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[Preprint]. 2025 Apr 29:2025.04.28.25326537.
doi: 10.1101/2025.04.28.25326537.

Prevalence of Long COVID in Mycobacterium tuberculosis- exposed Groups in Peru and Kenya

Asiko Ongaya  1 , Ariana R Cardenas  2   3 , Clement Shiluli  4 , Lourdes B Ramos  2 , Liz C Senador  2 , Juan A Flores  2 , Bernard N Kanoi  4 , Josephine F Reijneveld  3 , Angel Ruvalcaba  3 , Danny Perez  2 , Paul Waiganjo  1 , Cecilia S Lindestam Arlehamn  5   6 , Timothy J Henrich  3 , Michael J Peluso  7 , Segundo R Leon  2 , Jesse Gitaka  4 , Sara Suliman  3   8   9
Affiliations

Prevalence of Long COVID in Mycobacterium tuberculosis- exposed Groups in Peru and Kenya

Asiko Ongaya et al. medRxiv. .

Abstract

Background: Long COVID (LC), also referred to as post-COVID condition, refers to new or worsening symptoms lasting more than three months after SARS-CoV-2 infection. The prevalence of LC, and the impact of co-infection with prevalent pathogens such as Mycobacterium tuberculosis (Mtb), in low- and middle-income countries remain unclear. We aimed to address these gaps in two Mtb-exposed populations.

Methods: We recruited HIV-uninfected pulmonary tuberculosis (TB) patients (n=36) and their household contacts (n=63) in Peru, and healthcare workers (n=202) in Kenya. We collected clinical data using study instruments adapted from a United States based study of LC. Participants were sampled within 2 years of SARS-CoV-2 diagnosis.

Results: In Peru, 41.4% participants reported LC symptoms, with no TB-associated significant differences in the prevalence or clinical phenotypes of LC. The most common LC symptoms were neurological (e.g., headache and trouble sleeping) and musculoskeletal (e.g., back pain). Kenyan participants reported acute, but no LC symptoms, and reported a decline in the quality of life during acute infection. In Peru, the post-COVID-19 period was associated with a significant decline in all quality-of-life dimensions (p<0.01), except depression and anxiety (p=0.289).

Conclusion: This study shows that LC prevalence was high in Peru, where TB status was not linked to LC symptoms. Those with LC reported high levels of musculoskeletal and neurological symptoms. Unexpectedly, healthcare workers in Kenya denied the presence of LC symptoms. These findings highlight the need for long-term follow-up and larger studies in different geographic settings to dissect the impact of TB comorbidity on LC.

Keywords: COVID-19; Long COVID; post-COVID condition; post-acute sequelae of SARS-CoV-2 infection; tuberculosis.

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Conflict of interest statement

Potential conflicts of interest. The authors do not report conflicts of interest.

Figures

Figure 1:
Figure 1:
Long COVID symptoms in the Peruvian cohort. A. Median duration of Long COVID-19 symptoms by groups. B. Long COVID symptoms prevalence grouped by organ systems.
Figure 2:
Figure 2:
The median duration of COVID-19 symptoms by QFT+ and QFT− in Kenya.
Figure 3:
Figure 3:
The Prevalence Ratio (PR) of Long COVID according to the persistence of the symptoms for more than 10 days in the Peruvian Cohort. The model on the right is adjusted by age, sex, and BMI.
Figure 4:
Figure 4:
Quality of Life in both cohorts. a. Pre COVID-19, during COVID-19 and Post COVID-19 prevalence of difficulties found while performing an activity in the Kenyan Cohort. b. Pre COVID-19 and Post COVID-19 prevalence of difficulties found while performing an activity in the Peruvian Cohort. c. Self-reported health scores in the Kenyan Cohort. d. Self-reported health scores in the Peruvian Cohort.
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