RGUHS Nat. J. Pub. Heal. Sci Vol No: 9 Issue No: 3 eISSN: 2584-0460
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1Assistant Professor, Department of Community Medicine, Bangalore Medical College and Research Institute, Bengaluru-560002, Karnataka, India.
2Post graduate, Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore.
3Post graduate, Department of Community Medicine, Bangalore Medical College and Research Institute, Bangalore
*Corresponding Author:
Assistant Professor, Department of Community Medicine, Bangalore Medical College and Research Institute, Bengaluru-560002, Karnataka, India., Email: ssdrsaras@gmail.com
Abstract
Background: Post-covid syndrome is considered to be a multi‐system disease, which may occur even after a mild acute infection with Covid-19. The incidence of post‐covid syndrome is estimated to be 10–35%, while for hospitalized patients, it may reach 85%.
Methodology: A community-based cross-sectional study was undertaken during September-October 2022 in the urban field practice area of BMC&RI, to assess the prevalence of post-covid syndrome. 82 people aged 18 years and above were selected using simple random sampling and analysed for post-covid syndrome. Results: A majority of patients experienced at least one post‐ COVID‐19 symptom, with fatigue (85%) being the most common post‐discharge manifestations. Malaise or discomfort (84%) was the second most common symptom among post‐covid syndrome patients. Low mood or mood disturbance (82%) was the third most common complaint among post‐covid patients. Dyspnea was observed in about 58% of the participants. Chest pain was the least common symptom (9.7%). The majority of the participants had at least one post‐COVID manifestation: fatigue (85%), mood disturbance (82%), and malaise (84%). The other most common symptoms were dyspnoea (60%), joint pain (34%), and poor sleep (37%). Minor symptoms seen with post‐covid syndrome were anxiety (17%), loss of smell/taste (15%), cognitive/memory problems (13%), persistent headache (12%), chest pain (10%), persistent cough (9%) and fever (6%). The respiratory system was the most commonly affected system (48%). The other affected systems affected were cardiovascular system (5%), musculoskeletal system (15%), central nervous system (8%) and gastrointestinal system (7%).
Conclusion: Post-covid syndrome affects multi-organ systems to various degrees; hence, it is a matter of concern and needs to be addressed at the earliest possible.
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Introduction
The epidemiological and clinical manifestations, pathogenesis, and complications of patients with COVID-19 during the acute phase have been explicitly described; however, the long-term sequelae of COVID-19 remain largely unclear1 .
Post-COVID syndrome appears to be a multisystem disease that occurs even after a relatively mild acute illness of covid infection2,3.
A better understanding of post-COVID-19 syndrome and the dynamics and nature of the immune system response to SARS-CoV-2 infection might assist in identifying long-haulers and appropriate pathways of care4 .
Post-COVID-19 syndrome is defined as symptoms and abnormalities persisting beyond 12 weeks or more from the onset of acute COVID-19 and is not attributable to alternative diagnoses5 .
The main clinical symptoms are fatigue, shortness of breath, difficulty breathing, cough, joint, muscle, chest pain, memory disturbances, concentration or sleep problems, headache, tachycardia, loss of smell or taste, depression or anxiety, fever, dizziness, and malaise6 .
Recent literature has shown the long-term effects of COVID‐19 on various organ systems, including but not limited to respiratory, cardiovascular, neurological, musculoskeletal, and gastrointestinal system7 .
There is ample literature available on data related to the Covid-19 infected population. However, very few cases of post-COVID syndrome exist.
Due to the deficit of adequate literature related to post-COVID-19 symptoms and ignorance, the social stigma associated with that disease, rehabilitation of survivors is widely neglected8 .
Hence, this study was undertaken to assess the prevalence and characteristic distribution of post-covid syndrome with respect to different sociodemographic factors in Bangalore South.
