Symptom patterns of long COVID and chronic illness: a cross-sectional analysis of the SulCovid-19 Study (preprint)

Little is known about the natural history and consequences of SARS-CoV-2 infection. Some individuals who have had COVID continue to have symptoms after acute infection, a condition known as long COVID. Thus, the objective of this study is to identify the patterns of long COVID and its relationship with chronic diseases in adults and older adult residents in southern Brazil. Population-based cross-sectional study with data from the baseline of the SulCovid-19 Study. The sample consisted of 2,919 individuals with a positive diagnosis of COVID-19 between December 2020 and March 2021. For the construction of the outcome, 18 symptoms were evaluated. The exhibits were the medical diagnoses of 11 chronic diseases. Symptom patterns were identified using principal component analysis, and associations of patterns with chronic diseases were determined using Poisson regression. Four patterns of long COVID were identified. The cognitive pattern was the most prevalent (20.5%; 95% CI 19.0;22.0), followed by respiratory (15.7%; 95% CI 14.4;17.1), neuromusculoskeletal (15.4%; 95% CI 14.1;16.7) and neurosensory (14.0%; 95% CI 12.8;15.3). Heart problems, anxiety and back problems were associated with all patterns. Persistent symptoms after COVID-19 infection may constitute pattern behavior. Chronic illnesses increase the likelihood of developing long COVID symptom patterns.

Demand met by health services by individuals with musculoskeletal pain starting after covid-19 infection? (preprint)

Objective: The present work was aimed to verify the relationship between the use of health services and the presence of discomfort and musculoskeletal discomfort after Covid-19 infection in adults and elderly people in the southern region of Brazil.  Methodology: This is a cross-sectional study with individuals over 18 years of age who were diagnosed with covid-19 between December 2020 and March 2021. Questionnaires were collected electronically (with tablets) through the REDCap plataform by means of phone calls. The outcomes used were the use of health services: Primary Health Care, general practitioner, unit and private emergency care and specialized services. The presence of musculoskeletal pain exposure was assessed using the Nordic questionnaire on musculoskeletal symptoms before and during and/or after COVID-19 infection in the following regions: cervical, upper limbs, thoracic, lumbar, and lower limbs. Poisson regression was used to assess the relationship between health care service use after covid-19 infection and musculoskeletal pain. Data were analyzed using the Stata 16.1 statistical package.  Results: A total of 2,919 individuals were interviewed. Overall, the use of health services was about 15 percentage points (p.p) higher in individuals with musculoskeletal pain when compared with people without musculoskeletal pain. In adjusted analysis, individuals who reported pain in all outcomes during and after covid-19 infection was up to twice as likely to use health services and, among them, the emergency care unit was the most used, especially in those with pain in the lower limbs RP=2.19 (CI95% 1.66-2.87) and chest pain RP=2.04 (CI95% 1.47-2.84). In view of this, the highest magnitudes of association were related to emergency care units, doctors, and specialized services, especially neurologists, who were two to three times more likely to seek this profession, followed by pulmonologists.  Conclusion: In view of this, a new demand for more integrated care is recommended in a care model that offers comprehensive follow-up due to the diversity of users with specific needs.

Long COVID and Associated Factors in Individuals From Southern Brazil: a Population-based Study on COVID (preprint)

COVID-19 is an infection in which symptoms may persist after the acute phase. The aim of the present study was to verify the prevalence and factors associated with COVID-19 and to describe the main residual symptoms after 6–10 months of infection in individuals from the extreme south of Brazil. This was a cross-sectional study of 2919 individuals older than 18 diagnosed by RT‒PCR with COVID-19 in the city of Rio Grande/RS, Brazil, from December 2020 to March 2021 who were symptomatic, with data collected by telephone interview or home visit. The COVID-19 outcome was obtained from the sum of all symptoms that the individual claimed to continue having at the time of the interview, ranging from zero to 19. For the crude and adjusted analyses, we used Poisson regression with robust adjustment of variance calculating prevalence ratios (PRs) and their respective 95% confidence intervals. The adjusted analysis was performed by means of a hierarchical model built in four levels. The significance level adopted was 5%, and the analyses were performed with the statistical package Stata 16.1. The prevalence of COVID-long was 48.3% (95% CI 46.5; 50.1). The most prevalent residual symptoms were fatigue, memory loss, loss of attention, headache, loss of smell, muscle pain and loss of taste. The groups more likely to develop COVID-19 were female, exhibited anxiety, hypertension, heart problems, diabetes mellitus, musculoskeletal problems, respiratory problems, previous morbidities and hospitalization in a ward or ICU. Physical activity and self-perception of good and very good health were protective factors for the outcome. When adjusted, female gender, anxiety, morbidities and who were hospitalized remained associated with the outcome, while self-perception of good and very good health had a lower probability. This study showed that almost half of the individuals in the sample developed long COVID after 6–9 months of infection. Among the associated factors, female individuals and those with chronic conditions stand out, demanding the creation of public policies to promote integral and continued assistance to these individuals.