Health-related quality of life and coping strategies adopted by COVID-19 survivors: A nationwide cross-sectional study in Bangladesh.

INTRODUCTION: This study aims to investigate the health-related quality of life and coping strategies among COVID-19 survivors in Bangladesh. METHODS: This is a cross-sectional study of 2198 adult, COVID-19 survivors living in Bangladesh. Data were collected from previously diagnosed COVID-19 participants (confirmed by an RT-PCR test) via door-to-door interviews in the eight different divisions in Bangladesh. For data collection, Bengali-translated Brief COPE inventory and WHO Brief Quality of Life (WHO-QoLBREF) questionnaires were used. The data collection period was from October 2020 to March 2021. RESULTS: Males 72.38% (1591) were more affected by COVID-19 than females 27.62% (607). Age showed significant correlations (p<0.005) with physical, psychological and social relationships, whereas gender showed only a significant correlation with physical health (p<0.001). Marital status, occupation, living area, and co-morbidities showed significant co-relation with all four domains of QoL (p<0.001). Education and affected family members showed significant correlation with physical and social relationship (p<0.001). However, smoking habit showed a significant correlation with both social relationship and environment (p<0.001). Age and marital status showed a significant correlation with avoidant coping strategies (p<0.001); whereas gender and co-morbidities showed a significant correlation with problem-focused coping strategies (p<0.001). Educational qualification, occupation and living area showed significant correlation with all three coping strategies(p<0.001). CONCLUSION: Survivors of COVID-19 showed mixed types of coping strategies; however, the predominant coping strategy was avoidant coping, followed by problem-focused coping, with emotion-focused coping reported as the least prevalent. Marital status, occupation, living area and co-morbidities showed a greater effect on QoL in all participants. This study represents the real scenario of nationwide health-associated quality of life and coping strategies during and beyond the Delta pandemic.

Prevalence of Long COVID symptoms in Bangladesh: a prospective Inception Cohort Study of COVID-19 survivors.

BACKGROUND: The objective of this study was to identify the prevalence of long COVID symptoms in a large cohort of people living with and affected by long COVID and identify any potential associated risk factors. METHODS: A prospective survey was undertaken of an inception cohort of confirmed people living with and affected by long COVID (aged 18-87 years). 14392 participants were recruited from 24 testing facilities across Bangladesh between June and November 2020. All participants had a previously confirmed positive COVID-19 diagnosis, and reported persistent symptoms and difficulties in performing daily activities. Participants who consented were contacted by face-to-face interview, and were interviewed regarding long COVID, and restriction of activities of daily living using post COVID-19 functional status scale. Cardiorespiratory parameters measured at rest (heart rate, systolic blood pressure, diastolic blood pressure, oxygen saturation levels, maximal oxygen consumption, inspiratory and expiratory lung volume) were also measured. RESULTS: Among 2198 participants, the prevalence of long COVID symptoms at 12 weeks was 16.1%. Overall, eight long COVID symptoms were identified and in descending order of prominence are: fatigue, pain, dyspnoea, cough, anosmia, appetite loss, headache and chest pain. People living with and affected by long COVID experienced between 1 and 8 long COVID symptoms with an overall duration period of 21.8±5.2 weeks. Structural equation modelling predicted the length of long COVID to be related to younger age, female gender, rural residence, prior functional limitation and smoking. CONCLUSION: In this cohort, at 31 weeks post diagnosis, the prevalence of long COVID symptoms was 16.1%. The risk factors identified for presence and longer length of long COVID symptoms warrant further research and consideration to support public health initiatives.

