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

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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.