Assessing the short, intermediate and long-term health effects of COVID-19 on the survivors in Zambia: a prospective quantitative study protocol.

ABSTRACT

INTRODUCTION: Little is known about the clinical course of COVID-19 following mild symptoms, and how the disease affects the survivors over time. Moreover, information on the severity of the long-term health effects as well as the associated risk factors is scant. This study aims to determine the short, intermediate and long-term health effects of COVID-19 on the survivors and the associated risk factors. METHODS AND ANALYSIS: We propose conducting a 24-month prospective quantitative study in 10 health facilities (2 specialist, 3 regional, 2 mission and 3 subdistrict hospitals) from Lusaka and Southern Province of Zambia. Health facilities will be those which served as COVID-19 treatment centres during the third wave (June-August 2021). Study participants will comprise a randomly selected cohort of 450 COVID-19 survivors who had mild or no symptoms (80%) and severe cases (20%). Using a questionnaire, respondent demographic, clinical and laboratory data will be collected at baseline and at a 3-month interval for 18 months using a questionnaire. Respondents' medical records will be reviewed and data collected using a checklist. Descriptive statistics will be computed to summarise respondents' characteristics and clinical outcomes. Bivariate analysis (Χ2 and t-test) will be conducted to test the association between respondent characteristics and clinical outcomes. Multivariate logistic regression analysis will be run to determine the risk factors for short, intermediate and long-term health effects; adjusted ORs will be computed to test the strength of the association (p<0.05). ETHICS AND DISSEMINATION Ethical approval was obtained from the University of Zambia Biomedical Research and the National Health Research Authority. Results will be disseminated to key stakeholders in Zambia, international open-access peer-reviewed journals, websites and international conferences, and likely lead to design of evidence-informed strategies to mitigate health effects of COVID-19 on survivors.