Materials and Methods
A cross-sectional study was conducted in the urban field practice area of the BMCRI from September to October 2022. Informed consent was obtained from all the participants prior to the study. Institutional Ethics Committee approval was obtained before collection of data. Considering the prevalence of 94.9% from previous study conducted by Iqbal et al, 8 and considering 10% non-response rate, a sample size of 82 was obtained. Data were collected through a pre-tested, self-administered questionnaire using a simple random sampling technique. The population who survived Covid-19, aged 18 and above, had post-recovery symptoms, and gave consent for the study were included. Individuals who did not give consent and aged below 18 years were excluded.
Data on socio-demographic factors, post- covid symptoms like breathing difficulty, cough, fatigue and involvement of various organ-system were collected.
Data was copied to MS Excel and coded. Data analysis was performed using statistical software, SPSS version 28.0. The results were represented in terms of percentages, tables and graphs using appropriate statistical tests.
Results:
Among 82 people, approximately 23% of study population were in the age group of 18-45 years, 42% were in the age group of 46-59 years and 35% were above 60 years [Table 1].
About 56% were males and 44% were females [Table 2].
About 12% were illiterate and 11% were unemployed [Table 3].
All participants had at least one post-covid symptom with fatigue being the most common symptom. Breathing difficulty was observed in 60%, persistent cough in 9%, joint pain in 34%, low mood in 82%, persistent headache in 12%, poor sleep in 37%, fever in 6%, chest pain in 10% and loss of smell/taste in 15% of patients is seen. Approximately 17% of the participants had anxiety, 13% had cognitive/memory problems and 84% had malaise or discomfort [Table 4].
The most common organ system affected was respiratory system accounting to a population of about 48%, cardiovascular system in 5%, musculoskeletal system in 15%, nervous system in 8%, gastrointestinal system in 7%, and non-organ specific symptoms [Table 5]. Vaccination status of participants is mentioned in Table 6.
Discussion
In our study, most of the participants had fatigue as the most common post-covid recovery symptom, similar to the study done by Ayman Iqbal on the COVID-19 Sequelae8 . Our study showed difficulty in breathing in 60% of the population, whereas the previous study had only 50% of the population. Malaise/discomfort was the second most common symptom in the study participants, followed by low mood, whereas anxiety was the second most common symptom in the previous study. In this study, only approximately 34% had joint pain and 37% had poor sleep; however in the previous study it was 47.5% and 56.3% respectively. Our study showed anxiety in only 17% of the population but a previous study showed almost half of the population, that is, 53.2% with anxiety.
In our study, chest pain and loss of smell/taste accounted for 10% and 15% of the population respectively, while the same was observed in 35.4% and 47.5% of the patients, in the previous study. In the current study, only 9% and 12% of patients had persistent cough and persistent headache respectively, compared to 44.3% and 36.1%, respectively.
The present study showed less severe symptoms compared to the previous study as a whole.
Limitations of the study
• Follow up study was necessary to analyse the outcome after proper treatment of post-covid symptoms.
• There was a need to develop standard protocols and devise strategies to address and assess the severity of symptoms both qualitatively and quantitatively.
Conclusion
This study showed significantly mild symptoms of post-covid syndrome among the most of the affected population. The post-covid syndrome has features similar to post-discharge manifestations of the SARS (Severe Acute Respiratory Syndrome) and MERS (Middle – East Respiratory Syndrome).
Hence it is a matter of concern and must be addressed as soon as possible.
Recommendation
• Multi-disciplinary rehabilitation teams, healthcare workers and general public must recognize the need for systematic assessment of their recovery and further rehabilitation.
Acknowledgment
We are very grateful to all the study participants for dedicating their time to take part in this study. We also thank Head of the Educational Institution, Dean Cum Director, BMCRI, Bangalore, Head of Department, and all the faculty of Department of Community Medicine, BMCRI, Bangalore for giving us the platform to conduct the study. We also thank the almighty for providing us this opportunity and making it successful.
Source(s) of Support
Nil
Conflicts of Interest
No conflicts of interest
Supporting File
References
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