Long Term Health Consequences of COVID-19 in Hospitalized Patients from North India: A follow up study of upto 12 months

Abstract

Purpose: Long COVID syndrome is now a real and pressing public health concern. We cannot reliably predict who will recover quickly or suffer with mild debilitating long COVID 19 symptoms or battle life threatening complications. In order to address some of these questions, we studied the presence of symptoms and various correlates in COVID 19 patients who were discharged from hospital, 3 months and up to 12 months after acute COVID 19 illness. Methods: This is an observational follow up study of RT PCR confirmed COVID 19 patients admitted at 3 hospitals in north India between April August 2020. Patients were interviewed telephonically using a questionnaire regarding the post COVID symptoms. The first tele calling was done in the month of September 2020, which corresponded to 4 to 16 weeks after disease onset. All those who reported presence of long COVID symptoms, were followed up with a second call, in the month of March 2021, corresponding to around 9 to 12 months after the onset of disease. Results: Of 990 patients who responded to the first call, 615 (62.2%) had mild illness, 227 (22.9%) had moderate and 148 (15.0%) had severe COVID 19 illness at the time of admission. Nearly 40% (399) of these 990 patients reported at least one symptom at that time. Of these 399 long COVID patients, 311 (almost 78%) responded to the second follow up. Nearly 8% reported ongoing symptomatic COVID, lasting 1 to 3 months and 32% patients having post COVID phase with symptoms lasting 3 to 12 months. Nearly 11% patients continued to have at least one symptom even at the time of the second interview (9 to 12 months after the disease onset). Overall, we observed Long COVID in almost 40% of our study group. Incidence of the symptoms in both the follow ups remained almost same across age groups, gender, severity of illness at admission and presence of comorbidity, with no significant association with any of them. Most common symptoms experienced in long COVID phase in our cohort were fatigue, myalgia, neuro psychiatric symptoms like depression, anxiety, brain fog and sleep disorder, and breathlessness. Fatigue was found to be significantly more often reported in the elderly population and in those patients who had a severe COVID 19 illness at the time of admission. Persistence of breathlessness was also reported significantly more often in those who had severe disease at the onset. The overall median duration of long COVID symptoms was 16.9 weeks with inter quartile range of 12.4 to 35.6 weeks. The duration of symptom resolution was not associated with age, gender or comorbidity but was significantly associated with severity of illness at the time of admission (P=0.006). Conclusions: Long COVID is now being recognized as a new disease entity, which includes a constellation of symptoms. Long COVID was in almost 40% of our study group with no correlation to age, gender, comorbidities or to the disease severity. The duration of symptom resolution was significantly associated with severity of illness at the time of admission (P = 0.006). In our study, all patients reported minor symptoms such as fatigue, myalgia, neuro psychiatric symptoms like depression, anxiety, brain fog and sleep disorder and persistence of breathlessness. Severe organ damage was not reported by our subjects. This might be the longest post COVID follow up study on a sample of nearly 1000 cases from India.

Characterization of Post-COVID-19 Clinical Manifestations Among Patients Visiting a Post-COVID-19 Clinic in a Tertiary Care Center: A Descriptive Study

“…Diabetes mellitus (37%) was the most common comorbidity followed by systemic hypertension (30.8%). The same was reported by Budhiraja et al [ 22 ], Garrigues et al [ 23 ], Sykes et al [ 24 ], and Fatima et al [ 25 ]. But in the studies by Halpin et al [ 26 ], Peghin et al [ 27 ], Iqbal et al [ 28 ], and Todt et al [ 18 ], the prevalence of systemic hypertension was more compared to type 2 diabetes mellitus.…”

Characteristics and predictors of Long COVID among diagnosed cases of COVID-19

“…These estimates are similar to a study from India published in pre-print server, which reported dyspnea in 74.3% and fatigue and disturbed sleep in more than 50% of patients after 30 to 40 days of recovery [ 26 ]. Another study in pre-print, which estimated Long COVID in hospitalized patients of North India, gave an estimate of 40.3% after 4 to 6 weeks follow-up [ 27 ]. High prevalence of Long COVID symptoms in severe and hospitalized cases are reported from multiple studies from all over the world [ 28 , 29 ].…”

Short and Long-Term Wellbeing of Children following SARS-CoV-2 Infection: A Systematic Review

“…We screened 9768 results from de-duplicated retrieved records to populate our evidence map. After excluding those that focused on adults and those not meeting our eligibility criteria for this review, we identified 25 studies, including over 68 thousand children and adolescents (this is an estimate since case-mix studies did not provide the exact number; see Table 1 for a summary of the main characteristics and Figure 1 for a PRISMA flow chart and see our OSF project page for the full details of the excluded studies) [ 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. Most studies were available as journal articles (all in English), 84% had a longitudinal design, and six had a control group [ 7 , 23 , 29 , 30 , 39 , 41 , 45 ].…”

“…Five studies reported this outcome [ 26 , 29 , 34 , 36 , 40 ]. The LongCOVIDKidsDK controlled study indicated that 695 adolescents (10.5%) of those who tested positive for COVID-19 reported 16 or more days of school absence and poorer quality of life associated with school functioning (see Table 2 and section below on controlled studies) [ 29 ].…”

“…Another study with 990 participants included 14.6% of participants aged 1–29. This study reported that a subset of 331 participants at 10–12-month follow-up, of which 214 (68.8%) were able to resume their daily routine at a month, 77 (24.8%) at 1 to 3 months and 20 (6.4%) at 4 months or more after discharge [ 40 ].…”