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A Proposed Framework and Timeline of the Spectrum of Disease Due to SARS-CoV-2 InfectionIllness Beyond Acute Infection and Public Health Implications

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To identify the key insights or developments described in this article
1 Credit CME

Although much of the response to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has focused on acute coronavirus disease 2019 (COVID-19) illness, accumulating evidence demonstrates morbidity beyond acute SARS-CoV-2 infection.14 At least 2 other periods of illness appear to be temporally associated with SARS-CoV-2 infection: a rare postacute hyperinflammatory illness and late inflammatory and virological sequelae. These 3 illness periods not only define the temporal course of SARS-CoV-2 infection at the population level but also capture distinct phases of host-viral interaction.

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Article Information

Corresponding Author: Amish Talwar, MD, MPH, US Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop H21-3, Atlanta, GA 30329 (atalwar@cdc.gov).

Published Online: November 18, 2020. doi:10.1001/jama.2020.22717

Conflict of Interest Disclosures: None reported.

Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the US Centers for Disease Control and Prevention.

Additional Contributions: We recognize the following members of the US Centers for Disease Control and Prevention COVID-19 clinical team: Michael Melgar, MD, Ermias D. Belay, MD, Kevin R. Clarke, MD, John Iskander, MD, MPH, and John T. Brooks, MD.

References
1.
Abrams  JY , Godfred-Cato  SE , Oster  ME ,  et al.  Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2: a systematic review.   J Pediatr. Published online August 5, 2020. doi:10.1016/j.jpeds.2020.08.003 PubMedGoogle Scholar
2.
Morris  SB , Schwartz  NG , Patel  P ,  et al.  Case series of multisystem inflammatory syndrome in adults associated with SARS-CoV-2 Infection—United Kingdom and United States, March–August 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(40):1450-1456. doi:10.15585/mmwr.mm6940e1PubMedGoogle ScholarCrossref
3.
Carfì  A , Bernabei  R , Landi  F ; Gemelli Against COVID-19 Post-Acute Care Study Group.  Persistent symptoms in patients after acute COVID-19.   JAMA. 2020;324(6):603-605. doi:10.1001/jama.2020.12603PubMedGoogle ScholarCrossref
4.
Del Rio  C , Collins  LF , Malani  P .  Long-term health consequences of COVID-19.   JAMA. 2020;324(17):1723-1724. doi:10.1001/jama.2020.19719PubMedGoogle ScholarCrossref
5.
Wiersinga  WJ , Rhodes  A , Cheng  AC , Peacock  SJ , Prescott  HC .  Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review.   JAMA. 2020;324(8):782-793. doi:10.1001/jama.2020.12839PubMedGoogle ScholarCrossref
6.
Buitrago-Garcia  D , Egli-Gany  D , Counotte  MJ ,  et al.  Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: a living systematic review and meta-analysis.   PLoS Med. 2020;17(9):e1003346. doi:10.1371/journal.pmed.1003346PubMedGoogle Scholar
7.
Tenforde  MW , Billig Rose  E , Lindsell  CJ ,  et al; CDC COVID-19 Response Team.  Characteristics of adult outpatients and inpatients with COVID-19—11 academic medical centers, United States, March-May 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(26):841-846. doi:10.15585/mmwr.mm6926e3PubMedGoogle ScholarCrossref
8.
Young  BE , Ong  SWX , Ng  LFP ,  et al; Singapore 2019 Novel Coronavirus Outbreak Research team.  Viral dynamics and immune correlates of COVID-19 disease severity.   Clin Infect Dis. Published online August 28, 2020. doi:10.1093/cid/ciaa1280 PubMedGoogle Scholar
9.
Stokes  EK , Zambrano  LD , Anderson  KN ,  et al.  Coronavirus disease 2019 case surveillance—United States, January 22-May 30, 2020.   MMWR Morb Mortal Wkly Rep. 2020;69(24):759-765. doi:10.15585/mmwr.mm6924e2PubMedGoogle ScholarCrossref
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