LAUSR

BACKGROUND COVID-19 has caused an ongoing worldwide pandemic. Much remains unknown about detailed symptomatic features of COVID-19 onset and rehabilitation. METHODS In this retrospective cohort study, 932 hospitalized patients with COVID-19 in Wuhan were enrolled, including 52 severe cases and 880 non-severe cases. The symptomatic features were analyzed and compared between the severe and non-severe groups. All patients were followed up 3 months after discharge. RESULTS Of the 932 patients, fever (60%), cough (50.8%), and fatigue (36.4%) were the most common symptoms, followed by anorexia (21.8%) and dyspnea (19.2%). The median duration of fever was 7 days, which was characterized by persistent low fever. The median duration of cough was 17 days, characterized by dry cough without sputum. Most dyspnea occurred on the fourth day after illness onset, with a median duration of 16 days. The incidences of taste loss and olfactory disturbance were only 6.2% and 3.1%, respectively. After adjusting age and gender, multivariate regression analysis showed that fever lasting for more than 5 days (OR 1.90, 95%CI 1.00-3.62, P = 0.0498), anorexia at onset (2.61, 1.26-5.40, P = 0.0096), and modified Medical Research Council level above grade 2 when dyspnea occurred (14.19, 7.01-28.71, P < 0.0001) were symptomatic risk factors for severe COVID-19. Through follow-up, cough (6.2%), dyspnea (7.2%), fatigue (1.8%), olfactory and taste disorders (1.5%) were the significant remaining symptoms. CONCLUSIONS COVID-19 caused clusters of symptoms with multiple systems involved. Certain symptomatic characteristics have predictive value for severe COVID-19. Short-term follow-up showed that most patients had a good prognosis.