The Prevalence, Clinical Characteristics, Predicting Factors and Impact of Long COVID Syndrome Following Third Wave of Epidemic in Myanmar: Prospective Study

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Background: Coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019, became a major threat to health around the world by causing acute COVID-19 infection. After recovery, a significant number of patients experience prolonged symptoms, long COVID syndrome. The prevalence of long COVID syndrome, its symptoms, severity and relation between clinical parameters and long COVID syndrome, and its impact were not studied in Myanmar. Methods: A prospective study was conducted via telecommunication to patients with positive SARS COV 2 PCR from nasopharyngeal swab during the third wave from end of May to August 2021. Data were collected by using standardized forms and analysis was done. A chi-square test of independence was performed to examine the relation between age groups, gender, body mass index (BMI), vaccination status, comorbidity status, severity of initial symptoms, oxygen requirement status, and symptoms of long covid syndrome. Results: Though initial recruitment included 18,709 patients with PCR confirmed COVID-19 infection, only 853 patients with recovery were analyzed. Long COVID syndrome was recorded in nearly 40% (333/853) of them; sixty percent of them (520/853) did not experienced symptoms following recovery. The common presenting symptoms in order of frequency were fatigue 58.9% (196/333), insomnia 27.3% (91/333), palpitation 17.1% (57/333), poor concentration 15.6% (52/333), anxiety 8.7% (29/333), myalgia 6.6% (22/333), chest pain 5.1% (17/333), persistent cough 4.2% (14/333), rash 3% (10/333), headache 2.7% (9/333), diarrhea 1.8% (6/333), anosmia 1.5% (5/333), sensory symptoms 0.9% (3/333) and dyspnea 0.9% (3/333). The majority 70% described as mild- not disturbing daily activity or job; however, 3% had severe symptoms- disturbing daily activity or job. Minority of cases 3% (10/333) required oxygen therapy for 2 months. Age, sex and BMI were not related with long COVID syndrome. However, initial multiple symptoms more than 2, co-morbidity, vaccination and initial oxygen requirement had significantly relationship with development of long COVID syndrome. Conclusions: In this study, the prevalence of long COVID syndrome among survivors was 40%; the common presenting symptoms in order of frequency were fatigue, insomnia, palpitation and poor concentration. Most of the cases had mild symptoms- not disturb job or daily routine activity. Nearly 80% of them admitted that their health status was not back to pre-COVID condition. Not only the patients with COVID-19 infection having initial multiple symptoms, co-morbidity, no vaccination and initial oxygen requirement but also their care givers should be warned about possible long COVID syndrome; and the necessary for follow up. Vaccination may prevent long COVID syndrome; it should be prioritized to those with comorbidity. It highlighted the need for systematic follow-up after hospitalisation with COVID-19 with multi-disciplinary team, rehabilitation and further investigation.