ABSTRACT
BACKGROUND: COVID 19 is associated with the development of post COVID syndrome usually manifested as fatigue, anxiety, joint pain, headache, chest pain, dementia, depression, and dyspnea. Documented evidence of post COVID syndrome among patients with asymptomatic or mild infections, especially from India is less. METHODOLOGY: A community based prospective cohort study was conducted among 154 patients admitted in CFLTCs of coastal Thiruvananthapuram, Kerala during May-August 2020. They were enrolled at the time of their admission to CFLTCs and were followed up for three months after discharge. The discharged patients were followed up at regular intervals of three weeks and three months by telephonic interview using a structured proforma. RESULTS: Out of the 154 patients followed up, 57 (37%) were men and 97 (63%) were women. The mean (SD) age of study participants was 31.49 (18.4) years. At least one symptom was present in 120 (78.0%) patients at the time of admission. Cough (29, 18.8%), fever (26, 16.8%), headache (25, 16.2%), rhinitis (23,14.9%) and sore throat (18, 11.7%) were the major symptoms reported at the time of admission. At the end of three weeks, 11 (7.1%) patients and at the end of three months 18 (11.7%) patients reported to have symptoms. Fatigue (5.8%), headache (5.8%) myalgia (3.2%) joint pain (2.5%) and exertional dyspnea (2.5%) were the predominant symptoms. Presence of fatigue, cough and breathlessness at the time of admission, and presence of another COVID positive family member were significantly associated with the appearance of post COVID symptoms. CONCLUSION: Post COVID syndrome is not uncommon in COVID 19 patients with minimal symptoms. Understanding long term consequences of COVID 19 is as important as management of acute COVID 19 due to its multisystem involvement and its implications on health and well-being.
ABSTRACT
BACKGROUND: The wide range of symptoms of COVID-19 has brought out extensive researches across the world to enable early case detection. Very few studies in India give an overall view of the case scenario of any state. Our study aims to look into the symptomatology and epidemiological characteristics of COVID-19 patients of Kerala. METHODS: A cross sectional study was conducted among the COVID-19 patients reported in Kerala till 31<sup>st</sup> March 2020. Contact details of patients were obtained from Kerala State Disaster Management Authority (KSDMA). Patients were contacted over phone to obtain consent and to collect information regarding demography, contact and symptomatology. RESULTS: Among 202 patients in this study, 154 (76.2%) were foreign returnees and 48 (23.8%) acquired disease by local transmission. The mean age was 36.5 (+/- 13.9) years and majority were males (80.2%). The most common symptoms reported were fever (n = 90, 45%), cough (n = 54, 27%), sore throat (n = 44, 22%), diarrhoea (n = 29, 14.5%) and anosmia (n = 24, 12%), while 39 (19.3%) patients were asymptomatic. Presumptive median incubation period was 6 (IQR = 4) days and median duration of symptoms was 4 (IQR = 6) days. The proportion of asymptomatic, mild, moderate and severe cases were 19.3%, 68.8%, 8.9% and 3% respectively. Hypertension (adjusted OR = 3.5, (1.1 - 11.2), p = 0.03) and locally acquired infection (adjusted OR = 2.8, (1.1 - 7.1) p = 0.03) were significant predictors of severity of the disease on logistic regression. Case fatality rate was 0.99%. CONCLUSIONS: Mild and nonspecific symptoms and short duration of illness should not be overlooked in COVID-19 and high suspicion should be maintained as a large segment of infections are asymptomatic. The focus should be on insulating the elderly and those with comorbid conditions.