Author
Affilliation
Abstract
Introduction: A proportion of people develop Long Covid after acute COVID-19, but with most studies concentrated in high-income countries (HICs), the global burden is largely unknown. Our study aims to characterise long-term COVID-19 sequelae in populations globally and compare the prevalence of reported symptoms in HICs and low-income and middle-income countries (LMICs). Methods: A prospective, observational study in 17 countries in Africa, Asia, Europe and South America, including adults with confirmed COVID-19 assessed at 2 to <6 and 6 to <12 months post-hospital discharge. A standardised case report form developed by International Severe Acute Respiratory and emerging Infection Consortium's Global COVID-19 Follow-up working group evaluated the frequency of fever, persistent symptoms, breathlessness (MRC dyspnoea scale), fatigue and impact on daily activities. Results: Of 11 860 participants (median age: 52 (IQR: 41-62) years; 52.1% females), 56.5% were from HICs and 43.5% were from LMICs. The proportion identified with Long Covid was significantly higher in HICs vs LMICs at both assessment time points (69.0% vs 45.3%, p<0.001; 69.7% vs 42.4%, p<0.001). Participants in HICs were more likely to report not feeling fully recovered (54.3% vs 18.0%, p<0.001; 56.8% vs 40.1%, p<0.001), fatigue (42.9% vs 27.9%, p<0.001; 41.6% vs 27.9%, p<0.001), new/persistent fever (19.6% vs 2.1%, p<0.001; 20.3% vs 2.0%, p<0.001) and have a higher prevalence of anxiety/depression and impact on usual activities compared with participants in LMICs at 2 to <6 and 6 to <12 months post-COVID-19 hospital discharge, respectively. Conclusion: Our data show that Long Covid affects populations globally, manifesting similar symptomatology and impact on functioning in both HIC and LMICs. The prevalence was higher in HICs versus LMICs. Although we identified a lower prevalence, the impact of Long Covid may be greater in LMICs if there is a lack of support systems available in HICs. Further research into the aetiology of Long Covid and the burden in LMICs is critical to implement effective, accessible treatment and support strategies to improve COVID-19 outcomes for all.
Publisher
BMJ Publishing Group
Citation
PAZUKHINA, Ekaterina et al. Long Covid: a global health issue: a prospective, cohort study set in four continents. BMJ Global Health, v. 9, n. 10, p. 1-14, Oct. 2024.
DOI
10.1136/bmjgh-2024-015245
ISSN
2059-7908
Notes
Collaborators: ISARIC Clinical Characterisation Group and ISARIC Global Covid-19 follow up working group: Laurent Abel, Amal Abrous, Younes Ait Tamlihat, Aliya Mohammed Alameen, Marta Alessi, Beatrice Alex, Kévin Alexandre, Adam Ali, Kazali Enagnon Alidjnou, Clotilde Allavena, Nathalie Allou, Claire Andrejak, Andrea Angheben, François Angoulvant, Séverine Ansart, Jean-Benoît Arlet, Elise Artaud-Macari, Jean Baptiste Assie, Johann Auchabie, Hugues Aumaitre, Adrien Auvet, Eyvind W Axelsen, Laurène Azemar, Cecile Azoulay, Benjamin Bach, Delphine Bachelet, Claudine Badr, John Kenneth Baillie, Firouzé Bani-Sadr, Wendy S Barclay, Marie