Clinical Characteristics and the Long-Term Post-recovery Manifestations of the COVID-19 Patients—A Prospective Multicenter Cross-Sectional Study

Abstract

Objective: Coronavirus disease 2019 (COVID-19) or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is a global issue. In addition to managing acute cases, post-COVID-19 persisting symptoms/complaints and different hematological values are of great concern. These have an impact on the patient's well-being and are yet to be evaluated. Therefore, clinical and primary diagnosis based on routine laboratory findings bears high importance during the initial period of COVID-19, especially in regions with fewer diagnostic facilities.Methods: Clinical information and associated complaints of the COVID-19 illness confirmed by reverse transcription-polymerase chain reaction (RT-PCR) were collected directly from the patients. Regular follow-ups were obtained on the phone every 2 weeks following recovery for 20 weeks. Initial hematological and radiology findings of the hospitalized patients except for intensive care unit (ICU) and high dependency units (HDUs) and a follow-up evaluation after 4 weeks following recovery were analyzed.Results: The post-COVID-19 persisting symptoms/complaints were found among 21.4% of symptomatic patients, which persisted for ≥20 weeks and had a significant relationship with the duration of COVID-19 illness and the existing comorbidity (p < 0.05). Post-COVID-19 primary type 2 diabetes mellitus (DM, 0.64%) and hypertension (HTN, 1.28%) and unstable DM (54.55%) and HTN (34.78%) to the pre-existing diabetic and hypertensive patients were observed. Post-recovery remarkable changes in the laboratory values included leukocytosis (16.1%), lymphocytosis (14.5%), and an increased prothrombin time (PT, 25.8%). Abnormalities in the D-dimer, serum ferritin, hemoglobin, and erythrocyte sedimentation rate (ESR) levels were present to an extent. Laboratory findings like chest X-ray, ESR, white blood cell (WBC) count, lymphocyte count, C-reactive protein (CRP), serum glutamic pyruvic transaminase (SGPT), serum ferritin, PT, D-dimer, and serum creatinine are important markers for the diagnosis and prognosis of COVID-19 illness (p < 0.05).Conclusion: Post-COVID-19 persisting symptoms and the changes in the laboratory values need to be considered with importance and as a routine clinical measure. Post-COVID-19 periodic follow-up for evaluating the patient's physical condition and the biochemical values should be scheduled with care and managed accordingly to prevent future comorbidity in patients with the post-COVID-19 syndrome.

Clinical Characteristics and Mechanisms of Musculoskeletal Pain in Long COVID

“…The lowest prevalence was reported by Mohiuddin Chowdhury et al, for both mild body ache and back pain (0.3%) persisting for 4 weeks following recovery. 25 The highest prevalence of 65.2% COVID-19 survivors reporting new-onset pain at 16 weeks after hospital discharge has been reported by Carvalho-Soares et al 26 …”

“… Both depression and neuropathic pain may arise from a common underlying inflammatory process induced by the cytokine storm. Mahmud et al (2021) 96 Bangladesh 355 (207/148) N=162 with post-covid syndrome (symptomatic) N=193 no post-covid symptoms Yes Prospective cohort study 4 weeks after clinical improvement Myalgia Total (0.6%) Symptomatic (1.2%) Arthralgia Total (1.4%) Symptomatic (4.8%) Chest pain Total (0.8%) Symptomatic (1.8%) Not available Not available Not available Mohiuddin Chowdhury et al (2021) 25 Bangladesh 313 (251/62) Yes (n=62) No (n=251) Prospective multicenter cross-sectional study 4 weeks following recovery. Arthralgia (0.6%) Mild body ache (0.3%) Back pain (0.3%) Not available Not available Not available Moradian et al (2020) 97 Iran 200 (160/40) Yes Cross-sectional study 6 weeks after discharge Myalgia 8% Not available Not available Not available Moreno-Perez et al (2021) 98 Spain 277 (146/131) Severe (hospitalized) Mild (hospital follow-up) Prospective covid study 8–12 weeks Myalgias-arthralgias 19.6% Not available Not available Not available Ong et al (2021) 66 Singapore 288 (243/45) Yes …”

Global Trends and Research Hotspots in Long COVID: A Bibliometric Analysis

“…Epidemiologists surveyed the patient groups and found that most patients developed at least one long-term symptom [ 6 , 9 ]. Women were more likely to develop long COVID than men; elderly people were more likely to develop long COVID than young people [ 57 ]; and existing comorbidity and BMI index were also associated with long COVID [ 58 , 59 ]. Children are a special group.…”

Screening performance of C-reactive protein for active pulmonary tuberculosis in HIV-positive patients: A systematic review with a meta-analysis

“…Moreover, Parker et al. concluded that higher values of CRP were measured in patients diagnosed with all three infections: TB, HIV, and COVID-19 ( 67 ). However, researchers recommend CRP as a monitoring and prognosis tool in patients diagnosed with both TB and COVID-19, rather than as a rule-out screening test ( 68 ).…”