An observational multi-centric COVID-19 sequelae study among health care workers

Ajay Kumar Shukla; Shubham Atal; Aditya Banerjee; Ratinder Jhaj; Sadasivam Balakrishnan; Preeta Kaur Chugh; Denis Xavier; Atiya Faruqui; Aakanksha Singh; Ramasamy Raveendran; Jayanthi Mathaiyan; Jeevitha Gauthaman; Urwashi I Parmar; Raakhi K Tripathi; Sandhya K Kamat; Niyati Trivedi; Prashant Shah; Janki Chauhan; Harihar Dikshit; Hitesh Mishra; Rajiv Kumar; Dinesh Kumar Badyal; Monika Sharma; Mamta Singla; Bikash Medhi; Ajay Prakash; Rupa Joshi; Nabendu S Chatterjee; Jerin Jose Cherian; Ved Prakash Kamboj; Nilima Kshirsagar

doi:10.1016/j.lansea.2022.100129

An observational multi-centric COVID-19 sequelae study among health care workers

Lancet Reg Health Southeast Asia. 2023 Mar:10:100129. doi: 10.1016/j.lansea.2022.100129. Epub 2022 Dec 13.

Authors

Ajay Kumar Shukla¹, Shubham Atal¹, Aditya Banerjee¹, Ratinder Jhaj¹, Sadasivam Balakrishnan¹, Preeta Kaur Chugh², Denis Xavier³, Atiya Faruqui³, Aakanksha Singh³, Ramasamy Raveendran⁴, Jayanthi Mathaiyan⁴, Jeevitha Gauthaman⁴, Urwashi I Parmar⁵, Raakhi K Tripathi⁵, Sandhya K Kamat⁵, Niyati Trivedi⁶, Prashant Shah⁶, Janki Chauhan⁶, Harihar Dikshit⁷, Hitesh Mishra⁷, Rajiv Kumar⁷, Dinesh Kumar Badyal⁸, Monika Sharma⁹, Mamta Singla¹⁰, Bikash Medhi¹¹, Ajay Prakash¹¹, Rupa Joshi¹¹, Nabendu S Chatterjee¹², Jerin Jose Cherian¹², Ved Prakash Kamboj¹², Nilima Kshirsagar¹²

Affiliations

¹ Department of Pharmacology, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, 462020, India.
² Department of Pharmacology, Vardhman Mahavir Medical College & Safdarjung Hospital, Near AIIMS Hospital, Ansari Nagar West, New Delhi, 110029, India.
³ Department of Pharmacology, St John's Medical College Sarjapur - Marathahalli Rd, Beside Bank of Baroda, John Nagar, Koramangala, Bengaluru, Karnataka, 560034, India.
⁴ Department of Pharmacology, Jawaharlal Institute of Postgraduate Medical Education & Research, JIPMER Campus Rd, Gorimedu, Priyadarshini Nagar, Puducherry, 605006, India.
⁵ Department of Pharmacology & Therapeutics, Seth G. S. Medical College & K. E. M. Hospital, Acharya Donde Marg, Parel East, Parel, Mumbai, Maharashtra, 400012, India.
⁶ Department of Pharmacology, Medical College, Baroda, Vinoba Bhave Rd, Anandpura, Vadodara, Gujarat, 390001, India.
⁷ Department of Pharmacology, Indira Gandhi Institute of Medical Sciences, Allahabad Bank, Bailey Rd, Sheikhpura, Patna, Bihar, 800014, India.
⁸ Department of Pharmacology, Christian Medical College and Hospital, Brown Rd, CMC Campus, Ludhiana, Punjab, 141008, India.
⁹ Department of Paediatrics, Christian Medical College and Hospital, Brown Rd, CMC Campus, Ludhiana, Punjab, 141008, India.
¹⁰ Department of Psychiatry, Christian Medical College and Hospital, Brown Rd, CMC Campus, Ludhiana, Punjab, 141008, India.
¹¹ Department of Pharmacology, Postgraduate Institute of Medical Education and Research, Madhya Marg, Sector 12, Chandigarh, 160012, India.
¹² Dept. of Health Research, Ministry of Health and Family Welfare, V. Ramalingaswami Bhawan, P.O. Box No. 4911. Ansari Nagar, New Delhi, 110029, India.

Abstract

Background: India has seen more than 43 million confirmed cases of COVID-19 as of April 2022, with a recovery rate of 98.8%, resulting in a large section of the population including the healthcare workers (HCWs), susceptible to develop post COVID sequelae. This study was carried out to assess the nature and prevalence of medical sequelae following COVID-19 infection, and risk factors, if any.

Methods: This was an observational, multicenter cross-sectional study conducted at eight tertiary care centers. The consenting participants were HCWs between 12 and 52 weeks post discharge after COVID-19 infection. Data on demographics, medical history, clinical features of COVID-19 and various symptoms of COVID sequelae was collected through specific questionnaire.

Finding: Mean age of the 679 eligible participants was 31.49 ± 9.54 years. The overall prevalence of COVID sequelae was 30.34%, with fatigue (11.5%) being the most common followed by insomnia (8.5%), difficulty in breathing during activity (6%) and pain in joints (5%). The odds of having any sequelae were significantly higher among participants who had moderate to severe COVID-19 (OR 6.51; 95% CI 3.46-12.23) and lower among males (OR 0.55; 95% CI 0.39-0.76). Besides these, other predictors for having sequelae were age (≥45 years), presence of any comorbidity (especially hypertension and asthma), category of HCW (non-doctors vs doctors) and hospitalisation due to COVID-19.

Interpretation: Approximately one-third of the participants experienced COVID sequelae. Severity of COVID illness, female gender, advanced age, co-morbidity were significant risk factors for COVID sequelae.

Funding: This work is a part of Indian Council for Medical Research (ICMR)- Rational Use of Medicines network. No additional financial support was received from ICMR to carry out the work, for study materials, medical writing, and APC.

Keywords: ACE2, Angiotensin-converting enzyme 2; AE, Adverse events; BMI, Body mass index; CAD, Coronary artery disease; CI, Confidence interval; COVID sequelae; COVID-19; COVID-19, Corona virus disease 2019; CTRI, Clinical Trials Registry- India; DASS-21, Depression, Anxiety, and Stress Scale-21; ENT, Ear, nose, and throat; GERD, Gastroesophageal reflux disease; HCQ, Hydroxychloroquine; HCW, Health care worker; ICMR, Indian council of medical research; ICMR-RUMC; Long COVID; MOHFW, Ministry of Health and Family Welfare, Govt. of India; NICE, National Institute for Health and Clinical Excellence; OR, Odds ratio; PCOS, Polycystic Ovarian Disease; PLOG, Polymerase gamma-related disorders; RHD, Rheumatic heart disease; RUMC, Rational use of medicine center; SARS-CoV-2; SARS-CoV-2, Severe Acute Respiratory Syndrome Coronavirus 2; WHO, World Health Organization; p-value, Probability value.