Bartoli, Joaquín Baruch, Romain Basmaci, Jules Bauer, Alexandra Bedossa, Husna Begum, Marine Beluze, Nicolas Benech, Delphine Bergeaud, José Luis Bernal Sobrino, Giulia Bertoli, Simon Bessis, Sybille Bevilcaqua, Karine Bezulier, Krishna Bhavsar, Zeno Bisoffi, Laurent Bitker, Mathieu Blot, Laetitia Bodenes, Debby Bogaert, Anne-Hélène Boivin, Isabela Bolaños, Pierre-Adrien Bolze, Raphaël Borie, Elisabeth Botelho-Nevers, Lila Bouadma, Olivier Bouchaud, Sabelline Bouchez, Kévin Bouiller, Laurence Bouillet, Camile Bouisse, Anne-Sophie Boureau, Maude Bouscambert, Aurore Bousquet, Marielle Boyer-Besseyre, Axelle Braconnier, Sonja Hjellegjerde Brunvoll, Polina Bugaeva, Marielle Buisson, Danilo Buonsenso, Ingrid G Bustos, Denis Butnaru, Roar Bævre-Jensen, André Cabie, Eder Caceres, Cyril Cadoz, Jose Andres Calvache, Valentine Campana, Pauline Caraux-Paz, Nicolas Carlier, Thierry Carmoi, Marie-Christine Carret, Gail Carson, Maire-Laure Casanova, Guylaine Castor-Alexandre, François-Xavier Catherine, Minerva Cervantes-Gonzalez, Anissa Chair, Catherine Chakveatze, Meera Chand, Jean-Marc Chapplain, Charlotte Charpentier, Julie Chas, Léo Chenard, Antoine Cheret, Thibault Chiarabini, Catherine Chirouze, Bernard Cholley, Marie-Charlotte Chopin, Yock Ping Chow, Barbara Wanjiru Citarella, Sara Clohisey, Gwenhaël Colin, Marie Connor, Graham S Cooke, Hugues Cordel, Andrea Cortegiani, Grégory Corvaisier, Sandrine Couffin-Cadiergues, Roxane Courtois, Stéphanie Cousse, Juan Luis Cruz Bermúdez, Jaime Cruz Rojo, Elodie Curlier, Eric D'Ortenzio, Ana da Silva Filipe, Charlene Da Silveira, Andrew Dagens, John Arne Dahl, Jo Dalton, Etienne De Montmollin, Cristina De Rose, Thushan de Silva, Nathalie DeCastro, Alexa Debard, Marie-Pierre Debray, Romain Decours, Eve Defous, Isabelle Delacroix, Karen Delavigne, Christelle Delmas, Pierre Delobel, Elisa Demonchy, Emmanuelle Denis, Dominique Deplanque, Diane Descamps, Mathilde Desvallées, Alpha Diallo, Sylvain Diamantis, Fernanda Dias Da Silva, Kévin Didier, Jean-Luc Diehl, Vincent Dinot, Fara Diop, Alphonsine Diouf, Félix Djossou, Annemarie B Docherty, Christl A Donnelly, Céline Dorival, Nathalie Dournon, Thomas Drake, Amiel A Dror, Vincent Dubee, François Dubos, Alexandre Ducancelle, Susanne Dudman, Paul Dunand, Jake Dunning, Bertrand Dussol, Xavier Duval, Anne Margarita Dyrhol-Riise, Michael Edelstein, Linn Margrete Eggesbø, Mohammed El Sanharawi, Brigitte Elharrar, Merete Ellingjord-Dale, Philippine Eloy, Isabelle Enderle, Ilka Engelmann, Vincent Enouf, Olivier Epaulard, Hélène Esperou, Marina Esposito-Farese, Manuel Etienne, Marc Fabre, Isabelle Fabre, Cameron J Fairfield, Karine Faure, Raphaël Favory, François-Xavier Ferrand, Eglantine Ferrand Devouge, Nicolas Ferriere, Céline Ficko, William Finlayson, Thomas Flament, Tom Fletcher, Aline-Marie Florence, Victor Fomin, Erwan Fourn, Christophe Fraser, Stéphanie Fry, Valérie Gaborieau, Rostane Gaci, Jean-Charles Gagnard, Amandine Gagneux-Brunon, Linda Gail Skeie, Sérgio Gaião, Carrol Gamble, Esteban Garcia-Gallo, Noelia García Barrio, Denis Garot, Valérie Garrait, Anatoliy