Six-Month Trajectories of Symptoms, Perceived Recovery, and Functional Health in Ecuadorian Adults with COVID-19

Background/Objectives: Most longitudinal evidence on post-acute COVID-19 comes from hospitalized patients in high-income countries and less is known about community samples in low- and middle-income settings. This study examined changes in perceived recovery, symptom burden, general health perception, and functional difficulties over six months in Ecuadorian adults with confirmed COVID-19. Methods: In a prospective observational cohort in Quito, Ecuador, 120 adults with laboratory-confirmed COVID-19 were assessed at baseline (within four weeks of diagnosis) and again three and six months after the baseline assessment; 91 completed all three assessments. The Spanish-language ISARIC follow-up survey covered 39 symptoms, perceived recovery, the EQ-5D-5L and EQ-VAS, and six Washington Group functioning items rated retrospectively for the pre-COVID period and currently. Analyses were exploratory and descriptive, and all p-values are nominal and unadjusted for multiple comparisons. Results: Participants’ perceived complete recovery improved (χ2 = 15.24, p < 0.001), as did perceived general health (F(2, 178) = 5.80, p = 0.004). Chest pain, palpitations, muscle weakness, confusion, tinnitus, and diarrhea declined over follow-up. At six months, 37.4% still reported headaches, 35.2% fatigue, 35.2% confusion or inattention, and 25.3% sleep disturbance. Among EQ-5D-5L domains, only pain/discomfort improved (p = 0.012). Vision, walking, memory, and communication declined from pre-COVID to baseline and improved between baseline and six months; pre-COVID and six-month levels were not compared directly. Conclusions: Recovery over six months was gradual but incomplete, with a substantial minority reporting ongoing or recurrent symptoms at six months. These findings describe post-acute symptom burden following confirmed COVID-19 rather than formally diagnosed post-COVID-19 condition.