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BACKGROUND: Long COVID syndrome, characterized by symptoms like dyspnea, fatigue, and cough, persisting for weeks to months after the initial SARS-CoV-2 infection, poses significant challenges globally. Studies suggest a potential higher risk among females aged 40-50, with symptoms affecting individuals regardless of initial COVID-19 severity, underscoring the need for comprehensive understanding and management. METHODS: A prospective longitudinal study was conducted at a teaching tertiary care institute in Central India, involving COVID-19 patients from May 2020 to September 2021. Participants, aged 18 or older, diagnosed with COVID-19 and surviving until the last follow-up, were monitored telephonically and during outpatient visits for treatment details and outcomes. Data analysis was done using R software 4.2.1. RESULTS: The baseline characteristics of the study participants showed a majority of moderate COVID-19 severity (47.5%), with a higher proportion of males (64.8%) affected. Common comorbidities included diabetes (27.1%) and hypertension (22.9%). Long COVID-19 symptoms, notably breathlessness, were prevalent, with females exhibiting a significantly higher association. Pulmonary function abnormalities were associated with both long COVID-19 symptoms and higher COVID-19 severity categories, indicating lasting respiratory impact post-infection. CONCLUSION: Long after the pandemic, COVID-19 continues to raise concerns due to persistent sequelae, with a majority experiencing long COVID symptoms, particularly those with severe initial illness, including breathlessness and abnormal lung function, highlighting prevalent restrictive lung pattern changes.
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Background The outcome of acute kidney injury (AKI) in patients with COVID-19 and the factors associated with its outcome, including mortality, are understudied among the Indian population. Objective The objective of this study is to determine the outcome of AKI in a cohort of patients with COVID-19 admitted to medical wards and associated intensive care unit (ICU) and the factors associated with its outcome, including mortality. Method This is a retrospective study of patients with COVID-19 and AKI admitted to a tertiary care hospital. A total of 1765 patients were admitted to a hospital with COVID-19 between March 23, 2021, and June 30, 2021, during the second wave of the pandemic chiefly attributed to SARS-Co-V-2 lineage B.1.617. Patients with AKI for whom a nephrology call was sought for management (N=60) were included. Measurements carried out were the stage of AKI, co-morbidities, ICU admission, mechanical ventilation, lab parameters, and mortality. We classified AKI by comparing the highest to lowest recorded serum creatinine in hospital and staged AKI based on the Kidney Disease: Improving Global Outcomes (KDIGO) system. We further developed stepwise logistic regression models to find independent factors associated with mortality. Results Out of the 1765 patients hospitalized with COVID-19, a total of 60 (3.4%) patients with AKI were referred to nephrology for management. The observed mortality in this cohort was 41/60 (68.3%). AKI stage 3 was observed to be the most common (78.3%). Based on a univariate analysis of association, age, chronic kidney disease, admission to ICU, the requirement for vasopressor and ventilation, lactate dehydrogenase (LDH) DH, liver function tests (LFT), hypernatremia, and leucocytosis were associated with the mortality of patients (p<0.05) with AKI and COVID-19 infection. Multivariate analysis using logistic regression led to the identification of hypernatremia (OR 5.24 {0.95-42.31}) and multiple co-morbidities (OR 2.59 {1.03-8.75}, p<0.07) as potential factors independently associated with mortality. Conclusion The study indicates the potential association of hypernatremia with mortality in AKI, along with the simultaneous presence of multiple co-morbidities with COVID-19. As the statistical power of the association is weak, we are claiming the association as potential only. It needs to be confirmed in other larger studies.
