Vaccination status, favipiravir, and micronutrient supplementation roles in post-COVID symptoms: A longitudinal study

Abstract

Introduction Post-COVID symptoms are the new concern in the COVID-19 pandemic, where recovered patients experience residual symptoms affecting their quality of life. Therefore, it is imperative to evaluate the role of complete vaccination, prescribed medication, and micronutrients during COVID episodes in the occurrence of post-COVID symptoms. Method A longitudinal evaluation of Indonesia’s recovered COVID-19 patients was performed using the data collected from July 2021 and extracted in mid-February 2022. All participants were confirmed with a Real-Time Polymerase Chain Reaction test (PCR) and/or antigen test. This study collected demography and comorbidities information, symptoms and treatment of COVID-19, and collection of self-reported post-COVID symptoms every 30 days within 90 days after diagnosis/onset. Exposures of interest include vaccination status, Favipiravir administration, Vitamin C, Vitamin D, and Zinc. A Generalized Estimating Equation (GEE) was used to evaluate the longitudinal effect of exposures, presented with adjusted odds ratios and its 95% confidence interval. Results A total of 923 participants (18.2% fully-vaccinated) were involved in the study, with 79.7% being non-hospitalized. Only 25.7% did not develop any residual symptoms within 90 days. Fatigue was the most reported post-COVID symptom in each measurement time (39.5%, 16.3%, and 7.3%). Full-vaccination was effective against chronic cough (aOR 0.527, 95% CI 0.286–0.971), chronic headache (aOR 0.317, 95% CI 0.163–0.616), and chronic arthritis (aOR 0.285, 95% CI 0.116–0.703). The combination of micronutrient supplementations and Favipiravir gave no significant effect on all post-COVID symptoms. However, early initiation of Favipiravir and delaying vitamin D administration were associated with arthritis. Conclusion Full vaccination of COVID-19 prevents the disease and the development of residual symptoms when infected with SARS-COV-2. Hence, it is crucial to reconsider the prescription of micronutrient supplementation or adjust the dose of Favipiravir in the current guideline.

Vaccination efficacy against post-COVID-19 symptoms in Delta and Omicron waves: a prospective cohort in East Indonesia

“…The previous survey conducted during alpha, beta, and Delta waves showed a similar prevalence of post-COVID-19 symptoms [8]. Fatigue remains the most reported post-COVID-19 symptom in this study and is similar to the reported prevalence in a meta-analysis [23].…”

“…The researcher selected chronic cough as the primary outcome due to the nature of the SARS-COV2 infection. The initial study demonstrated that the Indonesian population's incidence of chronic cough within 30 days after COVID-19 was 17.3% [8]. With a 95% confidence level, a 5% margin of error, and 10% of non-responsive participants, the estimated sample size was 242.…”

“…However, there is limited study on how the different variants affect the occurrence of residual symptoms. For example, a longitudinal study in Indonesia addressed persistent symptoms, including fatigue, chronic cough, and chronic headache within 90 days [8], and the impact of vaccination against specific symptoms, such as olfactory dysfunction [9]. However, these studies did not cover the current period where the Omicron is the most prevalent strain.…”

InfluenCEF study: Clinical phenotype and duration of headache attributed to influenza infection

“…Second, another surprising finding was the short-lasting nature of the headache. This could be related with the high prevalence of prior influenza infection (31%), the prior occurrence of headache in the context of other infections (61%), and the proportion of patients who had been previously vaccinated (21%), as it has been observed in patients with SARS-CoV-2 (22,23). This points toward the immune response as a likely generator of the headache, suggesting that treatments should minimize the negative consequences of the immune activation, without preventing its physiologic function (23).…”

Delayed exacerbation of COVID-19 pneumonia in vaccinated kidney transplant recipients receiving immunosuppressants: a case series

“…In the general population, although late-onset or persistent complications of COVID-19 have been reported, including active shortness of breath, cough, asthma, and other respiratory complications, no cases of late-onset pneumonia were seen, unlike our study [ 11 ]. Another study reported that vaccination could reduce residual symptoms following COVID-19 in the general population [ 12 ]. However, these persistent or residual symptoms in the general population are different and less severe than the late-onset and exacerbated symptoms of the KTRs in our study, which required medical attention and subsequent hospitalization.…”