Dear Colleagues,
According to the World Health Organization clinical recovery for mild cases is approximately 2 weeks, but in Italy we are observing non-severe or critical patients still positive to COVID-19, after 40 days. Is it suggested to extend the quarantine period or patients can resume daily activities because the virus is no longer able to infect? Thanks.
Lots of confusion about real recovery time in COVID-19 illness. Different hospitals and countries are following different guidelines and criteria. Therefore, follow the local updated guidelines.
This is a very important question about which the patients as well the doctors caring for patients suffering from COVID-19 illness are confused.
A symptomatic patient with confirmed COVID-19 infection based on RT-PCR of a swab sample (often from nasopharyngeal airways) usually has acute illness of about 8-12 days and rarely 2 weeks. Therefore once a patient has improvement in symptoms and signs of the disease (with radiological or lab test results) for at least 3 days, two consecutive RT-PCR based tests at least 24 hours apart indicates recovery and an admitted patient can be discharged from hospital (1-2)
However, due to confusion about the infective period (due to reports of recurrence of positive RNA-based RT-PCR test, such patients are advised to self-quarantine at home for another two weeks.
However, a validated SAR-CoV-2 specific antibody test any time during the 2-4 weeks of the COVID-19 illness indicates recovery, and such patient is considered recovered.
1. https://www.ecdc.europa.eu/sites/default/files/documents/covid-19-guidance-discharge-and-ending-isolation-first%20update.pdf
2. https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-hospitalized-patients.html
It may take 2 weeks for your body to get over the illness. That’s the average recovery time for mild cases, according to the World Health Organization. For those with severe or critical cases, recovery can take up to 6 weeks.
Dear Dr. Saiu!
I heard about a case where a person died within two days from the diagnosis. Everything depends on the up-to-date cumulative knowledge on the virus: There are still many cases where people are not even aware they have been infected as the virus has no symptoms in certain cases. One must follow continuously the emerging sets of data related to the infections. There is a nice interactive portal below:
TIBCO (2020). " COVID-19 (Coronavirus) Visual Analysis Hub: Supporting the community, sharing insights" Copyright © 2020 TIBCO Software Inc. Available at:
https://www.tibco.com/covid19
In addition please find enclosed another update by Global Data.
Yours sincerely, Bulcsu Szekely
Recovery from the COVID-19 infection is different from recovery from COVID-19 related complications or complications related to comorbid conditions
It we talk of recovery from SARS-COV-2 infection, 2 weeks in a patient who survives will be enough, and on average most of the patients who improve symptomatically have 2 negative RT-PCR tests by that time.
However, many patients with critical COVID-19 related complications - respiratory failure, renal failure, stroke, heart failure needing more recovery time are still in the hospital. These patients may stay in hospital usually in ICU for weeks and months even if they have returned 2 consecutive negative RT-PCR tests.
Other patients with underlying heart, renal, respiratory failure or cancers and chronic neurological illnesses may end up in the hospital due to complications of the underlying diseases although recovered from the viral illness.
I know a patient after COVID-19 infection became negative in 2nd week of illness, but needed to stay due to multiorgan failure and died due to complications.
Dear Dr. Muhammad Yousuf thanks for your extended explanation, it is very useful for me, to understand the dynamics of covid-19 under multiple perspectives.
Dear Dr. Bulcsu Szekely, that's exactly what I thought, in fact, all new covid cases are very important to the cumulative knowledge of the virus but we also need effective regulatory provisions and more harmonized than now.
Recovery time will depend on how sick you became in the first place. Some people will shrug off the illness quickly, but for others it could leave lasting problems.
Age, gender and other health issues all increase the risk of becoming more seriously ill from Covid-19.
I believe you mean when we can say this patient is cured ?
To be honest with you, no one can give you exact answer 100%.
Some recommendations; recommend 14 days but actually there are many reports for more than even one month.
Some recommendations; recommend improvement of symptoms for at least 3 days,+ two consecutive RT-PCR based tests at least 24 hours apart but you will see some reports regarding +ve test after 2 consecutive two negative results and people think this is re infection but I believe it is just the primary infection that we labelled him as recovery while it is not. Another question; are we sure 100% regarding two samples with -ve result ? there is one study reported negative naso-pharyngeal test came negative but tracheal aspiration came +ve.
