Individuals hospitalised with Covid-19 are at higher risk of diabetes, respiratory, and cardiovascular complications in the following weeks, a study finds.
icddr,b and Bangabandhu Sheikh Mujib Medical University (BSMMU) jointly organised a dissemination seminar titled “Long-Term Sequelae of Covid-19: A Longitudinal Follow-Up Study in Dhaka, Bangladesh” on Tuesday.
The seminar also presented a guideline titled “Long Covid Clinical Management Guideline for Physicians.”
The study was conducted at two Covid-19-designated hospitals in Dhaka between December 15, 2020, and October 30, 2021.
The findings, based on the first five months of participant follow-ups, were recently published in The Lancet Regional Health Southeast Asia.
The study was funded by the United States Agency for International Development (USAID) Alliance for Combating TB (ACTB) in Bangladesh activity.
The first of its kind in Asia, the study revealed that Covid-19 survivors carry a high burden of long-term effects of Covid-19 infection, often described as post-Covid-19 syndrome (PCS) or long Covid.
Prof Shohael Mahmud Arafat, chairman, Department of Internal Medicine, BSMMU, Prof Chowdhury Meshkat Ahmed, Department of Cardiology, BSMMU, and Dr Farzana Afroze, associate scientist, Nutrition and Clinical Service Division, icddr,b and the principal investigator of the study presented key findings at the event.
The researchers recruited clinically recovered individuals older than 18 years with RT-PCR-confirmed Covid-19 who sought care from the study hospitals with or without hospitalisation.
The 362 enrolled participants were given comprehensive in-person follow-ups at one, three and five-month post-recovery intervals to evaluate the presence or trajectories of PCS symptoms which include neurological, cardiac, respiratory outcomes, and mental health. The study participants will be followed up for 24 months.
The study revealed that Covid-19 survivors over the age of 60 are twice as likely to develop cardiovascular (hypertension, high pulse rate, edema), and neurological (peripheral neuropathy or numbness, tingling sensation, and pain in the hands and feet, taste, and smell abnormalities) complications when compared to the age group younger than 40 years.
The long-term effects of the disease also seem to differ by gender - the prevalence of developing post-Covid complications was found to be 1.5 to 4 times higher in females than in males.
Long-term complications in hospitalised patients and those needing intensive care were 2-3 times more likely than in non-hospitalised patients.
Hospitalised survivors with pre-existing diabetes had a 9 to 11 times higher possibility of having uncontrolled blood sugar with regular medication and hence required the administration of insulin therapy more often compared to those who did not require hospitalisation.
The new occurrence of diabetes was 10 cases per 1,000 persons - among hospitalised patients, compared to none in the non-hospitalised group. Similarly, the new occurrence of renal impairment (high creatinine and proteinuria) and the increased liver enzyme were considerably high among Covid-19 survivors.
Most complications decreased over time in both groups, however, shortness of breath, fast pulse rate, post-traumatic stress disorder, anxiety and depression did not decline significantly in the non-hospitalised group, even five months after recovery.
The results highlight the need for continuous follow-up and care of Covid-19 survivors. Older and hospitalised patients should be routinely monitored for cardiovascular complications, given their increased risk.
Prof Shohael Mahmud Arafat presented the clinical management guideline for long-Covid for physicians, which was developed jointly by BSSMU and icddr,b.
Prof Md Sharfuddin Ahmed, vice-chancellor of BSMMU, attended the seminar as a special guest and appreciated the collaborative effort by scientists of icddr,b and BSMMU to understand and find solutions to long Covid complications.
Physicians from different medical colleges, representatives from BSMMU, icddr,b and media also attended the seminar.
The full findings of the study have been published in The Lancet Regional Health Southeast Asia in a paper titled “Features and risk factors of post-Covid-19 syndrome: Findings from a longitudinal study in Bangladesh.”
