study: COVID-19 Symptoms and Lifestyle,” World Journal of Biology Pharmacy and Health Sciences, 2021, 05(02), 033-044
[9]	National Institutes of Health, “Management of persons with COVID-19,” 2020b. [Online]. Available: https://www.covid19treatmentguidelines.nih.gov/overview/management-of-covid-19/.
[10]	Oliviero, H., “For some with COVID-19, symptoms can linger for weeks, even months,” 2020. [Online]. Available: https://medicalxpress.com/news/2020-06-covid-symptoms-linger-weeks-months.html.
[11]	National Institute for Health and Care Excellence (UK), “(NICE Guideline, No. 188.) COVID-19 rapid guideline: Managing the long-term effects of COVID-19, London,” Dec. 18, 2020. [Online]. Available: https://www.nice.org.uk/guidance/ng188.
[12]	Carfì, A, Bernabei, R, Landi, F, “Gemelli against COVID-19 post-acute care study group: Persistent symptoms in patients after acute COVID-19,” JAMA, 2020. 324(6), 603-605.
[13]	Petri, W, “What doctors know about lingering symptoms from coronavirus,” 2020. [Online]. Available: https://www.pbs.org/newshour/health/what-doctors-know-about-lingering-symptoms-from-coronavirus.
[14]	Montani, D., Savale, L., Beurnier, A., Colle, R., Noel, N., Pham, T., Monnet, X., Humbert, M. (2021). Multidisciplinary approach for acute COVID-19 syndrome: time to break down the walls. European Respiratory Journal. [Online]. Available: https://erj.ersjournals.com/content/early/2021/04/22/13993003.01090-2021#T1.
[15]	Nalbandian, A., Sehgal, K., Gupta, A. et al. (2021). “Post-acute COVID-19 syndrome,” 2021. Nat Med 27, 601-615.
[16]	National Institutes of Health, “When COVID-19 symptoms linger: New NIH initiative seeks to understand why some people continue to have symptoms long after recovery,” n.d. [Online]. Available: https://covid19.nih.gov/news-and-stories/when-COVID-19-symptoms-linger.
[17]	Jamil, A, Shyam, V, & Neupane, K, “Atypical presentation of pulmonary embolism several months after COVID-19 infection,” Cureus, 2021. 13(1), e12863.
[18]	World Health Organization, “Coronavirus disease 2019 (COVID-19) situation report – 51,” Mar.2020b. [Online]. Available: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200311-sitrep-51-covid-19.pdf.
[19]	U.S. Department of Health and Human Services, “Coronavirus: Community-based testing sites for COVID-19,” [Online]. Available: https://www.hhs.gov/coronavirus/community-based-testing-sites/index.html. Accessed: Jun.26, 2021.
[20]	Centers for Disease Control and Prevention, “Testing for COVID-19,” Jul. 2021a. [Online]. Available: https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html.
[21]	World Health Organization, “Global COVID-19 clinical platform case report form (CRF) for post covid condition (Post COVID-19 CRF),” 2021. [Online]. Available: https://www.who.int/publications/i/item/global-covid-19-clinical-platform-case-report-form-(crf)-for-post-covid-conditions-(post-covid-19-crf-).
[22]	National Institutes of Health, “COVID-19 community response survey guidance,” 2020. [Online]. Available: https://www.nlm.nih.gov/dr2/JHU_COVID-19_Community_Response_Survey_v1.3.pdf.
[23]	Lieberman-Cribbin, W, Tuminello, S, Flores, RM, Taioli, E, “Disparities in COVID-19 testing and positivity in New York City,” American Journal of Preventive Medicine, 59(3): 326-332, Sept. 2020.
[24]	Gottlieb, S, Rivers, C, McClellan, M.B, Silvis, L, Watson, C, (2020) “National coronavirus response: A road map to reopening. Washington, DC: American Enterprise Institute,” Mar. 2020. [Online]. Available: www.aei.org/wp-content/uploads/2020/03/National-Coronavirus-Response-a-Road-Map-to-Recovering-2.pdf. [Accessed April 10, 2020].
[25]	Vaughan L, Veruttipong, D, Shaw JG, Levy N, Edwards L, Winget M, “Relationship of socio-demographics, comorbidities, symptoms and healthcare access with early COVID-19 presentation and disease severity,” BMC Infectious Diseases. 2021; 21(1): 1-10.
[26]	Osikomaiya, B, Erinoso, O, Wright, KO, Odusola, AO, Thomas, B, Adeyemi, O, Bowale, A, et al. 2021. “Long COVID: Persistent COVID-19 symptoms in survivors managed in Lagos State, Nigeria,” BMC Infectious Diseases 21(1): 1-7.
[27]	Centers for Disease Control and Prevention, “Post-covid conditions,” 2021. [Online]. Available: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html. [Accessed July 12, 2021].
[28]	Centers for Disease Control and Prevention, “Medical conditions,” 2021. [Online]. Available: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html. [Accessed July 14, 2021].
[29]	Ebinger, J.E, Achamallah, N, Ji, H, Claggett, B.L, Sun, N, Botting P, et al., “Pre-existing traits associated with Covid-19 illness severity,” 2020. PLoS ONE 15(7): e0236240.
[30]	Singla, N, Rudresh, G, Mohindra, R, Suri, V, Dhibar, PS, Sharma,N, “Clinical spectrum and outcome of patients visiting coronavirus screening center in North India and clinical predictors for COVID-19,” Jan. 2021. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8132783/. [Accessed July 8, 2021].
[31]	Cockerham, W, “The social determinants of chronic disease,” 2017. [Online]. Available: https://www.researchgate.net/publication/311652666_The_Social_Determinants_of_Chronic_Disease#pf6. [Accessed July 13, 2021].
[32]	Braverman, P, “Accumulating knowledge on social determinants of health and infectious disease,” 2011. [Online]. Available: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150126/pdf/phr126s30028.pdf.
[33]	U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, “Social determinants of health,” n.d. [Online]. Available: https://health.gov/healthypeople/objectives-and-data/social-determinants-health. [Accessed July 12, 2021].
[34]	Centers for Disease Control and Prevention, “COVID-19 vaccines for people with underlying medical conditions.” Ju. 2021. [Online]. Available: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/underlying-conditions.html. [Accessed Jul. 2021].