Coping with COVID-19 Pandemic: A Population-Based Study in Bangladesh

This study aims to investigate coping strategies used by Bangladeshi citizens during the COVID-19 pandemic. DesignProspective, cross-sectional survey of adults (N=2001) living in Bangladesh. MethodsParticipants were interviewed for socio-demographic data and completed the Bengali translated Brief-COPE Inventory. Statistical data analysis was conducted using SPSS (Version 20). ResultsParticipants (N=2001), aged 18 to 86 years, were recruited from eight administrative divisions within Bangladesh (mean age 31.85{+/-}14.2 years). Male to female participant ratio was 53.4% (n=1074) to 46.6% (n=927). Higher scores were reported for approach coping styles (29.83{+/-}8.9), with lower scores reported for avoidant coping styles (20.83 {+/-} 6.05). Humor coping scores were reported at 2.68{+/-}1.3 and religion coping scores at 5.64{+/-}1.8. Both men and women showed similar coping styles. Multivariate analysis found a significant relationship between male gender and both humor and avoidant coping (p <.01). Male gender was found to be inversely related to both religion and approach coping (p <.01). Marital status and education were significantly related to all coping style domains (p<.01). Occupation was significantly related to approach coping (p <.01). Rural and urban locations differed significantly in participant coping styles (p <.01). Factor analysis revealed two cluster groups (Factor 1 and 2) comprised of unique combinations from all coping style domains. ConclusionParticipants in this study coped with the COVID-19 pandemic by utilizing a combination of coping strategies. Factor 1 revealed both avoidant and approach coping strategies and Factor 2 revealed a combination of humor and avoidant coping strategies. Overall, a higher utilization of approach coping strategies was reported, which has previously been associated with better physical and mental health outcomes. Religion was found to be a coping strategy for all participants. Future research may focus on understanding resilience in vulnerable populations, including people with disability or with migrant or refugee status in Bangladesh.

Knowledge, Attitudes, Behavioural Practises, and Psychological Impact Relating to COVID-19 Among People Living With Spinal Cord Injury During In-Patient Rehabilitation in Bangladesh.

AIM: The aim of this research is to focus on gaining an insight into the knowledge, attitudes, behavioural practises (KAP), and psychological impact relating to COVID-19 among the people living with spinal cord injury receiving in-patient rehabilitation. METHODS: A prospective, cross-sectional survey of people with SCI (N = 207), who were in active in-patient rehabilitation from two tertiary SCI Rehabilitation Centres in Bangladesh. Data were collected via face-to-face interviews, after voluntary consent, using a pretested, language validated questionnaire on Knowledge, Attitude and Behavioural practises (KAP) and the Depression, Anxiety, Stress Scale (DASS-21). Ethical approval and trial registration were obtained prospectively. RESULTS: A total of 207 people with SCI responded, among which 87% were men and 13% were women, with a mean age of 34.18 ± 12.9 years. Within the sample group, people living with tetraplegia comprised 33.8%, and people living with paraplegia comprised 66.2%. Overall, 63.8% of the participants were diagnosed with an SCI categorised as ASIA-A. Overall, the "knowledge score" was 8.59 ± 2.3 out of 12, "depression" was 11.18 ± 8, "anxiety" was 7.72 ± 5.1, and "stress" was 9.32 ± 6.7 from a total of 21 scores each category. The strong correlation was between knowledge, DASS scores, and age (p < 0.05). In addition, there was a strong correlation between knowledge, gender (p < 0.05) and education (p < 0.01). Binary logistic regression found a stronger association of knowledge and DASS scores with gender, young age, illiteracy (p < 0.01), and rural residence (p < 0.05). A positive relationship was found between depression and anxiety scores (p < 0.01) and a moderate positive relationship was found between depression and stress scores (p < 0.01). A positive attitude was reported by the majority of participants (p < 0.05). In terms of behavioural practises, participants reported both self and caregiver had followed health advice with regard to consulting health professionals (65.7%), implementing isolation (63.8%), taking droplet precaution care (87.4%), and hygiene care (90.3%). CONCLUSION: Participants in this study reported high levels of knowledge, adoption of positive attitudes, and the practise of positive health advisory behaviours related to COVID-19 prevention procedures. However, high levels of depression, anxiety, and stress were also reported. Overall, women and younger participants were more likely to have high KAP, whereas those living in rural areas and with literacy challenges were less likely to report high knowledge scores.