So it is not easy question and difficult to answer it because we lack enough knowledge regarding this disease (COVID-19).
While doing the literature survey of my article I could only found WHO's recommendation (cited) of the quarantine period. Recovery time I didn't find many references back then.
Article IoT-Q-Band: A low cost internet of things based wearable ban...
It is difficult to use PCR tests to define cure. The current estimates of numbers of COVID-19 cases are very inaccurate. The sensitivity and specificity of the diagnostic tests for COVID-19 are not yet known in vivo. There are reports of very high sensitivity and specificity in vitro. However a number of confounding factors (e.g. the stage of illness and the way the swab was taken) mean that the false positive and false negative rates of these tests may be high in clinical practice.
Wenling Wang; Yanli Xu; Ruqin Gao; et al Detection of SARS-CoV-2 in Different Types of Clinical Specimens. Jama 2020 (in press).
Recovery time varies from person to person stronger immunity person can less prone to infection and can able to fight against the virus but these pandemic disease recovery can be done only by keeping yourself as hygienic and quarantine from others as possible.
Yes, you are right in saying that recovery period is around 2 weeks in healthy people. But recovery also depends on immunity level which widely varies from person to person.
Also, Covid 19 is a new disease , we are yet to know a lot about it. Information regarding thus disease will modify as the pandemic progresses. Eg. earlier incubation period was supposed to be around 2 weeks, with a median of 5 days but we have been observing many patients turn symptomatic around 4 weeks and so IP has been changed accordingly
It depends on the health status of the patient. Some cases were able to spread the virus following 38 days of infection
According to the available data ,the median time from onset to clinical recovery for mild cases is nearly 2 week and is 3-6 weeks for patients with severe or critical disease.
I agree with Abdul Hadi Al-Qahtani ,
Until now, there is no real time to recover from this pandemic.
It depends upon a person to person as well as comorbidities. And recovery time is completely different from virus shedding time. And also depends upon whether they were intubated or any complications happened after that. As few patients might take 4 weeks to several months especially elderly individuals with multiple commorbidites and with severe complications after their intubations etc. otherwise its 2 weeks for milder cases and 3-6 weeks for moderate patients. Per several studies, PT, OT, Nutrition are very important for them to get back to their baseline, not sure they will be 100% back to baseline, am not sure because of that reason USA military is not accepting people with history of COVID-19.
World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus had mentioned that recovery times tend to be about two weeks for those with mild disease and about three to six weeks for those with the severe or critical disease.
Source: https://www.forbes.com/sites/brucelee/2020/05/05/how-long-does-it-take-to-recover-from-covid-19-coronavirus-and-return-to-work/#7e07f8304347
Certain grey-areas and unanswered questions to define recovery from COVID-19.
There are still unanswered questions about recovery from COVID-19.
1. Is recovery time in asymptomatic but laboratory confirmed COVID-19 patients the same as those with mild symptomatic disease or less?
2. Does a COVID-19 patient with mild to moderate symptoms who becomes asymptomatic in a few days but still has positive RNA-based RT-PCR tests on stool samples as late as 5-6 weeks be considered recovered or can still be infective?
3. For those patients who have symptomatically recovered from COVID-19 but still have positive RT-PCR based tests, can they be considered SARS-CoV-2 carriers.
These questions need to be addressed by longitudinal follow up studies of such COVID-19 patients, with testing for the SARS-CoV-2 specific validated antibody testing. Until we have more studies on these grey-areas of recovery, we will not be able to confidently allow such COVID-19 convalescent patients to resume their day-to-day activities.
https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
This can be a useful report
The natural history of this Disease is still confusing. Anyway, CDC recommends least 7 days in quarantine after recovery. Moreover, these individuals must be advised to practice behavioral preventive methods strictly when they are discharged from the treatment center at least for two weeks.
Dear Salvatore Saiu recovery time depends on a number of factors, including how sick you become, your age, gender and any other underlying health issues. According to the WHO, people with mild symptoms should take no longer than two weeks to recover. Precisely, the Report of the WHO-China Joint Mission published on Feb. 28 by WHO* (which is based on 55,924 laboratory confirmed cases), observed the following median time from symptoms onset to clinical recovery: a) mild cases: approximately 2 weeks; b) severe or critical disease: 3 - 6 weeks; c) time from onset to the development of severe disease (including hypoxia): 1 week; d) among patients who have died, the time from symptom onset to outcome ranges from 2 - 8 weeks.
