NEW DELHI: Many COVID-19 patients faced dyspnoea, fatigue and mental health issues even a year after discharge from hospital, according to a study by the Indian Council of Medical Research (ICMR) on post-infection impact.
The other common health issues reported among patients were weakness of limbs, bodyaches, joint pain, cough, headache, vomiting, chest pain, fever, and loss of taste or smell.
A mapping of patients from 31 hospitals across India between September 2020 and October 2022 showed that those who died within 90 days of discharge were above 60 years of age, and most had required intensive care. It also said that most deaths were due to heart failure or myocardial infarction.
The study, which was published in BMJ Global Health Journal, said that 18.6% out of 8,042 patients reported dyspnoea or laboured breathing in the first follow-up visit for a check-up within six months of the discharge. Another 10.5% complained of fatigue, and 9.3% had mental health problems, said the study.
The study also found that after a year, when 2,192 patients were studied, these instances came down. The dyspnoea cases were down to 11.9%, fatigue to 6.6% and mental health 9%, said the study, which based its findings on the National Clinical Registry for Covid-19, an ongoing electronic platform developed and maintained by the ICMR in collaboration with the Union health ministry and All India Institute of Medical Sciences, New Delhi; and ICMR-National Institute of Medical Statistics.
The study said a definitive cause of death was available in only 137 patients; the majority (88, 64.2%) had died owing to cardiac causes that included heart failure and myocardial infarction. Respiratory failure and sepsis/septic shock caused death among 26 (19%) and 15 (10.9%) participants, respectively. As many as 47% (204 of 434) of the patients who did not survive until the second follow-up died at home, while the rest (53%; 230 of 434) died at a healthcare facility. The median gap between discharge and death from the hospital was 14 days.
The study recommended a holistic management of cases to keep post-Covid complications under check.
“Hospitalised patients with Covid-19 experience a variety of long-term sequelae after discharge from hospitals which persists, although in reduced proportions, until 12 months post-discharge,” said the study. “While dyspnoea, mental health issues and fatigue were highest among patients admitted during the second wave of Covid-19, the post-discharge death before the first follow-up was highest among the patients admitted during the third wave of Covid-19,” it said.
The study also recommended that as Covid-19 survivors have been reporting symptoms pertaining to multiple organ systems, it is advisable to have a dedicated outpatient clinic for them managed by physicians trained in the needs and clinical management of post-Covid condition/syndrome. It said that considering the high load of post-Covid symptoms among the old, a geriatric medicine specialist is needed. The study also suggested mental health services with functional linkage with peer support groups and suicide helplines be established.
