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Kumar G, Bhalla A, Mukherjee A, Turuk A, Talukdar A, Mukherjee S, Bhardwaj P, Menon GR, Sahu D, Misra P, Sharma LK, Mohindra R, S S, Suri V, Das H, Sarkar D, Ghosh S, Ghosh P, Dutta M, Chakraborty S, Kumar D, Gupta MK, Goel AD, Baruah TD, Kannauje PK, Shukla AK, Khambholja JR, Patel A, Shah N, Bhuniya S, Panigrahi MK, Mohapatra PR, Pathak A, Sharma A, John M, Kaur K, Nongpiur V, Pala S, Shivnitwar SK, Krishna BR, Dulhani N, Gupta B, Gupta J, Bhandari S, Agrawal A, Aggarwal HK, Jain D, Shah AD, Naik P, Panchal M, Anderpa M, Kikon N, Humtsoe CN, Sharma N, Vohra R, Patnaik L, Sahoo JP, Joshi R, Kokane A, Ray Y, Rajvansh K, Purohit HM, Shah NM, Madharia A, Dube S, Shrivastava N, Kataria S, Shameem M, Fatima N, Ghosh S, Hazra A, D H, Salgar VB, Algur S, M L KY, M PK, Panda S, Vishnu Vardhana Rao M, Bhargava B. Post COVID sequelae among COVID-19 survivors: insights from the Indian National Clinical Registry for COVID-19. BMJ Glob Health 2023; 8:e012245. [PMID: 37816536 PMCID: PMC10565174 DOI: 10.1136/bmjgh-2023-012245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 08/20/2023] [Indexed: 10/12/2023] Open
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.
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Affiliation(s)
- Gunjan Kumar
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Ashish Bhalla
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aparna Mukherjee
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | - Alka Turuk
- Clinical Studies & Trials Unit, Indian Council of Medical Research, New Delhi, India
| | | | | | | | - Geetha R Menon
- National Institute of Medical Statistics, New Delhi, India
| | - Damodar Sahu
- National Institute of Medical Statistics, New Delhi, India
| | | | | | - Ritin Mohindra
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Samita S
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vikas Suri
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Himadri Das
- Medical College and Hospital Kolkata, Kolkata, India
| | | | | | - Priyanka Ghosh
- College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | - Moumita Dutta
- College of Medicine and Sagore Dutta Hospital, Kolkata, India
| | | | - Deepak Kumar
- All India Institute of Medical Sciences, Jodhpur, India
| | | | | | | | | | | | | | | | | | - Sourin Bhuniya
- All India Institute of Medical Sciences, Bhubaneswar, India
| | | | | | | | | | - Mary John
- Christian Medical College and Hospital, Ludhiana, India
| | | | | | | | | | | | | | | | | | | | | | - H K Aggarwal
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Deepak Jain
- Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, India
| | - Arti D Shah
- SBKS Medical Institute and Research Centre, Vadodara, India
| | - Parshwa Naik
- SBKS Medical Institute and Research Centre, Vadodara, India
| | | | | | - Nyanthung Kikon
- Department of Health and Family Welfare, Government of Nagaland, Kohima, India
| | | | - Nikita Sharma
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Rajaat Vohra
- Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | | | | | - Rajnish Joshi
- All India Institute of Medical Sciences, Bhopal, India
| | - Arun Kokane
- All India Institute of Medical Sciences, Bhopal, India
| | - Yogiraj Ray
- Institute of Postgraduate Medical Education and Research, Kolkata, India
| | | | | | - Nehal M Shah
- Smt NHL Municipal Medical College, Ahmedabad, India
| | | | | | | | | | | | | | - Saumitra Ghosh
- Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Avijit Hazra
- Department of Pharmacology, Institute of Postgraduate Medical Education and Research, Kolkata, India
| | - Himanshu D
- King George Medical University, Lucknow, India
| | | | - Santosh Algur
- Gulbarga Institute of Medical Sciences, Gulbarga, India
| | - Kala Yadhav M L
- Shri Atal Bihari Vajpayee Medical College and Research Institution, Bengaluru, India
| | | | - Samiran Panda
- Indian Council of Medical Research, New Delhi, India
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Kumar Prasad A, Bakorlin Khyriem A, Valarie Lyngdoh W, Jane Lyngdoh C, Chandra Phukan A, Kumar Bhattacharya P, Nongpiur V, Barman H, Baphira P, Sumitra Devi L, Gogoi N, Sapam S, Manisana Singh K, Bhattacharya S, Chakraborty S. Clinico-demographic profile of COVID-19 positive patients - first wave versus second wave - an experience in north-east India. J Infect Dev Ctries 2023; 17:166-177. [PMID: 36897893 DOI: 10.3855/jidc.16607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 12/05/2022] [Indexed: 03/11/2023] Open
Abstract
INTRODUCTION India witnessed two distinct COVID-19 waves. We evaluated the clinico-demographic profile of patients infected during first wave (FW) and second wave (SW) in a hospital in north-east India. METHODOLOGY Patients who tested positive for severe acute respiratory syndrome-coronavirus-2 specific gene by reverse transcriptase polymerase chain reaction across FW and SW were diagnosed as COVID-19 positive. The clinico-demographic data of these positive patients were retrieved from the specimen-referral-form. Vital parameters including respiratory rate, SpO2, data on COVID-19-associated mucormycosis (CAM), COVID-19-associated acute respiratory distress syndrome (CARDS) were obtained from hospital records for in-patients. Patients were categorized based on disease severity. The data obtained in both waves were analyzed comparatively. RESULTS Out of a total of 119,016 samples tested, 10,164 (8.5%) were SARS-CoV-2 positive (2907 during FW, 7257 during SW). Male predominance was seen across both waves (FW: 68.4%; SW:58.4%), with more children infected during SW. Patients with travel history (24%) and contact with laboratory confirmed cases (61%) were significantly higher during SW relative to FW (10.9% and 42.1% respectively). Healthcare worker infection was higher in SW (5.3%). Symptoms like vomiting [14.8%], diarrhea [10.5%], anosmia [10.4%] and aguesia [9.4%] were more in SW. More patients developed CARDS in SW (6.7%) compared to FW (3.4%) with 85% and 70% patients expiring across FW and SW respectively. No case of CAM is documented in our study. CONCLUSIONS This was probably the most comprehensive study from north-east India. Industrial oxygen cylinder usage may have been the source of CAM in the rest of the country.
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Affiliation(s)
- Abhijit Kumar Prasad
- Department of Microbiology, All India Institute of Medical Sciences (AIIMS), Raipur, India
| | - Annie Bakorlin Khyriem
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Wihiwot Valarie Lyngdoh
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Clarissa Jane Lyngdoh
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Anil Chandra Phukan
- Department of Microbiology, Narayan Medical College and Hospital, Jamuhar, India
| | - Prasanta Kumar Bhattacharya
- Department of Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Vijay Nongpiur
- Department of Medicine, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Himesh Barman
- Department of Paediatric, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Peter Baphira
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Laithangbam Sumitra Devi
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Neeta Gogoi
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | | | - Ksh Manisana Singh
- State Level Viral Research and Diagnostic Laboratory, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
| | - Sagnik Bhattacharya
- Department of Microbiology, Tripura Medical College and Dr. BR Ambedkar teaching Hospital, Agartala, India
| | - Sagar Chakraborty
- Department of Microbiology, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India
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