BMJ Global Health (Oct 2023)

Post COVID sequelae among COVID-19 survivors: insights from the Indian National Clinical Registry for COVID-19

  • Balram Bhargava,
  • Ashish Sharma,
  • Rajnish Joshi,
  • Amit Patel,
  • Deepak Kumar,
  • Ashish Pathak,
  • Sudhir Bhandari,
  • Manoj Kumar Panigrahi,
  • Prasanta Raghab Mohapatra,
  • Aparna Mukherjee,
  • Pankaj Bhardwaj,
  • Priyanka Ghosh,
  • Gunjan Kumar,
  • Simmi Dube,
  • Nehal M Shah,
  • Hemang M Purohit,
  • Vikas Suri,
  • Arti D Shah,
  • Alka Turuk,
  • Akhil Dhanesh Goel,
  • Manoj Kumar Gupta,
  • Ritin Mohindra,
  • Ashish Bhalla,
  • Star Pala,
  • Balkishan Gupta,
  • Damodar Sahu,
  • Sourin Bhuniya,
  • Abhishek Agrawal,
  • Samiran Panda,
  • Deepak Jain,
  • Arunansu Talukdar,
  • Janakkumar R Khambholja,
  • Nikita Sharma,
  • Geetha R Menon,
  • Subhasis Mukherjee,
  • Puspender Misra,
  • Lokesh Kumar Sharma,
  • Samita S,
  • Himadri Das,
  • Debasis Sarkar,
  • Soumyadeep Ghosh,
  • Moumita Dutta,
  • Shreetama Chakraborty,
  • Tridip Dutta Baruah,
  • Pankaj Kumar Kannauje,
  • Arvind Kumar Shukla,
  • Nitesh Shah,
  • Mary John,
  • Kiranpreet Kaur,
  • Vijay Nongpiur,
  • Sachin K Shivnitwar,
  • Bobba Rohil Krishna,
  • Naveen Dulhani,
  • Jigyasa Gupta,
  • H K Aggarwal,
  • Parshwa Naik,
  • Manisha Panchal,
  • Mayank Anderpa,
  • Nyanthung Kikon,
  • Christina Nzani Humtsoe,
  • Rajaat Vohra,
  • Lipilekha Patnaik,
  • Jagdish Prasad Sahoo,
  • Arun Kokane,
  • Yogiraj Ray,
  • Kruti Rajvansh,
  • Arun Madharia,
  • Neha Shrivastava,
  • Sushila Kataria,
  • Mohammad Shameem,
  • Nazish Fatima,
  • Saumitra Ghosh,
  • Avijit Hazra,
  • Himanshu D,
  • Veeresh B Salgar,
  • Santosh Algur,
  • Kala Yadhav M L,
  • Pavan Kumar M,
  • Mendu Vishnu Vardhana Rao

DOI
https://doi.org/10.1136/bmjgh-2023-012245
Journal volume & issue
Vol. 8, no. 10

Abstract

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Introduction The effects of COVID-19 infection persist beyond the active phase. Comprehensive description and analysis of the post COVID sequelae in various population groups are critical to minimise the long-term morbidity and mortality associated with COVID-19. This analysis was conducted with an objective to estimate the frequency of post COVID sequelae and subsequently, design a framework for holistic management of post COVID morbidities.Methods Follow-up data collected as part of a registry-based observational study in 31 hospitals across India since September 2020–October 2022 were used for analysis. All consenting hospitalised patients with COVID-19 are telephonically followed up for up to 1 year post-discharge, using a prestructured form focused on symptom reporting.Results Dyspnoea, fatigue and mental health issues were reported among 18.6%, 10.5% and 9.3% of the 8042 participants at first follow-up of 30–60 days post-discharge, respectively, which reduced to 11.9%, 6.6% and 9%, respectively, at 1-year follow-up in 2192 participants. Patients who died within 90 days post-discharge were significantly older (adjusted OR (aOR): 1.02, 95% CI: 1.01, 1.03), with at least one comorbidity (aOR: 1.76, 95% CI: 1.31, 2.35), and a higher proportion had required intensive care unit admission during the initial hospitalisation due to COVID-19 (aOR: 1.49, 95% CI: 1.08, 2.06) and were discharged at WHO ordinal scale 6–7 (aOR: 49.13 95% CI: 25.43, 94.92). Anti-SARS-CoV-2 vaccination (at least one dose) was protective against such post-discharge mortality (aOR: 0.19, 95% CI: 0.01, 0.03).Conclusion Hospitalised patients with COVID-19 experience a variety of long-term sequelae after discharge from hospitals which persists although in reduced proportions until 12 months post-discharge. Developing a holistic management framework with engagement of care outreach workers as well as teleconsultation is a way forward in effective management of post COVID morbidities as well as reducing mortality.