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16-03-2022 | COVID-19 | Original Paper

Post‐COVID-19 syndrome: assessment of short- and long-term post-recovery symptoms in recovered cases in Saudi Arabia

Authors: Mohammed A. Garout, Saleh A. K. Saleh, Heba M. Adly, Altaf A. Abdulkhaliq, Abdullah A. Khafagy, Magda R. Abdeltawab, Ali A. Rabaan, Alfonso J. Rodriguez-Morales, Jaffar A. Al-Tawfiq, Maher N. Alandiyjany

Published in: Infection | Issue 6/2022

Abstract

Introduction

Recent studies investigated the endurance of symptoms and occurrence of complications three months after SARS-CoV-2 infection. This study aims to examine the prevalence, variation, and severity of continual symptoms in the post‐COVID-19 using a single-center questionnaire.

Methods

The questionnaire was distributed among population in Saudi Arabia who recovered from COVID‐19 between April 1, 2020 and December 31, 2021.

Results

A total of 744 participants completed the questionnaire, 318 (42.8%) recovered less than 3 months, 75 (10.1%) recovered 3–6 months, while 351 (47.2%) recovered more than 6 months. About half of the participants 353 (47.5%) had incessant symptoms and of those patients, more than half had two or more symptoms. Common symptoms included fatigue 189 (25.4%), headache 118 (15.9%), and myalgia 63 (8.5%). Of the participants, 189 (21.4%) experienced continual symptoms including anxiety in 98 (13.2%) and depression in 70 (9.5%).

Conclusion

The current study showed a high proportion of individuals with long-COVID-19 symptoms. Thus, proper assessment of the individuals in the post-recovery period can guide the patients to the relevant clinics for rehabilitation. Moreover, there is a great importance to decrease COVID-19 infection, populations should be targeted to boost vaccine efficiency.

World Health Organization. WHO Coronavirus (COVID-19) Dashboard n.d. https://covid19.who.int/ (Accessed April 21, 2021).

Covidvax.live—Saudi Arabia n.d. https://covidvax.live/location/sau (Accessed February 4, 2022).

Assiri A, Al-Tawfiq JA, Alkhalifa M, Al Duhailan H, Al Qahtani S, Dawas RA, et al. Launching COVID-19 vaccination in Saudi Arabia: Lessons learned, and the way forward. Travel Med Infect Dis. 2021;43: 102119. https://doi.org/10.1016/j.tmaid.2021.102119.CrossRefPubMedPubMedCentral

Adly HM, Aljahdali IA, Garout MA, Khafagy AA, Saati AA, Saleh SAK. Correlation of COVID-19 pandemic with healthcare system response and prevention measures in Saudi Arabia. Int J Environ Res Public Health. 2020;17:1–13. https://doi.org/10.3390/ijerph17186666.CrossRef

Sivan M, Taylor S. NICE guideline on long covid. BMJ. 2020. https://doi.org/10.1136/BMJ.M4938.CrossRefPubMed

Carfì A, Bernabei R, Landi F. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324:603–5. https://doi.org/10.1001/jama.2020.12603.CrossRefPubMedPubMedCentral

Datta SD, Talwar A, Lee JT. A proposed framework and timeline of the spectrum of disease due to SARS-CoV-2 infection: illness beyond acute infection and public health implications. JAMA. 2020;324:2251–2. https://doi.org/10.1001/JAMA.2020.22717.CrossRefPubMed

Fernández-De-las-peñas C, Palacios-Ceña D, Gómez-Mayordomo V, Cuadrado ML, Florencio LL. Defining post-COVID symptoms (post-acute COVID, long COVID, persistent post-COVID): an integrative classification. Int J Environ Res Public Health. 2021;18:1–9. https://doi.org/10.3390/IJERPH18052621.CrossRef

Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020. https://doi.org/10.1136/BMJ.M3026.CrossRefPubMed

10.

Halpin S, O’Connor R, Sivan M. Long COVID and chronic COVID syndromes. J Med Virol. 2021;93:1242–3. https://doi.org/10.1002/jmv.26587.CrossRefPubMed

11.

CDC. Post-COVID conditions n.d. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html (Accessed February 5, 2022).

12.

Huang C, Huang L, Wang Y, Li X, Ren L, Gu X, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet (London, England). 2021;397:220–32. https://doi.org/10.1016/S0140-6736(20)32656-8.CrossRefPubMed

13.

Bellan M, Soddu D, Balbo PE, Baricich A, Zeppegno P, Avanzi GC, et al. Respiratory and psychophysical sequelae among patients with covid-19 four months after hospital discharge. JAMA Netw Open. 2021. https://doi.org/10.1001/jamanetworkopen.2020.36142.CrossRefPubMedPubMedCentral

14.