Gavrylov, Alexandre Gaymard, Eva Geraud, Louis Gerbaud Morlaes, Jade Ghosn, Tristan Gigante, Guillermo Giordano, Michelle Girvan, Valérie Gissot, Petr Glybochko, François Goehringer, Kyle Gomez, Marie Gominet, Yanay Gorelik, Isabelle Gorenne, Laure Goubert, Cécile Goujard, Tiphaine Goulenok, Pascal Granier, Christopher A Green, William Greenhalf, Segolène Greffe, Fiona Griffiths, Jérémie Guedj, Martin Guego, Romain Guery, Anne Guillaumot, Laurent Guilleminault, Thomas Guimard, Ali Hachemi, Nadir Hadri, Matthew Hall, Sophie Halpin, Rebecca Hamidfar, Bato Hammarström, Hayley Hardwick, Ewen M Harrison, Janet Harrison, Lars Heggelund, Ross Hendry, Maxime Hentzien, Diana Hernandez, Rupert Higgins, Hikombo Hitoto, Antonia Ho, Alexandre Hoctin, Isabelle Hoffmann, Jan Cato Holter, Peter Horby, Ikram Houas, Jean-Sébastien Hulot, Samreen Ijaz, Patrick Imbert, Mariachiara Ippolito, Margaux Isnard, Mette Stausland Istre, Danielle Jaafar, Salma Jaafoura, Julien Jabot, Clare Jackson, Stéphane Jaureguiberry, Florence Jego, Synne Jenum, Cédric Joseph, Mercé Jourdain, Silje Bakken Jørgensen, Ouifiya Kafif, Florentia Kaguelidou, Sabina Kali, Karl Trygve Kalleberg, Christiana Kartsonaki, Seán Keating, Sadie Kelly, Kalynn Kennon, Younes Kerroumi, Antoine Khalil, Saye Khoo, Beathe Kiland Granerud, Anders Benjamin Kildal, Antoine Kimmoun, Eyrun Floerecke Kjetland Kjetland, Paul Klenerman, Gry Kloumann Bekken, Stephen R Knight, Arsène Kpangon, Oksana Kruglova, Galyna Kutsyna, Marie Lachatre, Marie Lacoste, Nadhem Lafhej, Marie Lagrange, Fabrice Laine, Olivier Lairez, Antonio Lalueza, Marc Lambert, Marie Langelot-Richard, Vincent Langlois, Cédric Laouénan, Samira Laribi, Delphine Lariviere, Stéphane Lasry, Odile Launay, Didier Laureillard, Yoan Lavie-Badie, Andy Law, Minh Le, Clément Le Bihan, Cyril Le Bris, Georges Le Falher, Lucie Le Fevre, Quentin Le Hingrat, Marion Le Maréchal, Soizic Le Mestre, Gwenaël Le Moal, Vincent Le Moing, Hervé Le Nagard, Sylvie LeGac, Jennifer Lee, Gary Leeming, Laurent Lefebvre, Bénédicte Lefebvre, Benjamin Lefèvre, Jean-Daniel Lelievre, Adrien Lemaignen, Véronique Lemee, Anthony Lemeur, Marc Leone, Quentin Lepiller, François-Xavier Lescure, Olivier Lesens, Mathieu Lesouhaitier, Sophie Letrou, Bruno Levy, Yves Levy, Claire Levy-Marchal, Geoffrey Liegeon, Wei Shen Lim, Bruno Lina, Andreas Lind, Guillaume Lingas, Sylvie Lion-Daolio, Marine Livrozet, Paul Loubet, Bouchra Loufti, Guillame Louis, Jean-Christophe Lucet, Carlos Lumbreras Bermejo, Miles Lunn, Liem Luong, Dominique Luton, Moïse Machado, Gabriel Macheda, Guillermo Maestro de la Calle, Rafael Mahieu, Sophie Mahy, Mylène Maillet, Thomas Maitre, Denis Malvy, Victoria Manda, Laurent Mandelbrot, Julie Mankikian, Aldric Manuel, Samuel Markowicz, Laura Marsh, Guillaume Martin-Blondel, Martin Martinot, Olga Martynenko, Mathieu Mattei, Laurence Maulin, Thierry Mazzoni, Sarah E McDonald, Kenneth A McLean, Cécile Mear-Passard, France Mentré, Alexander J Mentzer, Emmanuelle Mercier, Antoine Merckx, Mayka Mergeay-Fabre, Laura Merson, Roberta Meta, Agnès Meybeck, Alison M Meynert, Vanina