ABSTRACT
Background Multisystem involvement of Covid-19 has been known since beginning of the pandemic. Multisystem after-effects or sequelae of covid-19 have been noted and the term 'long Covid' encompasses these signs and symptoms. This leads to prolonged morbidity which have not been adequately addressed by Covid guidelines.The primary aim of our study was to know the spectrum of different sequelae patients have endured after recovery from acute Covid-19 and study their impact on their quality of life. Methods It was a longitudinal observational study of a cohort of 146 patients who recovered from Covid-19 illness. Patients were enrolled within a week of their onset of Covid symptoms and were followed up monthly for a duration of 6 months with a detailed clinical and investigational pulmonary, cardiac, neurological and psychiatric assessment anda final follow-up after a year. Impact on quality of life was assessed using EQ-5D-3L questionnaire. Those lost to follow up were excluded from the analysis. Results 120/146 patients qualified for final analysis. Pulmonary sequelae (40%) were the majority among the patients, followed by psychiatric (25%), neurological (21.7%) and opportunistic infections (5.8%). 4/120 died within a year. 62/120 patients documented worsening in quality of life. Sequelae like pulmonary fibrosis, PTSD had the worst impact on the quality of life.95% severe, 54.5% moderate and 25% mild Covid patients reported deterioration in QoL score respectively. Conclusion Study indicates health related consequences from Covid-19 extend far beyond acute infection andmake significant impact on their quality of life, regardless of the severity of the disease. Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
Background Multisystem involvement of Covid-19 has been known since beginning of the pandemic. Multisystem after-effects or sequelae of covid-19 have been noted and the term 'long Covid' encompasses these signs and symptoms. This leads to prolonged morbidity which have not been adequately addressed by Covid guidelines.The primary aim of our study was to know the spectrum of different sequelae patients have endured after recovery from acute Covid-19 and study their impact on their quality of life. Methods It was a longitudinal observational study of a cohort of 146 patients who recovered from Covid-19 illness. Patients were enrolled within a week of their onset of Covid symptoms and were followed up monthly for a duration of 6 months with a detailed clinical and investigational pulmonary, cardiac, neurological and psychiatric assessment anda final follow-up after a year. Impact on quality of life was assessed using EQ-5D-3L questionnaire. Those lost to follow up were excluded from the analysis. Results 120/146 patients qualified for final analysis. Pulmonary sequelae (40%) were the majority among the patients, followed by psychiatric (25%), neurological (21.7%) and opportunistic infections (5.8%). 4/120 died within a year. 62/120 patients documented worsening in quality of life. Sequelae like pulmonary fibrosis, PTSD had the worst impact on the quality of life.95% severe, 54.5% moderate and 25% mild Covid patients reported deterioration in QoL score respectively. Conclusion Study indicates health related consequences from Covid-19 extend far beyond acute infection andmake significant impact on their quality of life, regardless of the severity of the disease. Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.
ABSTRACT
Background: The clinical manifestations of Covid-19 range from mild disease to severe ARDS. It is a matter of debate whether it is the excess viral load or the dysregulated immune response that leads to severe inflammation. It is also not clear whether the excess immune response is successful in rapid clearance of the virus. This study aims to understand the relationship between immune response, viral clearance and severity of illness in patients suffering from COVID-19. Methods: This was a cross sectional observational study wherein 65 SARS Cov2 RT-PCR positive participants were enrolled between 10th to 14th day of their illness and were selected from 2 distinct clinical groups as defined by ICMR guidelines. Group A consisted of Mild cases and Group B consisted of severe cases. A repeat throat swab for SARS Cov2 RT-PCR and blood levels of Covid specific antibodies, CRP and D-dimer were measured on day 14 of the illness. Results: On day-14, 2/34 (5.88%) tested RT-PCR negative (Ct value cut-off above 35) in group A compared to 5/31(16.13%) in group B which was not statistically significant. In groups A and B respectively, mean antibody titer was 35390.47 and 36426.11, mean CRP values were 4.91 and 31.01 mg/ dl, D-dimer levels were 895 and 2896 ng/ml. Conclusion: Severe covid cases had dysregulated immune response which did not significantly help in viral clearance. Also most patients remained RT-PCR positive on day 14.