Logue JK, Franko NM, McCulloch DJ, McConald D, Magedson A, Wolf CR, et al. Sequelae in adults at 6 months after COVID-19 infection. JAMA Netw Open. 2021. https://doi.org/10.1001/JAMANETWORKOPEN.2021.0830.CrossRefPubMedPubMedCentral

15.

Taquet M, Geddes JR, Husain M, Luciano S, Harrison PJ. 6-month neurological and psychiatric outcomes in 236 379 survivors of COVID-19: a retrospective cohort study using electronic health records. The Lancet Psychiatry. 2021;8:416–27. https://doi.org/10.1016/S2215-0366(21)00084-5.CrossRefPubMedPubMedCentral

16.

Havervall S, Rosell A, Phillipson M, Mangsbo SM, Nilsson P, Hober S, et al. Symptoms and functional impairment assessed 8 months after mild COVID-19 among health care workers. JAMA. 2021;325:2015–6. https://doi.org/10.1001/JAMA.2021.5612.CrossRefPubMedPubMedCentral

17.

Donnelly JP, Wang XQ, Iwashyna TJ, Prescott HC. Readmission and death after initial hospital discharge among patients with COVID-19 in a large multihospital system. JAMA. 2021;325:304–6. https://doi.org/10.1001/JAMA.2020.21465.CrossRefPubMed

18.

Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re’em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinical Med. 2021. https://doi.org/10.1016/j.eclinm.2021.101019.CrossRef

19.

Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, et al. Attributes and predictors of long COVID. Nat Med. 2021;27:626–31. https://doi.org/10.1038/S41591-021-01292-Y.CrossRefPubMedPubMedCentral

20.

Norton A, Olliaro P, Sigfrid L, Carson G, Paparella G, Hastie C, et al. Long COVID: tackling a multifaceted condition requires a multidisciplinary approach. Lancet Infect Dis. 2021;21:601–2. https://doi.org/10.1016/S1473-3099(21)00043-8.CrossRefPubMedPubMedCentral

21.

Walter K. An inside look at a post-COVID-19 clinic. JAMA-J Am Med Assoc. 2021;325:2036–7. https://doi.org/10.1001/jama.2021.2426.CrossRef

22.

Rovere-Querini P, De Lorenzo R, Conte C, Brioni E, Lanzani C, Yacoub MR, et al. Post-COVID-19 follow-up clinic: depicting chronicity of a new disease. Acta Biomed. 2020;91:22–8. https://doi.org/10.23750/abm.v91i9-S.10146.CrossRefPubMedPubMedCentral

23.

Santhosh L, Block B, Kim SY, Raju S, Shah RJ, Thakur N, et al. Rapid design and implementation of post-COVID-19 clinics. Chest. 2021;160:671–7. https://doi.org/10.1016/j.chest.2021.03.044.CrossRefPubMed

24.

Sivan M, Halpin S, Gee J. Assessing long-term rehabilitation needs in COVID-19 survivors using a telephone screening tool (C19-YRS tool). Adv Clin Neurosci. 2020;19:14.

25.

Parkin A, Davison J, Tarrant R, Ross D, Halpin S, Simms A, et al. A multidisciplinary NHS COVID-19 service to manage post-COVID-19 syndrome in the community. J Prim Care Community Heal. 2021. https://doi.org/10.1177/21501327211010994.CrossRef

26.

Sivan M, Halpin S, Hollingworth L, Snook N, Hickman K, Clifton IJ. Development of an integrated rehabilitation pathway for individuals recovering from COVID-19 in the community. J Rehabil Med. 2020. https://doi.org/10.2340/16501977-2727.CrossRefPubMed

27.

Chopra V, Flanders SA, O’Malley M, Malani AN, Prescott HC. Sixty-day outcomes among patients hospitalized with COVID-19. Ann Intern Med. 2021;174:576–8. https://doi.org/10.7326/M20-5661.CrossRefPubMed

28.

Michielsen HJ, De Vries J, Van Heck GL. Psychometric qualities of a brief self-rated fatigue measure: the fatigue assessment scale. J Psychosom Res. 2003;54:345–52. https://doi.org/10.1016/S0022-3999(02)00392-6.CrossRefPubMed

29.

Moreno-Pérez O, Merino E, Leon-Ramirez JM, Andres M, Ramos JM, Arenas-Jiménez J, et al. Post-acute COVID-19 syndrome. Incidence and risk factors: a Mediterranean cohort study. J Infect. 2021;82:378–83. https://doi.org/10.1016/J.JINF.2021.01.004.CrossRefPubMedPubMedCentral

30.

