ABSTRACT
Background: Following acute COVID-19, some (~10-20%) individuals continue to experience a persistent variety of symptoms often referred to as long COVID- 19. However, evidence on long COVID-19 is limited from countries in Africa. We sought to describe the clinical presentation and factors associated with long COVID-19 in Zambia. Method(s): We conducted a cross-sectional analysis of routinely collected clinical information from patients receiving care in Zambia following SARS-CoV- 2 infection. Data were collected from 13 'post-acute COVID-19' (PAC-19) clinics established across Zambia to care for people following their acute infection. Long COVID-19 was defined as experiencing persistent symptoms >=4 weeks after initial diagnosis. Comorbidities detected at the time of SARS-CoV-2 infection were considered newly diagnosed. Severe illness was defined as acute COVID-19 that required supplemental oxygen therapy. We analyzed data from the first visit to the PAC-19 clinics and developed logistic regression models to assess factors associated with long COVID-19 at first visit to a PAC-19 clinic. Result(s): In total, 1,238 persons (< 1%) had >=1 visit to a PAC-19 clinic from August 2020 to April 2022 (out of ~319,500 confirmed cases in Zambia). Eight hundred twenty-three (66%) persons had been hospitalized for acute COVID-19 and the median length of stay was 8 days (interquartile range [IQR]: 4-16 days). Of these 1,238 persons, 641 (52%) were female while 403 (33%) had long COVID-19. The median age in persons with long COVID-19 was 54 years (IQR: 44-63) compared to 50 years (IQR: 37-61) in those without (p< 0.001). Cough (22%), fatigue (21%), and shortness of breath (15%) were frequently reported symptoms among persons with long COVID-19, while 4% had forgetfulness. Having severe illness (adjusted odds ratio [aOR] 2.8) and hospitalization for acute COVID-19 with length of stay >=15 days (aOR 13) were associated with having long COVID-19 (Table 1). Conclusion(s): Long COVID-19 was common among people attending PAC-19 clinics in Zambia, yet few persons with COVID-19 had attended a PAC-19 clinic. Those with severe illness were more likely to experience long COVID-19, which is consistent with other studies of long COVID-19. Given the burden of COVID-19 in Zambia, systems to care for patients with long COVID-19 might be needed in the future. Scaling up PAC-19 services and integrating into routine clinical care could improve access and further aid in understanding long COVID-19 in Zambia. (Table Presented).