Post COVID sequelae among COVID-19 survivors: insights from the Indian National Clinical Registry for COVID-19
Authors: Kumar Gunjan , Bhalla Ashish , Mukherjee Aparna , Turuk Alka , Talukdar Arunansu , Mukherjee Subhasis , Bhardwaj Pankaj , Menon Geetha R , Sahu Damodar , Misra Puspender , Sharma Lokesh Kumar , Mohindra Ritin , S Samita , Suri Vikas , Das Himadri , Sarkar Debasis , Ghosh Soumyadeep , Ghosh Priyanka , Dutta Moumita , Chakraborty Shreetama , Kumar Deepak , Gupta Manoj Kumar , Goel Akhil Dhanesh , Baruah Tridip Dutta , Kannauje Pankaj Kumar , Shukla Arvind Kumar , Khambholja Janakkumar R , Patel Amit , Shah Nitesh , Bhuniya Sourin , Panigrahi Manoj Kumar , Mohapatra Prasanta Raghab , Pathak Ashish , Sharma Ashish , John Mary , Kaur Kiranpreet , Nongpiur Vijay , Pala Star , Shivnitwar Sachin K , Krishna Bobba Rohil , Dulhani Naveen , Gupta Balkishan , Gupta Jigyasa , Bhandari Sudhir , Agrawal Abhishek , Aggarwal H K , Jain Deepak , Shah Arti D , Naik Parshwa , Panchal Manisha , Anderpa Mayank , Kikon Nyanthung , Humtsoe Christina Nzani , Sharma Nikita , Vohra Rajaat , Patnaik Lipilekha , Sahoo Jagdish Prasad , Joshi Rajnish , Kokane Arun , Ray Yogiraj , Rajvansh Kruti , Purohit Hemang M , Shah Nehal M , Madharia Arun , Dube Simmi , Shrivastava Neha , Kataria Sushila , Shameem Mohammad , Fatima Nazish , Ghosh Saumitra , Hazra Avijit , D Himanshu , Salgar Veeresh B , Algur Santosh , M L Kala Yadhav , M Pavan Kumar , Panda Samiran , Vishnu Vardhana Rao Mendu , Bhargava Balram 
Published: October 2023

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.