Ayoubkhani D, Khunti K, Nafilyan V, Maddox T, Humberstone B, Diamond I, et al. Post-covid syndrome in individuals admitted to hospital with covid-19: Retrospective cohort study. BMJ. 2021. https://doi.org/10.1136/bmj.n693.CrossRefPubMed

31.

Buonsenso D, Munblit D, De Rose C, Sinatti D, Ricchiuto A, Carfi A, et al. Preliminary evidence on long COVID in children. Acta Paediatr. 2021;110:2208–11. https://doi.org/10.1111/APA.15870.CrossRefPubMedPubMedCentral

32.

Kayaaslan B, Eser F, Kalem AK, Kaya G, Kaplan B, Kacar D, et al. Post-COVID syndrome: A single-center questionnaire study on 1007 participants recovered from COVID-19. J Med Virol. 2021;93:6566–74. https://doi.org/10.1002/JMV.27198.CrossRefPubMedPubMedCentral

33.

Menges D, Ballouz T, Anagnostopoulos A, Aschmann HE, Domenghino A, Fehr JS, et al. Burden of post-COVID-19 syndrome and implications for healthcare service planning: a population-based cohort study. PLoS ONE. 2021. https://doi.org/10.1371/JOURNAL.PONE.0254523.CrossRefPubMedPubMedCentral

34.

Al-Tawfiq JA, Koritala T, Alhumaid S, Barry M, Alshukairi AN, Temsah M-H, et al. Implication of the emergence of the delta (B.1.617.2) variants on vaccine effectiveness. Infection. 2022. https://doi.org/10.1007/S15010-022-01759-1.CrossRefPubMedPubMedCentral

35.

Abdelrahman MM, Abd-Elrahman NM, Bakheet TM. Persistence of symptoms after improvement of acute COVID19 infection, a longitudinal study. J Med Virol. 2021;93:5942–6. https://doi.org/10.1002/JMV.27156.CrossRefPubMedPubMedCentral

36.

Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract. 2021. https://doi.org/10.1111/IJCP.13746.CrossRefPubMed

37.

Tenforde MW, Kim SS, Lindsell CJ, Billig Rose E, Shapiro NI, Files DC, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network—United States, March-June 2020. MMWR Morb Mortal Wkly Rep. 2020;69:993–8. https://doi.org/10.15585/MMWR.MM6930E1.CrossRefPubMedPubMedCentral

38.

Robinson P. Long COVID and breathlessness: an overview. Br J Community Nurs. 2021;26:438–43. https://doi.org/10.12968/BJCN.2021.26.9.438.CrossRefPubMed

39.

Cénat JM, Blais-Rochette C, Kokou-Kpolou CK, Noorishad PG, Mukunzi JN, McIntee SE, et al. Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: a systematic review and meta-analysis. Psychiatry Res. 2021. https://doi.org/10.1016/j.psychres.2020.113599.CrossRefPubMedPubMedCentral

40.

Hussain N, Agarwala P, Iqbal K, Omar HMS, Jangid G, Patel V, et al. A systematic review of acute telogen effluvium, a harrowing post-COVID-19 manifestation. J Med Virol. 2021. https://doi.org/10.1002/jmv.27534.CrossRefPubMedPubMedCentral

41.

Xiong TY, Redwood S, Prendergast B, Chen M. Coronaviruses and the cardiovascular system: acute and long-term implications. Eur Heart J. 2020;41:1798–800. https://doi.org/10.1093/EURHEARTJ/EHAA231.CrossRefPubMed

42.

Tleyjeh IM, Saddik B, AlSwaidan N, AlAnazi A, Ramakrishnan RK, Alhazmi D, et al. Prevalence and predictors of post-acute COVID-19 syndrome (PACS) after hospital discharge: a cohort study with 4 months median follow-up. PLoS ONE. 2021. https://doi.org/10.1371/JOURNAL.PONE.0260568.CrossRefPubMedPubMedCentral

43.

Tleyjeh IM, Saddik B, Ramakrishnan RK, AlSwaidan N, AlAnazi A, Alhazmi D, et al. Long term predictors of breathlessness, exercise intolerance, chronic fatigue and well-being in hospitalized patients with COVID-19: a cohort study with 4 months median follow-up. J Infect Public Health. 2022;15:21–8. https://doi.org/10.1016/J.JIPH.2021.11.016.CrossRefPubMed

44.

Hosey MM, Needham DM. Survivorship after COVID-19 ICU stay. Nat Rev Dis Prim. 2020. https://doi.org/10.1038/S41572-020-0201-1.CrossRefPubMed

45.

Inoue S, Hatakeyama J, Kondo Y, Hifumi T, Sakuramoto H, Kawasaki T, et al. Post-intensive care syndrome: its pathophysiology, prevention, and future directions. Acute Med Surg. 2019;6:233–46. https://doi.org/10.1002/AMS2.415.CrossRefPubMedPubMedCentral

46.

