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Prevalence of anxiety/depression was investigated in 105 COVID‐19 patients at 1‐3 months from virological clearance by Hospital Anxiety and Depression Scale (HADS‐A/D). 30% of patients displayed pathological HADS‐A/D, 52.4% showed persistent symptoms. Pathological HADS‐A/D patients more commonly reported symptom persistence, even after adjustment for age, gender, disease severity. Psychological assessments should be encouraged in COVID‐19 patients’ follow‐up. This article is protected by copyright. All rights reserved.

A long period of isolation was observed in patients hospitalized for COVID-19 in Milan over March-September 2020 (45; IQR: 37–54 days). A significantly shorter period would have been observed by the application of May-WHO (22, IQR: 17–30 days, P < 0.001) and October-Italian (26, IQR: 21–34 days, P < 0.001) Guidelines. The adoption of the new symptom-based criteria is likely to lead to a significant reduction in the length of the isolation period with potential social, economic and psychological benefits, particularly in the younger population with mild/moderate disease and no comorbidities. In our opinion, the release from isolation after 21 days from symptoms onset, even without a PCR diagnostic test, in most cases seems the most adequate strategy that could balance precautions to prevent SARS CoV-2 transmission and unnecessary prolonged isolation or overuse of diagnostic testing.

Objective We explored the association between female gender and “long COVID” syndrome, defined as persistence of physical and/or psychological symptoms for more than 4 weeks after recovery from acute COVID-19 disease. Secondary aim was to identify predictors of “long COVID” syndrome by multivariable logistic regression analysis. Methods This is a single-centre prospective cohort study conducted at San Paolo Hospital in Milan, Italy. We enrolled adult patients that were evaluated at the post-COVID outpatient service of our Infectious Diseases Unit between April 15th 2020 and December 15th 2020. Participants were individuals who had clinically recovered from COVID-19 and in whom virological clearance had occurred. Previous infection by SARS-CoV-2 was microbiologically documented by positivity at reverse-transcriptase polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab. All enrolled patients underwent blood tests and a comprehensive medical examination at follow-up. Individuals were interviewed about resolved and persisting symptoms and were asked to fill in two questionnaires to allow assessment of the Hospital Anxiety and Depression symptoms (HADS) score and of the Impact of Event Scale–Revised (IES-R) score. Results A total of 377 patients were enrolled in the study. The median time from symptom onset to clinical recovery and virological clearance was 79 (IQR 69-102) and 56 (IQR 47-74) days, respectively. A diagnosis of “long COVID” syndrome was made in 260/377 (69%) patients. The most common reported symptoms were fatigue (149/377, 39.5%), exertional dyspnoea (109/377, 28.9%), musculoskeletal pain (80/377, 21.2%) and “brain fog” (76/377, 20.2%). Anxiety symptoms were ascertained in 71/377 (18.8%) individuals, whereas 40/377 (10.6%) patients presented symptoms of depression. Post-traumatic stress disorder (defined by a pathological IES-R score) was diagnosed in one-third of patients (85/275, 31%). Female gender was independently associated with “long COVID” syndrome at multivariable analysis (AOR 3.3 versus males, 95%CI 1.8-6.2, p