Post COVID-19 sequelae: A prospective observational study from Northern India

Abstract

Post COVID-19 sequelae are a constellation of symptoms often reported after recovering from COVID-19. There is a need to better understand the clinical spectrum and long-term course of this clinical entity. The aim of this study is to describe the clinical features and risk factors of post COVID-19 sequelae in the North Indian population. This prospective observational study was conducted at a tertiary healthcare centre in Northern India between October 2020 and February 2021. Patients aged >18 years with laboratory-confirmed COVID-19 were recruited after at least two weeks of diagnosis, and details were captured. A total of 1234 patients were recruited and followed up for a median duration of 91 days (IQR: 45-181 days). Among them, 495 (40.1%) had persistent symptoms post-discharge or recovery. In 223 (18.1%) patients, the symptoms resolved within four weeks; 150 (12.1%) patients had symptoms till 12 weeks, and 122 (9.9%) patients had symptoms beyond 12 weeks of diagnosis/symptom-onset of COVID-19. Most common symptoms included myalgia (10.9%), fatigue (5.5%), shortness of breath (6.1%), cough (2.1%), insomnia (1.4%), mood disturbances (0.48%) and anxiety (0.6%). Patients who were hospitalized were more likely to report fatigue as a feature of long COVID. Hypothyroidism (OR: 4.13, 95% CI: 2.2-7.6, p-value < 0.001) and hypoxia (SpO 2 ≤ 93%) (OR: 1.7, 95% CI: 1.1-2.4, p-value 0.012) were identified as risk factors for long COVID sequelae. In conclusion, long COVID symptoms were common (22%), and 9.9% had the post COVID-19 syndrome. Myalgias, fatigue and dyspnoea were common symptoms. Patients with hypothyroidism and hypoxia during acute illness were at higher risk of long COVID.

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).…”

“…Among the Indian studies, a prospective study done in a north Indian cohort of 1234 COVID-19 patients had reported 40.1% patients reporting persistent symptoms at clinical remission of the acute disease, while 9.9% had symptoms beyond 3 months since remission (15). This study also found SOB, fatigue and insomnia among the commonly reported lingering symptoms.…”

“…Exploring the factors that make convalescent subjects more susceptible to long-COVID is a domain of active research. A considerable number of prospective follow-up studies and telephone surveys done in different parts of the world have been asserting about the commonly reported post-COVID-symptoms (PCS) and revealing the heterogeneity of susceptibility among different cohorts, based on ethnicity, age-groups, pre-existing co-morbidities as well as nature of the acute disease (9)(10)(11)(12)(13)(14)(15).…”

Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus

“…The reported prevalence of long COVID has varied across and within many countries: UK 1.6–71%, 16–19 Germany 35–77%, 20 , 21 China 49–76%, 22 , 23 Africa 68%, 24 India 22%, 25 , 26 Bangladesh 16–46%, 27 , 28 Denmark 1%, 29 Italy 5–51%, 30 , 31 USA 16–53%, 32 , 33 Norway 61%. 34 Studies assessing hospitalized patients have typically reported higher prevalence estimates (e.g.…”

Is Abdominal Cocoon a Sequela in Recovered Cases of Severe COVID-19?

“…Apart from the small bowel, it can also contain the large intestine, liver, or stomach as its contents [ 12 ]. Risk factors that are associated with potential long-term COVID-19 sequela include the severity of disease (SpO 2 <94% and patient requiring ICU support and mechanical ventilation) and the presence of comorbidities particularly hypothyroidism [ 13 , 14 ]. Around 44% of individuals, who had successfully recovered from COVID-19, presented with fresh GI symptoms almost three months after discharge [ 2 ].…”