Malik J, Muhammad Jawad Zaidi S, Iqbal R, Khan K, Ali M, Sattar Rana A, et al. Post-acute COVID-19 syndrome and its prolonged effects: an updated systematic review. MedRxiv. 2021. https://doi.org/10.1101/2021.05.09.21256911.CrossRef

47.

Huang L, Yao Q, Gu X, Wang Q, Ren L, Wang Y, et al. 1-year outcomes in hospital survivors with COVID-19: a longitudinal cohort study. Lancet (London, England). 2021;398:747–58. https://doi.org/10.1016/S0140-6736(21)01755-4.CrossRefPubMed

48.

Malik P, Patel K, Pinto C, Jaiswal R, Tirupathi R, Pillai S, et al. Post-acute COVID-19 syndrome (PCS) and health-related quality of life (HRQoL)—a systematic review and meta-analysis. J Med Virol. 2022;94:253–62. https://doi.org/10.1002/jmv.27309.CrossRefPubMed

49.

Antonelli M, Penfold RS, Merino J, Sudre CH, Molteni E, Berry S, et al. Risk factors and disease profile of post-vaccination SARS-CoV-2 infection in UK users of the COVID Symptom Study app: a prospective, community-based, nested, case-control study. Lancet Infect Dis. 2022;22:43–55. https://doi.org/10.1016/S1473-3099(21)00460-6.CrossRefPubMedPubMedCentral

50.

Koritala T, Hussain A, Pleshkova Y, Dondapati L, Tirupathi R, Rabaan AA, et al. A narrative review of emergency use authorization versus full FDA approval and its effect on COVID-19 vaccination hesitancy. Le Infez Med. 2021;29:339–44. https://doi.org/10.53854/LIIM-2903-4.CrossRef

51.

Temsah MH, Barry M, Aljamaan F, Alhuzaimi A, Al-Eyadhy A, Saddik B, et al. Adenovirus and RNA-based COVID-19 vaccines’ perceptions and acceptance among healthcare workers in Saudi Arabia: a national survey. BMJ Open. 2021. https://doi.org/10.1136/bmjopen-2020-048586.CrossRefPubMed

52.

Temsah MH, Barry M, Aljamaan F, Alhuzaimi AN, Al-Eyadhy A, Saddik B, et al. SARS-CoV-2 B.1.1.7 UK variant of concern lineage-related perceptions, COVID-19 vaccine acceptance and travel worry among healthcare workers. Front Public Heal. 2021. https://doi.org/10.3389/fpubh.2021.686958.CrossRef

53.

Barry M, Temsah MH, Aljamaan F, Saddik B, Al-Eyadhy A, Alenezi S, et al. COVID-19 vaccine uptake among healthcare workers in the fourth country to authorize BNT162b2 during the first month of rollout. Vaccine. 2021;39:5762–8. https://doi.org/10.1016/J.VACCINE.2021.08.083.CrossRefPubMedPubMedCentral

54.

Barry M, Alotaibi M, Almohaya A, Aldrees A, AlHijji A, Althabit N, et al. Factors associated with poor outcomes among hospitalized patients with COVID-19: experience from a MERS-CoV referral hospital. J Infect Public Health. 2021;14:1658–65. https://doi.org/10.1016/j.jiph.2021.09.023.CrossRefPubMedPubMedCentral

55.

Al-Tawfiq JA, Hoang V-T, Le Bui N, Chu D-T, Memish ZA. The emergence of the omicron (B.1.1.529) SARS-CoV-2 variant: what is the impact on the continued pandemic? J Epidemiol Glob Health. 2022. https://doi.org/10.1007/s44197-022-00032-w.CrossRefPubMedPubMedCentral

Title: Post‐COVID-19 syndrome: assessment of short- and long-term post-recovery symptoms in recovered cases in Saudi Arabia
Authors: Mohammed A. Garout
Saleh A. K. Saleh
Heba M. Adly
Altaf A. Abdulkhaliq
Abdullah A. Khafagy
Magda R. Abdeltawab
Ali A. Rabaan
Alfonso J. Rodriguez-Morales
Jaffar A. Al-Tawfiq
Maher N. Alandiyjany
Publication date: 16-03-2022
Publisher: Springer Berlin Heidelberg
Keywords: COVID-19
Post-COVID Syndrome
Published in: Infection / Issue 6/2022
Print ISSN: 0300-8126
Electronic ISSN: 1439-0973
DOI: https://doi.org/10.1007/s15010-022-01788-w

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Abstract

Introduction

Methods

Results

Conclusion

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