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. 2023 Jun 20;10(7):ofad320.
doi: 10.1093/ofid/ofad320. eCollection 2023 Jul.

Respiratory, Cardiac, and Neuropsychiatric Manifestations of Postacute Sequelae of Coronavirus Disease 2019 in Lima, Peru

Rifat S Rahman  1 , Marco A Tovar  2   3 , Jesús Peinado  2 , J Santiago Palomino  2 , Claudio Ramirez  4 , Fernando Llanos-Zavalaga  4   5 , Ernesto Peralta  4 , Gissela Valderrama  2 , Lourdes B Ramos Cordova  2 , Lucero I Sanchez Cortez  2 , German Rodriguez  6 , Allison N LaHood  7 , Molly F Franke  7 , Carole D Mitnick  7   8   9 , Leonid Lecca  2   7 , Gustavo E Velásquez  8   10   11
Affiliations

Respiratory, Cardiac, and Neuropsychiatric Manifestations of Postacute Sequelae of Coronavirus Disease 2019 in Lima, Peru

Rifat S Rahman et al. Open Forum Infect Dis. .

Abstract

Background: Few studies have examined the burden of postacute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in low- and middle-income countries. We sought to characterize PASC with self-reported questionnaires and clinical examinations of end-organ function in Lima, Peru.

Methods: From January to July 2021, we recruited participants at least 8 weeks after COVID-19 diagnosis from a case registry in Lima, Peru. We evaluated participants for PASC with questionnaires, neuropsychiatric evaluations, chest X-ray, spirometry, electrocardiogram, and echocardiogram. We used multivariable models to identify risk factors for PASC.

Results: We assessed 989 participants for PASC at a median 4.7 months after diagnosis. Clinically significant respiratory symptoms were reported by 68.3% of participants, particularly those who had been severely ill during acute COVID-19, and were associated with cardiac findings of ventricular hypertrophy or dilation on echocardiogram. Neuropsychiatric questionnaires were consistent with depression in 20.7% and cognitive impairment in 8.0%. Female sex and older age were associated with increased risk of respiratory (adjusted odds ratio [aOR], 2.36 [95% confidence interval {CI}, 1.69-3.31] and aOR, 1.01 [95% CI, 1.00-1.03], respectively) and neuropsychiatric sequelae (aOR, 2.99 [95% CI, 2.16-4.18] and aOR, 1.02 [95% CI, 1.01-1.03], respectively).

Conclusions: COVID-19 survivors in Lima, Peru, experienced frequent postacute respiratory symptoms and depression, particularly among older and female participants. Clinical examinations highlighted the need for cardiopulmonary rehabilitation among persons with severe COVID-19; psychosocial support may be required among all COVID-19 survivors.

Keywords: COVID-19; Peru; SARS-CoV-2; postacute; sequelae.

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Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

Figures

Figure 1.
Figure 1.
Participant flow diagram. Abbreviations: COVID-19, coronavirus disease 2019; PCR, polymerase chain reaction.
Figure 2.
Figure 2.
Risk factors associated with postacute sequelae of coronavirus disease 2019 (PASC). A, Respiratory sequelae. B, Cardiac sequelae. C, Neuropsychiatric sequelae. Adjusted multivariable analysis included all covariates associated with sequelae with P < .1 in univariable analysis. Rows with P < .05 are shown in bold. Definitions of respiratory, cardiac, and neuropsychiatric PASC are shown in Table 1. Abbreviations: BMI, body mass index; CI, confidence interval; OR, odds ratio.
See this image and copyright information in PMC

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