@Article{info:doi/10.2196/40028,
author="Nair, Chithira V
and Moni, Merlin
and Edathadathil, Fabia
and A, Appukuttan
and Prasanna, Preetha
and Pushpa Raghavan, Roshni
and Sathyapalan, Dipu T
and Jayant, Aveek",
title="Incidence and Characterization of Post-COVID-19 Symptoms in Hospitalized COVID-19 Survivors to Recognize Syndemic Connotations in India: Single-Center Prospective Observational Cohort Study",
journal="JMIR Form Res",
year="2023",
month="Apr",
day="18",
volume="7",
pages="e40028",
keywords="COVID-19; follow-up; incidence; fatigue; long COVID; post-COVID; post-COVID-19 symptoms; questionnaire; tertiary-care center; intensive care; symptom monitoring; prospective observational study; treatment; steroid; viral therapy; postdischarge",
abstract="Background: Long COVID, or post-COVID-19 syndrome, is the persistence of signs and symptoms that develop during or after COVID-19 infection for more than 12 weeks and are not explained by an alternative diagnosis. In spite of health care recouping to prepandemic states, the post-COVID-19 state tends to be less recognized from low- and middle-income country settings and holistic therapeutic protocols do not exist. Owing to the syndemic nature of COVID-19, it is important to characterize post-COVID-19 syndrome. Objective: We aimed to determine the incidence of post-COVID-19 symptoms in a cohort of inpatients who recovered from COVID-19 from February to July 2021 at a tertiary-care center in South India. In addition, we aimed at comparing the prevalence of post-COVID-19 manifestations in intensive care unit (ICU) and non-ICU patients, assessing the persistence, severity, and characteristics of post-COVID-19 manifestations, and elucidating the risk factors associated with the presence of post-COVID-19 manifestations. Methods: A total of 120 adult patients admitted with COVID-19 in the specified time frame were recruited into the study after providing informed written consent. The cohort included 50 patients requiring intensive care and 70 patients without intensive care. The follow-up was conducted on the second and sixth weeks after discharge with a structured questionnaire. The questionnaire was filled in by the patient/family member of the patient during their visit to the hospital for follow-up at 2 weeks and through telephone follow-up at 6 weeks. Results: The mean age of the cohort was 55 years and 55{\%} were men. Only 5{\%} of the cohort had taken the first dose of COVID-19 vaccination. Among the 120 patients, 58.3{\%} had mild COVID-19 and 41.7{\%} had moderate to severe COVID-19 infection. In addition, 60.8{\%} (n=73) of patients had at least one persistent symptom at the sixth week of discharge and 50 (41.7{\%}) patients required intensive care during their inpatient stay. The presence of persistent symptoms at 6 weeks was not associated with severity of illness, age, or requirement for intensive care. Fatigue was the most common reported persistent symptom with a prevalence of 55.8{\%}, followed by dyspnea (20{\%}) and weight loss (16.7{\%}). Female sex (odds ratio [OR] 2.4, 95{\%} CI 1.03-5.58; P=.04) and steroid administration during hospital stay (OR 4.43, 95{\%} CI 1.9-10.28; P=.001) were found to be significant risk factors for the presence of post-COVID-19 symptoms at 6 weeks as revealed by logistic regression analysis. Conclusions: Overall, 60.8{\%} of inpatients treated for COVID-19 had post-COVID-19 symptoms at 6 weeks postdischarge from the hospital. The incidence of post-COVID-19 syndrome in the cohort did not significantly differ across the mild, moderate, and severe COVID-19 severity categories. Female sex and steroid administration during the hospital stay were identified as predictors of the persistence of post-COVID-19 symptoms at 6 weeks. ",
issn="2561-326X",
doi="10.2196/40028",
url="https://formative.jmir.org/2023/1/e40028",
url="https://doi.org/10.2196/40028",
url="http://www.ncbi.nlm.nih.gov/pubmed/36920842"
}