Long covid: a global health issue - a prospective, cohort study set in four continents - Repository

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: https://doi.org/10.1136/bmjgh-2024-015245

Abstract

Introduction: A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs). Methods: A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to <6 and 6 to <12 months post-hospital discharge. A standardised case report form developed by International Severe Acute Respiratory and emerging Infection Consortium’s Global COVID-19 Follow-up working group evaluated the frequency of fever, persistent symptoms, breathlessness (MRC dyspnoea scale), fatigue and impact on daily activities. Results: Of 11 860 participants (median age: 52 (IQR: 41–62) years; 52.1% females), 56.5% were from HICs and 43.5% were from LMICs. The proportion identified with Long Covid was significantly higher in HICs vs LMICs at both assessment time points (69.0% vs 45.3%, p<0.001; 69.7% vs 42.4%, p<0.001). Participants in HICs were more likely to report not feeling fully recovered (54.3% vs 18.0%, p<0.001; 56.8% vs 40.1%, p<0.001), fatigue (42.9% vs 27.9%, p<0.001; 41.6% vs 27.9%, p<0.001), new/persistent fever (19.6% vs 2.1%, p<0.001; 20.3% vs 2.0%, p<0.001) and have a higher prevalence of anxiety/depression and impact on usual activities compared with participants in LMICs at 2 to <6 and 6 to <12 months post-COVID-19 hospital discharge, respectively. Conclusion: Our data show that Long Covid affects populations globally, manifesting similar symptomatology and impact on functioning in both HIC and LMICs. The prevalence was higher in HICs versus LMICs. Although we identified a lower prevalence, the impact of Long Covid may be greater in LMICs if there is a lack of support systems available in HICs. Further research into the aetiology of Long Covid and the burden in LMICs is critical to implement effective, accessible treatment and support strategies to improve COVID-19 outcomes for all.

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This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

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Pazukina, E., Garcia-Gallo, E., Reyes, L., Kildal, A., Jassat, W., Dryden, M., Holter, J., Chatterjee, A., Gomez, K., Søraas, A., Puntoni, M., Latronico, N., Bozza, F., Edelstein, M., Gonçalves, B., Kartsonaki, C., Kruglova, O., Gaião, S., Chow, Y., Doshi, Y., Duque, S., Ibañez, E., Fuentes, Y., Hastie, C., O’Hara, M., Balan, V., Menkir, T., Merson, L., Kelly, S., Citarella, B., Scott, J., Munblit, D., Sigfrid, L., ISARIC Clinical Characterization Group & ISARIC Global Paediatric Long COVID Working Group 2024, 'Long covid: a global health issue - a prospective, cohort study set in four continents', BMJ Global Health, 9(10), article no: e015245. https://doi.org/10.1136/bmjgh-2024-015245

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DOI: https://doi.org/10.1136/bmjgh-2024-015245

Repository URI: https://eprints.gla.ac.uk/333096/