BMJ Glob Health
. 2024 Oct 21;9(10):e015245.
doi: 10.1136/bmjgh-2024-015245. Long Covid: a global health issue - a prospective, cohort study set in four continents
Ekaterina Pazukhina 1 , Esteban Garcia-Gallo 1 , Luis Felipe Reyes 2 3 , Anders Benjamin Kildal 4 5 , Waasila Jassat 6 7 , Murray Dryden 7 , Jan Cato Holter 8 9 , Allegra Chatterjee 10 , Kyle Gomez 11 , Arne Søraas 12 , Matteo Puntoni 13 , Nicola Latronico 14 15 , Fernando A Bozza 16 17 , Michael Edelstein 18 , Bronner P Gonçalves 19 , Christiana Kartsonaki 20 , Oksana Kruglova 21 , Sérgio Gaião 22 , Yock Ping Chow 23 , Yash Doshi 24 , Sara Isabel Duque Vallejo 25 , Elsa D Ibáñez-Prada 26 , Yuli V Fuentes 26 , Claire Hastie 27 , Margaret E O'Hara 27 , Valeria Balan 1 , Tigist Menkir 28 , Laura Merson 1 , Sadie Kelly 29 , Barbara Wanjiru Citarella 1 , Malcolm G Semple 30 31 , Janet T Scott 32 33 , Daniel Munblit 34 35 , Louise Sigfrid 36 37 ; ISARIC Clinical Characterisation Group and ISARIC Global Covid-19 follow up working group
Collaborators, Affiliations
Introduction: A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs).
Methods: A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to <6 and 6 to <12 months post-hospital discharge. A standardised case report form developed by International Severe Acute Respiratory and emerging Infection Consortium's Global COVID-19 Follow-up working group evaluated the frequency of fever, persistent symptoms, breathlessness (MRC dyspnoea scale), fatigue and impact on daily activities.
Results: Of 11 860 participants (median age: 52 (IQR: 41-62) years; 52.1% females), 56.5% were from HICs and 43.5% were from LMICs. The proportion identified with Long Covid was significantly higher in HICs vs LMICs at both assessment time points (69.0% vs 45.3%, p<0.001; 69.7% vs 42.4%, p<0.001). Participants in HICs were more likely to report not feeling fully recovered (54.3% vs 18.0%, p<0.001; 56.8% vs 40.1%, p<0.001), fatigue (42.9% vs 27.9%, p<0.001; 41.6% vs 27.9%, p<0.001), new/persistent fever (19.6% vs 2.1%, p<0.001; 20.3% vs 2.0%, p<0.001) and have a higher prevalence of anxiety/depression and impact on usual activities compared with participants in LMICs at 2 to <6 and 6 to <12 months post-COVID-19 hospital discharge, respectively.
Conclusion: Our data show that Long Covid affects populations globally, manifesting similar symptomatology and impact on functioning in both HIC and LMICs. The prevalence was higher in HICs versus LMICs. Although we identified a lower prevalence, the impact of Long Covid may be greater in LMICs if there is a lack of support systems available in HICs. Further research into the aetiology of Long Covid and the burden in LMICs is critical to implement effective, accessible treatment and support strategies to improve COVID-19 outcomes for all.
Keywords: COVID-19; Cohort study; Epidemiology; Global Health; Public Health.
. 2024 Oct 21;9(10):e015245.
doi: 10.1136/bmjgh-2024-015245. Long Covid: a global health issue - a prospective, cohort study set in four continents
Ekaterina Pazukhina 1 , Esteban Garcia-Gallo 1 , Luis Felipe Reyes 2 3 , Anders Benjamin Kildal 4 5 , Waasila Jassat 6 7 , Murray Dryden 7 , Jan Cato Holter 8 9 , Allegra Chatterjee 10 , Kyle Gomez 11 , Arne Søraas 12 , Matteo Puntoni 13 , Nicola Latronico 14 15 , Fernando A Bozza 16 17 , Michael Edelstein 18 , Bronner P Gonçalves 19 , Christiana Kartsonaki 20 , Oksana Kruglova 21 , Sérgio Gaião 22 , Yock Ping Chow 23 , Yash Doshi 24 , Sara Isabel Duque Vallejo 25 , Elsa D Ibáñez-Prada 26 , Yuli V Fuentes 26 , Claire Hastie 27 , Margaret E O'Hara 27 , Valeria Balan 1 , Tigist Menkir 28 , Laura Merson 1 , Sadie Kelly 29 , Barbara Wanjiru Citarella 1 , Malcolm G Semple 30 31 , Janet T Scott 32 33 , Daniel Munblit 34 35 , Louise Sigfrid 36 37 ; ISARIC Clinical Characterisation Group and ISARIC Global Covid-19 follow up working group
Collaborators, Affiliations
- PMID: 39433402
- DOI: 10.1136/bmjgh-2024-015245
Introduction: A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs).
Methods: A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to <6 and 6 to <12 months post-hospital discharge. A standardised case report form developed by International Severe Acute Respiratory and emerging Infection Consortium's Global COVID-19 Follow-up working group evaluated the frequency of fever, persistent symptoms, breathlessness (MRC dyspnoea scale), fatigue and impact on daily activities.
Results: Of 11 860 participants (median age: 52 (IQR: 41-62) years; 52.1% females), 56.5% were from HICs and 43.5% were from LMICs. The proportion identified with Long Covid was significantly higher in HICs vs LMICs at both assessment time points (69.0% vs 45.3%, p<0.001; 69.7% vs 42.4%, p<0.001). Participants in HICs were more likely to report not feeling fully recovered (54.3% vs 18.0%, p<0.001; 56.8% vs 40.1%, p<0.001), fatigue (42.9% vs 27.9%, p<0.001; 41.6% vs 27.9%, p<0.001), new/persistent fever (19.6% vs 2.1%, p<0.001; 20.3% vs 2.0%, p<0.001) and have a higher prevalence of anxiety/depression and impact on usual activities compared with participants in LMICs at 2 to <6 and 6 to <12 months post-COVID-19 hospital discharge, respectively.
Conclusion: Our data show that Long Covid affects populations globally, manifesting similar symptomatology and impact on functioning in both HIC and LMICs. The prevalence was higher in HICs versus LMICs. Although we identified a lower prevalence, the impact of Long Covid may be greater in LMICs if there is a lack of support systems available in HICs. Further research into the aetiology of Long Covid and the burden in LMICs is critical to implement effective, accessible treatment and support strategies to improve COVID-19 outcomes for all.
Keywords: COVID-19; Cohort study; Epidemiology; Global Health; Public Health.