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The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors, 2021, Iqbal et al

Discussion in 'Long Covid research' started by Andy, Mar 9, 2021.

  1. Andy

    Andy Committee Member

    Messages:
    21,809
    Location:
    Hampshire, UK
    Background
    As of January 19, 2021, around two million fatalities and 68 million recoveries from coronavirus disease 2019 (COVID-19) have been reported around the globe. The past pandemics of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) hint toward a risk of occurrence of "Long-COVID" syndrome, i.e., the persistence of post-discharge symptoms among COVID-19 survivors. With the scarcity of literature addressing post-COVID-19 manifestations and little regard for the stigma associated with this disease, survivors' rehabilitation remains widely neglected. The current study aims to assess the prevalence and characteristics of post-COVID-19 manifestations and their effect on the quality of life (QoL) of COVID-19 recovered individuals. We have also analyzed the relationship of time since the recovery of COVID-19 and its severity with the post-discharge symptoms. The stigma affiliated with the infection of SARS coronavirus-2 (SARS-CoV-2) has also been highlighted.

    Methodology
    A descriptive, cross-sectional, questionnaire-based study was conducted from September 2020 to December 2020 among 158 COVID-19 recovered patients, whose information was obtained from Dow Diagnostic Laboratory, Ojha Campus, Karachi, Pakistan. The questionnaire consisted of four sections: sociodemographic data, post-COVID-19 manifestations, questions relating to the stigma, and the QoL of the recovered COVID-19 patients. We used the EuroQol five-dimension five-level questionnaire to assess the QoL, while the modified BG Prasad Socioeconomic Classification updated for 2019 was employed to determine the socioeconomic status of the participants. Data were analyzed using SPSS version 24.0 (IBM Corp., Armonk, NY, USA). Data were presented in the form of frequencies and percentages.

    Results
    An overwhelming majority (94.9%) experienced at least one post-COVID-19 symptom, with fatigue (82.9%) being the most prevalent post-discharge manifestation. We observed a significant correlation of post-COVID-19 symptoms with gender, age, and time since recovery. COVID-19 severity was found to be significantly related to the five dimensions of the QoL. A significant difference in EuroQol Visual Analog Scale health score was observed between the participants with mild, moderate, and severe COVID-19 infection (p < 0.001). Besides, the associated stigma with SARS-CoV-2 infection was found to be more prevalent in the participants belonging to the upper class as compared to the other classes (p < 0.05). Nonetheless, we also observed a significant association of disease severity with post-COVID-19 manifestations and pre-existing comorbidities.

    Conclusions
    The long-COVID syndrome is similar to the post-discharge manifestations of the survivors of prior pandemics of SARS and MERS. Multi-disciplinary rehabilitation teams, healthcare workers, and the general population should recognize the need for systematic assessment of their recovery and further rehabilitation.

    Open access, https://www.cureus.com/articles/509...need-for-rehabilitation-of-covid-19-survivors
     
  2. Hutan

    Hutan Moderator Staff Member

    Messages:
    26,520
    Location:
    Aotearoa New Zealand
    I think it's interesting to see how the emergence of Long Covid is acknowledged in different cultures.

    So the survey was done approximately 1 to 3 months after 'recovery'. Participants were obtained by use of the details of people PCR tested at the Dow Diagnostic Laboratory.

    The social class of each participant was recorded with a 5 point scale (Lower, Middle-Lower, Middle, Upper-Middle, Upper), with 82% being Upper class. So this was not a representative sample of the Pakistan population. 71% had a mild Covid illness.

    As the abstract says, fatigue was overwhelmingly common (83%). But brain fog was only reported by 19% (and blurred vision also only 19%). It doesn't look as though people were asked about weakness, or anything like post-exertional malaise.

    Screen Shot 2021-03-11 at 5.15.11 PM.png

    So, nearly half had moderate to great difficulty with their usual activities. A small number had things like strokes, renal failure and pulmonary fibrosis - note that there's a decimal point issue in Table 2 for the incidence of stroke and diabetes. Of the 71% who had a mild Covid illness, 25% reported moderate to great difficulty carrying out their usual activities.

    There's acknowledgement of the likelihood that CFS/ME is part of the clinical picture:
    It was noted though that there may have been some 'social desirability' issues with the interview approach to data gathering.

    There's an assumption that patients will gradually return to normalcy, but at least there is the suggestion that healthcare workers and rehabilitation teams should be aware of the problems and empathise.
    Proposed treatments:
    The conclusions are pretty good:
     
    Wyva, Sean and Andy like this.

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