First 'close encounters' of post-COVID patients after mildly symptomatic COVID-19

Background: COVID-19 patients frequently report residual symptoms after SARS-CoV-2 disappearance. However, the clinical post-COVID course of patients after mildly symptomatic COVID-19 is poorly known. We addressed this question because of our current clinical involvement in COVID-19 [1] and opening of a dedicated post-COVID19 outpatient clinic at 1, 3, 6, and 12 months after recovery. Materials and Methods: We enrolled 61 patients (26 males, age range 21-79 years) after a mild SARS-CoV-2 infection (i.e., no hospitalization, home quarantine, n = 48, or hospitalization to internal medicine/pneumology units for mild pneumonia, n = 13). The presence of 20 symptoms (dyspnea, fatigue, anxiety/depression, myalgia, memory impairment, chest pain, insomnia, joint pain, concentration impairment, cough, anosmia, headache, sicca syndrome, rhinitis, dysgeusia, alopecia, diarrhea, loss of appetite, dizziness, sweating, fever) was assessed semi-quantitatively by questionnaires before COVID-19, and 1 (n = 24), 3 (n = 29) or 6 months (n = 8 subjects) after recovery confirmed by two negative and consecutive nasopharyngeal swabs. Results: The prevalence of a cluster of six residual symptoms was higher after 1 month, than before infection: dyspnea (50% vs. 0%, respectively, P = 0.0001), fatigue (41.7% vs. 8.2%, p = 0.0002), myalgia (33.3% vs. 3.3%, p = 0.0001), memory impairment (33.3% vs. 13.1%, p = 0.03), insomnia (29.1% vs. 4.9%, p = 0.02), joint pain (25% vs. 8.2%, p = 0.03). The frequency of four of these symptoms was still higher after 3 months (dyspnea 24.5%, fatigue 58.6%, myalgia 31%, memory impairment 48.2% of cases;p < 0.03 in all cases vs. before infection). At this time, we observed an increased prevalence of concentration impairment (41.4% vs. 25% before infection, p = 0.001) and headache (24.1% vs. 6.6% before infection, p = 0.01). After 6 months all symptoms disappeared, except than fatigue (25%), memory impairment (12.5%) and headache (12.5%). Conclusions: A post-COVID syndrome occurs also in subjects with prior mild disease, and symptoms last 1-6 months after viral recovery. The prevalence of fatigue and neuropsychological symptoms, in particular, is still high after 6 months and should require support to improve public quality of life.