Post-COVID-19 symptoms are not uncommon among recovered patients-A cross-sectional online survey among the Indian population.

Rao, V. G.; Gella, V.; Radhakrishnan, M.; Kumar, J. V.; Chatterjee, R.; Kulkarni, A. V.; Reddy, N. D.

Background: Coronavirus disease-2019 (COVID-19) can have a myriad of symptoms. However, it is now known that most patients recovered from COVID-19 have symptoms related to COVID-19. There is a paucity of literature on post-COVID-19 symptoms from India. Hence we aimed to assess the incidence of post-COVID-19 symptoms in patients recovered from COVID-19. Methods: An online Microsoft forms survey was conducted through multiple social media platforms. Results: Of the 5,347 individuals who received and clicked the link, a total of 2038 infected patients responded (Supplementary figure). Approximately 48% (967/2038) had recovered from COVID-19 within 1-3 months (short-term recovered), 34.2% (375/2038) had recovered from COVID-19 >3 months ago (long recovered), and 18.4% (375) were recovered within the last one month (recently recovered). Nearly 38% (770/2038) had a history of hospitalization for COVID-19. Of them, 34.28% (264/770) required oxygen therapy during the hospital stay. Most patients were discharged within 5-10 days of hospital stay (54%, 415/770). Only 5.58% (43/770) required a stay of more than 20 days. Seventy-five percent (575/770) of the hospitalized patients received steroid therapy. Of those who received steroid therapy, 56.5% (325/575) had not required oxygen therapy. Forty percent (233/575) of patients received steroid therapy for two weeks, 24% (138/575) for one week, 33.73% received steroids only during the hospital stay, and 1.73% were still on steroid therapy during the survey. Most importantly, of the 2038 respondents, 41.8% (851/2038) still had persistent symptoms related to COVID-19. Most common symptom was fatigue (64.15%), followed by body pain (31%) and gastrointestinal symptoms (25%) (Figure). Six percent (49/851) of them required hospitalization for post-COVID-19 symptoms. Forty-six percent (449/967) in the short term recovered group (1-3 months), 40.1% (279/696) in the long-recovered group, and 32.8% (123/375) in the recently recovered group had persistent symptoms related to COVID-19 (P=0.001). Forty-eight percent (374/770) of the hospitalized patients developed post-COVID-19 symptoms, while only 37.6% (477/1268) developed post-COVID-19 symptoms among the non-hospitalized patients (P<0.001). Fifty-three percent (303/575) of those who received steroids developed post-COVID-19 symptoms, while only 36.41% (71/195) of those who did not receive steroids developed post-COVID-19 symptoms (P<0.001). 49% (159/325) of patients who received steroids despite being not requiring oxygen developed post-COVID-19 symptoms compared to only 37.5% (543/1449) who did not receive steroids and were not on oxygen therapy (P<0.001). Nearly 40% (336/851) of respondents felt that post-COVID-19 symptoms are not being appropriately treated or taken care of seriously. Conclusions: Post-COVID-19 symptoms are common in patients who recovered from COVID-19. These symptoms are more often noted in patients who received steroid therapy. Post-COVID-19 symptomatology is present in a significant number of patients and requires to be addressed seriously.