Many thanks for your intriguing question. Best regards. Daniele
* Source: https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
Dear Prof. Daniele Porcheddu thank you for your in-depth answer.
Best Regards
Salvatore Saiu
Thank you Dr. Saiu for starting the discussion. Its a million dollar question as of now. Thank you Prof. Daniel Porcheddu and Dr Yousuf for sharing very useful information.
Please take advantage of the link.
https://www.bbc.com/news/health-52301633
The WHO always recommends screening for prediagnostic detection in apparent affected.
It has not been generalized at the moment in this pandemic.
The actual recovery time of a COVID-19 patient can be determined with CONUT, as well as to check the beginning and evolution of the illness and predicting lethality (this has been demonstrated in Wuhan).
CONUT Is a Spanish biomarker whose objective is to quantify the affectation by diseases of different nature, in this case of contact from the presymptomatic period.”
Dear José Ignacio de Ulibarri thanks for the valuable clarifications!
Best regards
Salvatore
Sfortunatamente, dovremo andare avanti a mano ancora per molto tempo (con i guanti naturalmente)
The median recovery time is 22 days. Article Clinical course and risk factors for mortality of adult inpa...
Well Mr. Saiu I would share Pakistan experience, peoples getting well very early here. But it depends on age limit. Old aged persons takes much time to get well. We believe on Almighty Allah and beg pray for the innocent peoples of world.
Day 49 since I first had symptoms, and i had the mainly gastric version with silent hypoxia. My recovery still ongoing, but felt significantly better on day 26, though gastric symptoms continued for another week. Continued fatigue and other aspects seem to be part of recovery. I know others that are experiencing a similar very long recovery, who also seemed to have the same mainly gastric/low oxygen symptoms. Lung capacity is severely compromised presently, hoping that is going to be a short term problem.
It is true that recovery time varies from individual to individual. This fact is also true that there is asymptotic infection people don’t even come to know of it till either they are tested or they have symptoms sometimes they collapse and then are test positive for Covid19 in some cases of heart attacks. People test negative first dischraged then again come to hospitals with symptoms sometimes different and test positive.
Since it is a new virus and nothing is sure of . Moreover the body’s immune system varies and response to drugs varies (Pharmacogenomics ) from individual to individual so nothing is sure.
We have to be sure and a person once infected with it has to get tested for antibody titres to be sure of recovery.
Covid-19 is a new coronavirus, which scientists and experts are still discovering and trying to understand. Significant gaps remain, according to a WHO report) in late February.
However, healing of the Coronavirus, as with viral infections, occurs spontaneously in the majority of cases, naturally thanks to the person's immune defenses.
En la COVID-19 siempre es conveniente el apoyo profiláctico y terapéutico, pero cuando las defensas inmunes fallan, los apoyos se hacen imprescindibles, así como la monitorización hasta pasada la convalecencia.
According to WHO:
Using available preliminary data, the median time from onset to clinical recovery for mild cases is approximately 2 weeks and is 3-6 weeks for patients with severe or critical disease.
Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19)
https://www.who.int › docs › default-source › who-china-joint-mission-on-c...
Dr Salvatore Saiu ,
According to the available data, many factors such as health issues, age, immune system among others, influence the time taken by patients to recover from COVID-19.
The two weeks mentioned by WHO is part of the experience of China published in the report of the joint-mission implemented in February when the pandemic was at its beginning. At this time, there was not really control on its different facets, until now besides.
In my opinion we must wait for the next researches related to the question so as to be more specific about recovery time of COVID-19.
Dear Ammcise Apply , I agree with you, we need to wait for the next studies, I suppose we will have a deeper view of the disease and more quality data.
Thanks.
Regards
Dear Dr. Salvatore Saiu, I suggest to extend the quarantine period .
Best
An addendum to my previous answer, if you would like more case studies there are several support groups on Facebook, with a lot of members from around the world, including one named Long Tail Covid Sufferers. You can probably glean some valuable insight into how many of us there are, and what the ongoing symptoms are. Reduced lung capacity seems to be rife.
