An observational multi-centric COVID-19 sequelae study among health care workers

Abstract

Background: India has seen more than 43 million confirmed cases of COVID-19 as of April 2022, with a recovery rate of 98.8%, resulting in a large section of the population including the healthcare workers (HCWs), susceptible to develop post COVID sequelae. This study was carried out to assess the nature and prevalence of medical sequelae following COVID-19 infection, and risk factors, if any.

Methods: This was an observational, multicenter cross-sectional study conducted at eight tertiary care centers. The consenting participants were HCWs between 12 and 52 weeks post discharge after COVID-19 infection. Data on demographics, medical history, clinical features of COVID-19 and various symptoms of COVID sequelae was collected through specific questionnaire.

Finding: Mean age of the 679 eligible participants was 31.49 ± 9.54 years. The overall prevalence of COVID sequelae was 30.34%, with fatigue (11.5%) being the most common followed by insomnia (8.5%), difficulty in breathing during activity (6%) and pain in joints (5%). The odds of having any sequelae were significantly higher among participants who had moderate to severe COVID-19 (OR 6.51; 95% CI 3.46-12.23) and lower among males (OR 0.55; 95% CI 0.39-0.76). Besides these, other predictors for having sequelae were age (≥45 years), presence of any comorbidity (especially hypertension and asthma), category of HCW (non-doctors vs doctors) and hospitalisation due to COVID-19.

Interpretation: Approximately one-third of the participants experienced COVID sequelae. Severity of COVID illness, female gender, advanced age, co-morbidity were significant risk factors for COVID sequelae.

Funding: This work is a part of Indian Council for Medical Research (ICMR)- Rational Use of Medicines network. No additional financial support was received from ICMR to carry out the work, for study materials, medical writing, and APC.

Keywords: ACE2, Angiotensin-converting enzyme 2; AE, Adverse events; BMI, Body mass index; CAD, Coronary artery disease; CI, Confidence interval; COVID sequelae; COVID-19; COVID-19, Corona virus disease 2019; CTRI, Clinical Trials Registry- India; DASS-21, Depression, Anxiety, and Stress Scale-21; ENT, Ear, nose, and throat; GERD, Gastroesophageal reflux disease; HCQ, Hydroxychloroquine; HCW, Health care worker; ICMR, Indian council of medical research; ICMR-RUMC; Long COVID; MOHFW, Ministry of Health and Family Welfare, Govt. of India; NICE, National Institute for Health and Clinical Excellence; OR, Odds ratio; PCOS, Polycystic Ovarian Disease; PLOG, Polymerase gamma-related disorders; RHD, Rheumatic heart disease; RUMC, Rational use of medicine center; SARS-CoV-2; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; WHO, World Health Organization; p-value, Probability value.