A study excluding post-COVID-19 status in South African inpatients

In a recent study posted on medRxiv* A preprint server, an interdisciplinary team of researchers from South Africa and the United Kingdom (UK), has conducted a longitudinal cohort observational study of patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) for continuous follow-up. Was carried out.

They had a post-coronavirus infection (COVID-19) status (PCC) in 2019 in patients after 3 months of hospitalization during the second and third waves of the COVID-19 pandemic in South Africa. Determined morbidity and risk factors.

The World Health Organization (WHO) has defined PCC as a variety of ongoing, new, or recurrent health problems experienced by survivors of COVID-19. To date, limited information is available on ongoing and long-term complications of COVID-19, which represents a new public health priority.

To date, more than 70% of people in South Africa have SARS-CoV-2 infections. The impact of PCC can be exacerbated in Africa due to unreliable economic conditions and poor access to medical services. This study was developed to establish how PCC affected long-term COVID-19 patients and to determine at-risk population subgroups in South Africa.

Research design

In this study, the National Hospital Surveillance System-DATCOV identified patients with SARS-CoV-2 in hospital and acquired baseline characteristics such as demographic characteristics, comorbidities, and patient admission. Random selection of participants was made over the phone one month after discharge and followed up with standardized questionnaires at 3, 6, and 12 months.

Standardized case report (CRF) and follow-up protocols implemented by the Open Access Tool (International Consortium for Severe Acute Respiratory and Emerging Infectious Diseases (ISARIC)) have detected patient variables. Patient data was stored using a research electronic data capture (REDCap) repository hosted by the University of Oxford.

The authors used the median and interquartile range (IQR) to represent the continuous data of the study. Five multivariable logistic regression models were developed and used to evaluate parameters related to PCC.

Survey results

The results of this study showed that of the 1,873 SARS-CoV-2 participants after 3 months of discharge, more than 89% reported symptoms during the acute phase of COVID-19. Of the participants who reported acute symptoms, 7.6%, 11.3%, 13.2%, and 57.2% reported one, two, three, and four or more COVID-19-related symptoms, respectively.Most frequently reported COVID19 Symptoms The acute phase included fatigue (56.8%), shortness of breath (50.3%), fever (46.2%), croup (45.3%), and headache (37.2%).

After 3 months of discharge, more than 66% of participants reported new or persistent COVID-19 symptoms. These 19.8%, 14.8%, 9.6%, and 22.5% of participants reported one, two, three, and four or more persistent symptoms, respectively. The most common symptoms were fatigue (50.3%), shortness of breath (23.4%), lack of concentration or confusion (17.5%), headache (13.8%), and blurred vision (10.1%).

The prevalence of persistent symptoms decreased by more than 82% one month after discharge and decreased to about 66% three months later. The most frequently reported COVID-19 symptoms in patients one month after discharge were fatigue (64.9%), shortness of breath (34.8%), headache (20.0%), arm or leg weakness (18.8%), and concentration. It was a lack of power / confusion. (16.0%).

The authors analyzed the effects of persistent symptoms on lifestyle, and 11.6%, 13.6%, and 4.6% of participants reported problems with mobility, daily activity, and self-care, respectively. I pointed out that I did.

Over 17% of participants experienced varying degrees of pain. Participants also reported mild (11.9%), moderate (6.0%), and severe (2.6%) severe anxiety / depression. More women experienced these symptoms compared to men. After COVID-19, 21.8%, 14.3%, and 9.6% of participants reported problems with remembering, walking, and seeing, respectively.

Of the participants surveyed, more than 44% consulted with a general practitioner, 4.4% required readmission, and more than 1% required oxygen supplementation after 3 months of discharge.

More than 2% of the participants surveyed reported occupational changes after 3 months of COVID-19, and more than 31% of occupational changes were due to the effects of PCC. A survey of social habits showed that participants’ smoking and alcohol intake 3 months after admission were reduced by 24% and 65% or more, respectively, compared to the pre-COVID-19 diagnosis. In addition, more than 56% and 30% of patients ate a healthier diet and exercised regularly 3 months after COVID-19 infection.

Multivariate analysis revealed that factors such as gender, mixed race, and oxygen requirements on admission for women over the age of 65 were associated with new or persistent symptoms.

Conclusion

The results of the study showed an increased prevalence of persistent symptoms in SARS-CoV-2 patients 3 months after discharge that affected the health, lifestyle, and occupation of COVID-19 survivors. ..

The information gathered in this study informs African public health measures, identifies individuals at high risk of developing PCC, and provides appropriate patient care, support, and medical service plans for these patients. increase.

The authors assess the effects of COVID-19 vaccination on PCC and ensure the need for further analysis to compare PCC during various SARS-CoV-2 variant-driven waves in South Africa.

*Important Notices

medRxiv publishes unpeer-reviewed preliminary scientific reports and should not be considered definitive, guide clinical / health-related behaviors, or be treated as established information.