The time from onset to clinical recovery time for patients suffering from coronavirus disease depends on how sick a person is after being attacked by the virus. Some people will get rid of it quickly, but in others it may last long causing serious problem. Furthermore, age and health issues increase risk of severity of the disease. People with mild symptom make speedy recovery i.e. two weeks on the average. The disease can become more serious and some people will need to go to hospital for oxygen therapy and hence it could take 2-8 weeks to recover.
I believe that the recovery time depends on several factors and there are different experiences according with the Health System of every country or city. So, there is no approved generalized recommendation regarding with this point.
The disease can become more serious, and some people will have to go to the hospital for oxygen therapy, and therefore, recovery can take 2-8 weeks. The face shape as practice has shown takes 2 weeks. Regards, Sergey Viktorovich Pushkin
So, following the WHO classification and the factors discussed above along with the duration of symptoms and stay in the hospital- we recommend a variable duration of quarantine which is individualized for each patient and mentioned with the exact dates on the discharge summary/advice of all patients. Our national guidelines do not even recommend a negative COVID report before discharge in mild to moderate cases, making this home isolation duration even more important.
The recovery time depends on several factors such as severity of infection, age, immune status of the patients and underlying health issues. According to the WHO, people with mild symptoms should take no longer than two weeks to recover and for patients with severe disease time required for recovery is 3-6 weeks. Hence, there is no approved generalized recommendation regarding the recovery time.
Besides, recovery time is relevant for a person only. Long term sequelae may be seen in the future in COVID-19 also.
At present, it is the period of infectivity which is an important epidemiologic parameter. to determine isolation and quarantine guidelines
Recovery time from COVID-19 depends on the degree of infection, as well as age, the immunity power of a person, or whether the person had been suffering from diseases like diabetes, cardiac or respiratory. However, for mild cases the recovery time might take up to two weeks, that for moderate cases up to three to four weeks and for critical cases up to six weeks or more.
The acute period of the disease is 10-14 days. Recovery time depends on several factors, such as the severity of the infection, age, patients' immune status, and underlying health problems. This period is 3-6 weeks. There is no approved generic recovery time guide. This is the time for the restoration of many body systems. Middle-aged people go through this period faster. I know several yellow people who were in the hospital for 3 months, while during this period 2 streams have already been discharged from young patients. Regards, Sergey Viktorovich Pushkin
It depends on the immunity power of a person. From several evidences it has been observed that it takes about 2-3 weeks.
As one of the very large Long Haul Covid group I can confirm that for a large group of people the recovery time is at least six months.
I have recently replied to a similar question on this platform. Please see the RG link below.
https://www.researchgate.net/post/About-recovery-from-covid19
Depends on severity of the disease, age, immunity and treatment. Usually it takes 2-6 weeks.
Covid19 is a Retro Virus. The viruses are self limiting and infection depends upon the response of the patients immune system.
Due to several reasons COVID-19 recovery period is not completely well defined. Diverse factors influence such period: disease severity, immune properties of the patient, level of vaccination, treatment, etc.
New Model for the COVID-19 Reported Cases and Deaths of Ghana in Accelerated Spread and Prediction of the Delayed Phase
https://www.researchgate.net/publication/356970930_New_Model_for_the_COVID-19_Reported_Cases_and_Deaths_of_Ghana_in_Accelerated_Spread_and_Prediction_of_the_Delayed_Phase
The people I knew of who had had COVID-19 had been vaccinated and were not ill for long.
However, I have just met someone (who I knew before) with long COVID. He has been so ill that there was doubt that he would live. He was ill for months and after discharged from hospital, was cared for in a convalescent home as he lives alone. Now back in his own home, he is still far from well but feels he is improving and as always, he is very positive. But to me, he is not the healthy man who I knew before. However, I'm so pleased that he survived such a bad experience and that he feels that he is improving.
Of course, it is a long time since he was infectious, but the virus has left its legacy.
I think the Gaussian principle is applicable to Covid 19 disease spectrum too. In extreme cases people can die of covid within days and those who survive the disease recover ( in most cases ) within weeks. But what is intriguing is the long covid symptoms, most common being general debilitation. From whatever cases I had observed in some they persist even for months. They are non specific, so require intensive investigations to rule out other causes for the symptoms.