A systematic review and meta-analysis estimates a nearly 50% long-COVID rate months after infection in Africa, with psychiatric conditions the most common manifestations.
Published today in Scientific Reports, the February 2023 literature search and analysis involved 25 observational, English language long-COVID studies with 29,213 infected African patients.
Nearly half (48%) of the studies were from Egypt, the average patient age was 42 years (range, 7 to 73 years), 59.3% were females, and the median follow-up was 3 months.
“In low-income countries, the estimates of its [long COVID’s] incidence vary greatly due to a significant number of hidden infections (i.e., asymptomatic or undisclosed) and difficulties in accessing testing,” the study authors wrote.
A fourth of patients reported poor quality of life
The team, led by researchers from the University of Bari in Italy, found a long-COVID rate of 48.6%, with a predominance of psychiatric conditions, especially post-traumatic stress disorder (25.8%).
The most common neurologic symptom was cognitive impairment (15%), and shortness of breath was the most common respiratory symptom (18.3%), followed by cough (10.7%). Other notable symptoms were loss of appetite (12.7%), weight loss (10.4%), fatigue (35.4%), and muscle pain (15.5%). A quarter (25.4%) of patients reported poor quality of life.
The high incidence of fatigue is particularly worrisome because of its debilitating nature. “This is concerning because, in Africa, it has the potential to lead to important impairment in productivity and further loss of economic agency,” the researchers wrote.
The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients.
Likewise, the mental illness burden in long-COVID patients poses a challenge on a continent with few mental health resources: “These findings highlight the pressing need for immediate policy implementation and reallocation of resources to address this severely underestimated public health issue.”
Risk factors for long COVID included older age and hospitalization during infection.
“The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients,” the authors concluded, noting that high-quality studies are urgently needed.
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