The Course of Recovery From Moderate and Severe COVID-19 and its Sequelae: A Three-month Observational Follow-up Study in Indian Population

Deepika Gupta, Jony Garg, S. Palta, Kshitiz Vashista, Deepanshu Dhiman
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Abstract

Introduction: Challenges associated with COVID-19 are not only associated with its acute phase but also with its sequelae. Multiple studies have been conducted on long-term follow ups of patients suffering from COVID-19. In a detailed search of the literature, we did not find any long-term follow up study in the Indian population. Methodology: The present study is an ambi-directional observational follow up study. A total of 83 patients were included in the study and a follow up was conducted at 2, 6 and 12 weeks after recovery from acute phase of moderate to severe COVID-19. The primary objective was to identify symptoms pertaining to respiratory, cardiac, neurological and mental health in post-COVID period. Secondary objectives were to identify patients consistent with a diagnosis of post-COVID syndrome and to assess the difference in the recovery profile between moderate and severe cases. Results: Significant improvement was observed in fatigue, cough, SpO2, breath-holding time and EuroQL-5D with maximum improvement by 12 weeks of recovery. Patients having longer ICU stays and requiring non-invasive ventilation had a longer persistence of symptoms. Forty-five patients had symptoms persistent even after 12 weeks consistent with a diagnosis of post-COVID syndrome. Conclusion: We observed 50% of the patients in the cohort had complete resolution of symptoms by six weeks follow up. Therefore, a follow up period of at least six weeks is warranted for all patients suffering from moderate to severe COVID-19, along with continuous screening of patients who tend to develop post-COVID-19 syndrome.
中度和重度 COVID-19 的恢复过程及其后遗症:印度人群的三个月观察随访研究
导言:COVID-19 带来的挑战不仅与急性期有关,还与后遗症有关。已有多项关于 COVID-19 患者长期随访的研究。在对文献的详细搜索中,我们没有发现任何针对印度人群的长期随访研究。研究方法本研究是一项环境定向观察随访研究。共有 83 名患者参与了研究,并在中度至重度 COVID-19 急性期恢复后的 2、6 和 12 周进行了随访。研究的首要目标是确定 COVID 后的呼吸、心脏、神经和精神健康症状。次要目标是确定符合后 COVID 综合征诊断的患者,并评估中度和重度病例恢复情况的差异。研究结果疲劳、咳嗽、SpO2、憋气时间和EuroQL-5D均有明显改善,恢复期12周时改善最大。入住重症监护室时间较长和需要无创通气的患者症状持续时间较长。有 45 名患者的症状在 12 周后仍持续存在,这与后 COVID 综合征的诊断一致。结论我们观察到,50% 的患者在随访六周后症状完全消失。因此,所有中度至重度 COVID-19 患者都应接受至少六周的随访,并对易患后 COVID-19 综合征的患者进行持续筛查。
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