Prevalence of Long COVID Symptoms in Bangladesh: A Prospective Inception Cohort Study of COVID-19 Survivors

Abstract

Background: The aim of this study was to identify the prevalence of ‘Long COVID’ symptoms (LCS) in a large cohort of survivors and identify any potential associated risk factors.Methods: A prospective survey was undertaken of an inception cohort of confirmed COV|ID-19 survivors (Aged 18 to 87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June, and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented, were contacted by telephone, and were interviewed regarding LCS, and restriction of activities of daily living. Cardio-respiratory parameters were also measured. Statistical analysis included binary logistic and multiple linear regressions were performed with LCS as the dependent variable. Associated risk factors were identified using Structural Equation Modelling (SEM).Findings: Among 2198 participants, the prevalence of LCS at 12 weeks was 16·1%. Overall, eight LCS were identified and in descending order of prominence are: fatigue, pain, dyspnea, cough, anosmia, appetite loss, headache, and chest pain. COVID survivors experienced between 1 to 5 LCS with an overall duration period of 21·8 ± 5·2 weeks. SEM predicted the length of LCS to be related to younger age, female gender, rural residence, prior functional limitation and smoking.Interpretation: In this cohort of survivors, at 31 weeks post diagnosis, the prevalence of LCS was 16·1%. The risk factors identified for presence and longer length of LCS warrant further research and consideration to support public health initiatives.Clinical Trial Registration Details: The study was registered at World Health Organization (WHO) Primary Clinical trial registry platform (CTRI/2020/09/028165) on 30/09/2020 with the title “Symptoms presentation among the COVID-19 survivors in Bangladesh”.Funding Information: No funding.Declaration of Interests: We declare no competing interests.Ethics Approval Statement: Ethical permission was obtained from the Institutional Review Board at the Institute of Physiotherapy, Rehabilitation, and Research (Ethical review committee at Bangladesh Physiotherapy Association) on September 17, 2020 (BPA-IPRR/IRB/17/09/2020/028). Verbal consent was obtained during the initial telephone call and written consent was obtained at interview. The principles of the Helsinki Declaration19 were followed throughout the research to ensure confidentiality, ethics and privacy.