Meysonnier, Mehdi Mezidi, Isabelle Michelet, Shona C Moore, Sarah Moore, Lina Morales Cely, Lucia Moro, Clara Mouton Perrot, Julien Moyet, Jimmy Mullaert, Daniel Munblit, Marlène Murris, Srinivas Murthy, Alamin Mustafa, Karl Erik Müller, Fredrik Müller, Ebrahim Ndure, Nadège Neant, Nikita Nekliudov, Anthony Nghi, Duc Nguyen, Mahdad Noursadeghi, Saad Nseir, Elsa Nyamankolly, Anders Benteson Nygaard, Piero L Olliaro, Wilna Oosthuyzen, Peter Openshaw, Claudia Milena Orozco-Chamorro, Paul Otiku, Nadia Ouamara, Rachida Ouissa, Eric Oziol, Justine Pages Maïder Pagadoy, Massimo Palmarini, Carlo Palmieri, Nathalie Pansu, Aurélie Papadopoulos, Jérémie Pasquier, Bruno Pastene, Christelle Paul, William A Paxton, Jean-François Payen, Miguel Pedrera Jiménez, Florent Peelman, Nathan Peiffer-Smadja, Vincent Peigne, Daniel Perez, Thomas Perpoint, Vincent Pestre, Ventzislava Petrov-Sanchez, Frank Olav Pettersen, Gilles Peytavin, Walter Picard, Olivier Picone, Lionel Piroth, Chiara Piubelli, Riinu Pius, Laurent Plantier, Julien Poissy, Ryadh Pokeerbux, Georgios Pollakis, Diane Ponscarme, Sébastien Preau, Mark G Pritchard, Víctor Quirós González, Else Quist-Paulsen, Christian Rabaud, Marie Rafiq, Blandine Rammaert, Christophe Rapp, Stanislas Rebaudet, Sarah Redl, Dag Henrik Reikvam, Anne-Sophie Resseguier, Matthieu Revest, Luis Felipe Reyes, Antonia Ricchiuto, Laurent Richier, Patrick Rispal, Karine Risso, Stephanie Roberts, David L Robertson, Olivier Robineau, Paola Rodari, Amanda Rojek, Roberto Roncon-Albuquerque, Mélanie Roriz, Manuel Rosa-Calatrava, Andrea Rossanese, Patrick Rossignol, Carine Roy, Benoît Roze, Clark D Russell, Aleksander Rygh Holten, Nadia Saidani, Charlotte Salmon Gandonniere, Hélène Salvator, Olivier Sanchez, Vanessa Sancho-Shimizu, Pierre-François Sandrine, Benjamine Sarton, Egle Saviciute, Arnaud Scherpereel, Marion Schneider, Janet T Scott, Nicholas Sedillot, Malcolm G Semple, Eric Senneville, Pablo Serrano Balazote, Catherine A Shaw, Victoria Shaw, Nassima Si Mohammed, Jeanne Sibiude, Louise Sigfrid, Dario Sinatti, Vegard Skogen, Sue Smith, Lene Bergendal Solberg, Tom Solomon, Agnès Sommet, Albert Sotto, Edouard Soum, Elisabetta Spinuzza, Shiranee Sriskandan, Sarah Stabler, Trude Steinsvik, Birgitte Stiksrud, David Stuart, Charlotte Summers, Andrey Svistunov, Arne Søraas, Renaud Tamisier, Coralie Tardivon, Pierre Tattevin, Marie-Capucine Tellier, Olivier Terrier, Nicolas Terzi, Vincent Thibault, Simon-Djamel Thiberville, Benoît Thill, Emma C Thomson, Mathew Thorpe, Ryan S Thwaites, Vadim Tieroshyn, Peter S Timashev, Jean-François Timsit, Noémie Tissot, Kristian Tonby, Cécile Tromeur, Tiffany Trouillon, Jeanne Truong, Christelle Tual, Sarah Tubiana, Lance C W Turtle, Anders Tveita, François Téoulé, Timothy M Uyeki, Piero Valentini, Sylvie Van Der Werf, Noémie Vanel, Charline Vauchy, Aurélie Veislinger, Fanny Vuotto, Steve Webb, Jia Wei, Murray Wham, Paul Henri Wicky, Aurélie Wiedemann, Natalie Wright, Yazdan Yazdanpanah, Cécile Yelnik, Hodane Yonis, Marion Zabbe, Maria Zambon, David Zucman.
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