Longitudinal trends in the endemic symptomatic burden of COVID-19: Insights from community-based participatory virological surveillance in the Netherlands, November 2020-April 2025.
Carstens, Gesa Han, Wanda Timmermanns, Luisa van den Hof, Susan Eggink, Dirk van Hoek, Albert Jan
Carstens, Gesa
Han, Wanda
Timmermanns, Luisa
van den Hof, Susan
Eggink, Dirk
van Hoek, Albert Jan
Series / Report no.
Open Access
Type
Journal Article
Article
Article
Language
en
Date of publication
2025-11-28
Year of publication
Research Projects
Organizational Units
Journal Issue
Title
Longitudinal trends in the endemic symptomatic burden of COVID-19: Insights from community-based participatory virological surveillance in the Netherlands, November 2020-April 2025.
Translated Title
Published in
Int J Infect Dis 2025; 163:108264
Abstract
OBJECTIVES: To analyze changes over time in symptomatology and symptom burden of SARS-CoV-2 infected individuals.
METHODS: Data from symptomatic individuals from Infectieradar, an online community-based, participatory surveillance platform in the Netherlands, were analyzed (November 2020-April 2025). Weekly questionnaires collected self-reported data on SARS-CoV-2 testing, health score (scale: 0-100), medication use, and healthcare visits. Longitudinal trends were evaluated using logistic regression models adjusted for age, sex, and comorbidities.
RESULTS: During 4.5 years, 18,600 participants reported a positive SARS-CoV-2 test at least once. Upper respiratory symptoms became more prominent over time, and loss of smell and taste less. The self-reported health score and the proportion of symptomatic SARS-CoV-2-positive individuals with a high number of symptoms (more than 10 symptoms) remained relatively stable over time (October 2022-April 2025), with a health impact comparable to influenza virus infections (n = 768).
CONCLUSION: The findings suggest that the clinical presentation of COVID-19 has evolved toward upper respiratory symptoms. Despite shifting symptoms, the impact on reported well-being in this population was remarkably stable, without a significantly lower endemic symptomatic burden. The health impact of COVID-19 is more comparable to influenza than to other common respiratory infections.