Evidence suggests that individuals who have more severe coronavirus disease 2019 (COVID-19)illness requiring hospitalization may still have symptoms that persist even after recovery from infection.1 However, little is known about recovery from COVID-19 in young patients without underlying health conditions not requiring hospitalization. There has been a recent surge in cases of COVID-19 among individuals aged 18-40 years as more businesses have begun to reopen, and many experts believe some young adults may not be as cautious with social distancing and mask wearing.2,3

CDC Study and Implications
The CDC conducted telephone interviews April 15, 2020-June 25, 2020 in a random sample of adults aged 18 years and older who had a first positive test for SARS-CoV-2, the virus that causes COVID-19, at an outpatient visit at one of 14 United States academic health care systems in 13 states.4 Individuals included in the analysis were not hospitalized. The CDC interviewed patients by telephone 14-21 days from the test date to obtain self-reported baseline demographic data and information about chronic health conditions. The following circumstances caused study participants to be excluded: incomplete interview; someone else (e.g. family member) answered the interview questions; a previous positive SARS-CoV-2 test was reported; and failure to answer symptom questions.4 

Of the 292 respondents, 94% reported 1 or more symptoms at testing and were included in the data analysis.4 The median age of the study participants was 42.5 years (range 31-54 years).  Overall, 141 of 264 respondents with available data reported 1 or more chronic medical conditions. Among 270 of 274 study participants with current health status data, 65% reported that they returned to their baseline health within a median of 7 days (range 5-12 days). Thirty-five percent of individuals reported that they had not returned to their usual health at the time of their interview within 14-21 days after being tested, which included the following age groups: 26% (18-34 years), 32% (35-49 years), and 47% (50 years and older).4 

Among individuals aged 18-34 years with no chronic medical conditions, 19% reported not returning to their usual health 14-21 days after testing positive.4 Overall, cough was not resolved in 43% of patients, and fatigue still persisted in 35% of individuals.4 One study limitation is that surveys include self-reported data, which could lead to incomplete information. This study provides valuable information about COVID-19 recovery in the outpatient setting and demonstrates that young adults without underlying health conditions can still have persistent symptoms. Ultimately, this can result in missed time from work and college studies. Future research should continue to evaluate hospitalized and non-hospitalized patients to gain a better understanding of recovery from COVID-19 and long-term effects. 

Pharmacists can continue to serve as public health champions by educating patients about the importance of consistent and correct use of face coverings, frequent hand washing, and social distancing to prevent the spread of COVID-19.4     

REFERENCES
  1. Gershman J. Patients may continue experiencing COVID-19 symptoms after infection recovery. Pharmacy Times.  https://www.pharmacytimes.com/news/patients-may-still-continue-experiencing-symptoms-after-covid-19-infection-recovery.  Published July 14, 2020.  Accessed July 25, 2020.
  2. CDC. CDC COVID data tracker. https://www.cdc.gov/covid-data-tracker/index.html#demographics. Updated July 24, 2020. Accessed July 25, 2020.
  3. Cleveland Clinic. Here’s why the surge of coronavirus cases among young adults is bad news. https://health.clevelandclinic.org/surge-of-coronavirus-cases-young-adults/.  Published July 15, 2020. Accessed July 25, 2020.
  4. Tenforde MW, Kim SS, Lindsell CJ, et al. Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020. MMWR Morb Mortal Wkly Rep. ePub: 24 July 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6930e1.