Longitudinal symptom burden in people with and without COVID-19: results from LIFELINES

High symptom burden has been reported during an acute SARS-CoV-2 infection (1). In the weeks and months after the infection, persistent symptoms have been described in hospitalized and non-hospitalized patients with COVID-19 (2, 3, 4). Respiratory (e.g. dyspnoea, cough, chest tightness) and non-respiratory related symptoms (e.g. fatigue, muscle pain, headache, joint pain, loss of smell and taste) seem to be very common. Moreover, scores on different patient-reported outcome measures, including care dependency, mood status, frailty, sleep quality and quality of life show abnormalities in about half of the patients studied (3, 5). 
To date, it remains to be determined what the symptom burden and quality of life (QoL) is in the weeks prior, during, and after test-based COVID-19, as prospective data are lacking. In addition, it is unknown how these trajectories differ between subjects with a positive COVID-19 test (hospitalized and non-hospitalized), subjects with a negative COVID-19 test, and subjects without a COVID-19 test. Moreover, the influence of pre-existing symptoms and comorbidities on the symptom burden during and after  a test-based COVID-19 infection needs to be determined. The study design of the Lifelines COVID-19 Cohort allows to answer these questions. Therefore, this proposal aims [1] to study prospectively the symptom burden and QoL in weeks/months prior, during and after test-based COVID-19; [2] to compare symptom/QoL trajectories between subjects with a positive COVID-19 test (hospitalized- and non-hospitalized), subjects with a negative COVID-19 test, and subjects without a COVID-19 test; and [3] to study the influence of pre-existing symptoms and comorbidities on the symptom burden during and after the test-based COVID-19 infection.