Assessment of Post COVID-19 Health Problems and its Determinants in North India: A descriptive cross section study

Abstract

With millions of people getting affected with COVID-19 pandemic caused by a novel severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), people living with post COVID-19 Symptoms (PCS) are expected to rise in the future. The present study aimed at assessing PCS comprehensively and its associated factors among COVID-19 recovered adult population in north India. Methods: In a tertiary health centre at Delhi, an online based cross-sectional study was conducted using a semi-structured questionnaire, developed by employing a nominal group technique, in aged 18 years and above who were SARS-CoV-2 positive during the month of January to April 2021. Socio-demographic, various potential risk factors, including pre-existing morbidities, vaccination status, and severity of acute COVID-19 illness, information on acute illness for management and a spectrum of PCS were collected between June 16 to July 28, 2021. Each participant was contacted telephonically before sending the survey link. PCS were presented as relative frequency; chi-square test, odds ratio, including adjusted, were calculated to rule out association between PCS and potential predictors. Results: A total of 773 of 1801 COVID recovered participants responded to the link reaching a participation rate of 42 ·9%, with a median age of 34 years (IQR 27 to 44). Male respondents were 56 ·4%. Around 33·2% of them had PCS at four or more weeks, affecting almost all body organ systems. The most prevalent PCS were fatigue (79·3%), pain in the joins (33·4%), muscle (29·9%), hair loss (28·0%), headache (27·2%), breathlessness (25·3%), sleep disturbance (25·3%) and cough (24·9%). The prevalence of PCS was reduced to 12·8% at 12 weeks after positive test. Factor such as female gender, older age, oxygen supplementation during the acute illness, working in healthcare care facilities, the severity of acute illness, and pre-existing co-morbid were risk factors for PCS. Further, vaccination (second dose) reduced the odds of developing PCS by 45% compared to unvaccinated participants (adjusted Odds Ratio 0.65; 95%CI 0·45-0·96). Finally, 8·3% of participants rated their overall health status was either poor or very poor following COVID-19 illness. Conclusions: The PCS involves almost all organ systems, regardless of the severity of acute COVID-19 illness. Two doses of vaccine help to reduce development of PCS.

Post-COVID-19 tele-survey for persistent symptoms in a single center hospital cohort in India along with a parallel country-wide web-survey

“…The PCS found to be most prevalent in our study have also been reported by previous studies done in different parts of the world (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20), although the relative distribution varied among cohorts, as did the demographic and clinical associations. The most extensive and long physical follow-up study, done in Wuhan, China, reported fatigue and muscle weakness (63%) and sleep difficulties (26%) to be the most prevalent PCS at a median of 186 days since symptom onset (N=1655) (9).…”

“…A north Indian single hospital study collected data from a younger cohort of patients (N=773, median age 34 years) and reported the prevalence of PCS (again most common being fatigue) to be 12.8% at 3 months since diagnosis. This study also reported PCS to be more prevalent in females (17).…”

COVID-19 Vaccine and Long COVID: A Scoping Review

“…Senjam et al [ 14 ] conducted a cross-sectional study aimed to examine a total of 773 participants with confirmed COVID-19 infection by asking them to complete a survey over a 6-week period. Of those participants, 407 were unvaccinated, 173 were partially vaccinated, and 193 were fully vaccinated.…”

Impact of COVID-19 vaccination on long COVID: a systematic review and meta-analysis

“…Firstly, by preventing infection with SARS-CoV-2 (Level 1); secondly, by reducing the severity of the disease in vaccinated but infected individuals (Level 2); and finally, vaccination may benefit people who already have long COVID (Level 3). However, recent observational studies provide contradictory results and contain methodological flaws which preclude firm conclusions on level 2 and 3 vaccine impact (6, 7).…”