Long COVID-19 symptoms found in 40% of acute coronavirus patients, Max group study reveals

New Delhi: A follow-up study conducted on a cohort of patients with acute coronavirus infection across three facilities of a leading healthcare group has found that 40 percent of them had ’long-Covid’ symptoms, the hospital authorities said on Wednesday. The study on about 1,000 patients was designed as a two-step tele-interview, based on symptoms recall to a set of questions, and was undertaken to shed light on the burden of prolonged symptoms faced by the hospitalised COVID-19 patients in India after discharge, they said. Observational follow-up study of RT-PCR-confirmed coronavirus patients admitted at three hospitals of Max healthcare group in north India between April-August in 2020 were part of the study, a spokesperson of the group said. It was conducted on the presence of symptoms and various correlates in these patients, three-twelve months post-discharge after acute COVID-19 illness, and a follow-up of up to one year, he said. The exhaustive study titled “Long term health consequences of COVID-19 in hospitalised patients from north India: A follow up study of up to 12 months” led by Dr Sandeep Budhiraja, Group Medical Director of Max Super Specialty Hospital, is possibly the “longest post-COVID follow-up study”, the hospital authorities claimed. For the study, all the patients who were admitted at the three hospitals between April-August 2020 were contacted twice over the telephone for follow-up. The first follow-up was done in September 2020 (4-16 weeks from the onset of disease) and the second follow up call was done in March 2021 with those patients who had reported symptoms during the first follow-up and profile of prolonged symptoms of long-COVID, the spokesperson said. The details were captured using a questionnaire along with the pre-discharge and discharge data, which was extracted from the hospital’s Computerised Patient Record System (CPRS). “We found that overall, long-COVID occurred in almost 40 percent of these cases. Of the 990 patients studied, 31.8 percent patients had post-COVID symptoms beyond three months, and 11 percent of the patients continued to have some form of symptoms for as long as 9-12 months from the onset of disease,” Budhiraja said. “Of the notable findings, fatigue was found to be the most commonly reported with 12.5 percent cases, followed by myalgia (9.3 percent). Persistence of breathlessness was also reported significantly more often in those who had severe disease at the onset,” he said. Fatigue showed significant association with age, with only 1 of 44 (2.3 percent) in the age group of less than 30 years had fatigue, which increased to 21.5 percent in the age-group of 60 years or more, the doctor said The patients in the study group also reported neuro-psychiatric symptoms like depression, anxiety, ‘brain fog’ and sleep disorder and persistence of breathlessness. The duration of symptom resolution was significantly associated with severity of illness at the time of admission, as per the study, which has been submitted to a journal for publication. However, there were no reports of severe organ damage from the study group, the healthcare group claimed. Budhiraja said the study found “no correlation” between developing post-Covid symptoms and age, gender, comorbidities or the severity of disease; however duration of post-Covid symptoms had significant correlations to the disease severity at time of admission but not to age, gender and comorbidities. Among the 990 respondents of the first follow-up, 32.3 percent (320 patients) were female and 67.7 percent (670 patients) were male. It was also noted that more than one-third (37.3 percent) reported at least one comorbidity at admission; diabetes (23.7 percent) and hypertension (20.4 percent) being the most common, as per the study. In March 2021, of the 311 individuals responding to the second round of telephonic interview, 36 percent (112 patients) were females and 64 percent (199 patients) were males, and of these 46.6 percent (145 patients) reported to have at least one comorbidity at the time of hospitalisation, it said. This study will help in assessing the need and type of long-term follow-up and rehabilitation programmes required for patients hospitalised for COVID-19, doctors said. Elaborating on the severity of the illness at the time of admission to the hospital, Budhiraja said, “Of the 990 patients who responded to the first interview, 62.2 percent (615 patients) had mild illness, 22.9 percent (227 patients) had moderate and 15 percent (148) had severe COVID-19 illness at the time of admission." “It was also noted in the study that nearly 40 percent (399) of the studied patients reported at least one symptom at that time. Of these 399 long-COVID patients, almost 78 percent (311 patients) responded to the second follow-up and nearly 8 percent reported ongoing symptomatic Covid, lasting one to three months and 32 percent patients having post-Covid phase with symptoms lasting three to 12 months,” he added. This study will be a very important consideration to make projections on the potential burden on the health systems that might be brought about by long-Covid in India, the healthcare group said.