학술논문
Post COVID sequelae among COVID-19 survivors: insights from the Indian National Clinical Registry for COVID-19
Document Type
article
Author
Balram Bhargava; Ashish Sharma; Rajnish Joshi; Amit Patel; Deepak Kumar; Ashish Pathak; Sudhir Bhandari; Manoj Kumar Panigrahi; Prasanta Raghab Mohapatra; Aparna Mukherjee; Pankaj Bhardwaj; Priyanka Ghosh; Gunjan Kumar; Simmi Dube; Nehal M Shah; Hemang M Purohit; Vikas Suri; Arti D Shah; Alka Turuk; Akhil Dhanesh Goel; Manoj Kumar Gupta; Ritin Mohindra; Ashish Bhalla; Star Pala; Balkishan Gupta; Damodar Sahu; Sourin Bhuniya; Abhishek Agrawal; Samiran Panda; Deepak Jain; Arunansu Talukdar; Janakkumar R Khambholja; Nikita Sharma; Geetha R Menon; Subhasis Mukherjee; Puspender Misra; Lokesh Kumar Sharma; Samita S; Himadri Das; Debasis Sarkar; Soumyadeep Ghosh; Moumita Dutta; Shreetama Chakraborty; Tridip Dutta Baruah; Pankaj Kumar Kannauje; Arvind Kumar Shukla; Nitesh Shah; Mary John; Kiranpreet Kaur; Vijay Nongpiur; Sachin K Shivnitwar; Bobba Rohil Krishna; Naveen Dulhani; Jigyasa Gupta; H K Aggarwal; Parshwa Naik; Manisha Panchal; Mayank Anderpa; Nyanthung Kikon; Christina Nzani Humtsoe; Rajaat Vohra; Lipilekha Patnaik; Jagdish Prasad Sahoo; Arun Kokane; Yogiraj Ray; Kruti Rajvansh; Arun Madharia; Neha Shrivastava; Sushila Kataria; Mohammad Shameem; Nazish Fatima; Saumitra Ghosh; Avijit Hazra; Himanshu D; Veeresh B Salgar; Santosh Algur; Kala Yadhav M L; Pavan Kumar M; Mendu Vishnu Vardhana Rao
Source
BMJ Global Health, Vol 8, Iss 10 (2023)
Subject
Language
English
ISSN
2059-7908
Abstract
Introduction The effects of COVID-19 infection persist beyond the active phase. Comprehensive description and analysis of the post COVID sequelae in various population groups are critical to minimise the long-term morbidity and mortality associated with COVID-19. This analysis was conducted with an objective to estimate the frequency of post COVID sequelae and subsequently, design a framework for holistic management of post COVID morbidities.Methods Follow-up data collected as part of a registry-based observational study in 31 hospitals across India since September 2020–October 2022 were used for analysis. All consenting hospitalised patients with COVID-19 are telephonically followed up for up to 1 year post-discharge, using a prestructured form focused on symptom reporting.Results Dyspnoea, fatigue and mental health issues were reported among 18.6%, 10.5% and 9.3% of the 8042 participants at first follow-up of 30–60 days post-discharge, respectively, which reduced to 11.9%, 6.6% and 9%, respectively, at 1-year follow-up in 2192 participants. Patients who died within 90 days post-discharge were significantly older (adjusted OR (aOR): 1.02, 95% CI: 1.01, 1.03), with at least one comorbidity (aOR: 1.76, 95% CI: 1.31, 2.35), and a higher proportion had required intensive care unit admission during the initial hospitalisation due to COVID-19 (aOR: 1.49, 95% CI: 1.08, 2.06) and were discharged at WHO ordinal scale 6–7 (aOR: 49.13 95% CI: 25.43, 94.92). Anti-SARS-CoV-2 vaccination (at least one dose) was protective against such post-discharge mortality (aOR: 0.19, 95% CI: 0.01, 0.03).Conclusion Hospitalised patients with COVID-19 experience a variety of long-term sequelae after discharge from hospitals which persists although in reduced proportions until 12 months post-discharge. Developing a holistic management framework with engagement of care outreach workers as well as teleconsultation is a way forward in effective management of post COVID morbidities as well as reducing mortality.