Post-COVID-19 syndrome among symptomatic COVID-19 patients: A prospective cohort study in a tertiary care center of Bangladesh
Post-coronavirus disease (COVID-19) syndrome includes persistence of symptoms beyond viral clearance and fresh development of symptoms or exaggeration of chronic diseases within a month after initial clinical and virological cure of the disease with a viral etiology. We aimed to determine the incide...
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| Veröffentlicht in: | PloS one 2021-04, Vol.16 (4), p.e0249644-e0249644 |
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| creator | Mahmud, Reaz Rahman, Md Mujibur Rassel, Mohammad Aftab Monayem, Farhana Binte Sayeed, S K Jakaria Been Islam, Md Shahidul Islam, Mohammed Monirul |
| description | Post-coronavirus disease (COVID-19) syndrome includes persistence of symptoms beyond viral clearance and fresh development of symptoms or exaggeration of chronic diseases within a month after initial clinical and virological cure of the disease with a viral etiology. We aimed to determine the incidence, association, and risk factors associated with development of the post-COVID-19 syndrome.
We conducted a prospective cohort study at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. All the enrolled patients were followed up for a month after clinical improvement, which was defined according the World Health Organization and Bangladesh guidelines as normal body temperature for successive 3 days, significant improvement in respiratory symptoms (respiratory rate 93% without assisted oxygen inhalation.
Among the 400 recruited patients, 355 patients were analyzed. In total, 46% patients developed post-COVID-19 symptoms, with post-viral fatigue being the most prevalent symptom in 70% cases. The post-COVID-19 syndrome was associated with female gender (relative risk [RR]: 1.2, 95% confidence interval [CI]: 1.02-1.48, p = 0.03), those who required a prolonged time for clinical improvement (p |
| doi_str_mv | 10.1371/journal.pone.0249644 |
| format | Article |
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We conducted a prospective cohort study at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. All the enrolled patients were followed up for a month after clinical improvement, which was defined according the World Health Organization and Bangladesh guidelines as normal body temperature for successive 3 days, significant improvement in respiratory symptoms (respiratory rate <25/breath/minute with no dyspnea), and oxygen saturation >93% without assisted oxygen inhalation.
Among the 400 recruited patients, 355 patients were analyzed. In total, 46% patients developed post-COVID-19 symptoms, with post-viral fatigue being the most prevalent symptom in 70% cases. The post-COVID-19 syndrome was associated with female gender (relative risk [RR]: 1.2, 95% confidence interval [CI]: 1.02-1.48, p = 0.03), those who required a prolonged time for clinical improvement (p<0.001), and those showing COVID-19 positivity after 14 days (RR: 1.09, 95% CI: 1.00-1.19, p<0.001) of initial positivity. Patients with severe COVID-19 at presentation developed post-COVID-19 syndrome (p = 0.02). Patients with fever (RR: 1.5, 95% CI: 1.05-2.27, p = 0.03), cough (RR: 1.36, 95% CI: 1.02-1.81, p = 0.04), respiratory distress (RR: 1.3, 95% CI: 1.4-1.56, p = 0.001), and lethargy (RR: 1.2, 95% CI: 1.06-1.35, p = 0.003) as the presenting features were associated with the development of the more susceptible to develop post COVID-19 syndrome than the others. Logistic regression analysis revealed female sex, respiratory distress, lethargy, and long duration of the disease as risk factors.
Female sex, respiratory distress, lethargy, and long disease duration are critical risk factors for the development of post-COVID-19 syndrome.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0249644</identifier><identifier>PMID: 33831043</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adult ; Aged ; Asthma ; Asymptomatic ; Bacterial diseases ; Bangladesh ; Bangladesh - epidemiology ; Biology and Life Sciences ; Blood coagulation ; Chronic diseases ; Chronic fatigue syndrome ; Chronic infection ; Clotting ; Cohort analysis ; Complications ; Complications and side effects ; Coronaviruses ; COVID-19 ; COVID-19 - complications ; COVID-19 - epidemiology ; COVID-19 - therapy ; Demographic aspects ; Dyspnea ; Epidemics ; Etiology ; Fatigue - epidemiology ; Fatigue - etiology ; Female ; Fever ; Headache ; Health risks ; Heart diseases ; Hospitals ; Humans ; Hypothalamus ; Hypoxia ; Infections ; Male ; Medical schools ; Medicine and Health Sciences ; Mental disorders ; Middle Aged ; Migraine ; Myocardial infarction ; Myocarditis ; Oxygen saturation ; Patients ; Physiological aspects ; Pneumonia ; Polymerase chain reaction ; Prospective Studies ; Recovery ; Respiratory distress syndrome ; Risk analysis ; Risk Factors ; SARS-CoV-2 ; Sepsis ; Severe acute respiratory syndrome coronavirus 2 ; Signs and symptoms ; Syndrome ; Tertiary Care Centers ; Viral diseases ; Viral infections</subject><ispartof>PloS one, 2021-04, Vol.16 (4), p.e0249644-e0249644</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Mahmud et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Mahmud et al 2021 Mahmud et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-70b3be5288df93a6cffa526cf099851b6a1f91b78e0ec7b2d618f16b5e649bbc3</citedby><cites>FETCH-LOGICAL-c758t-70b3be5288df93a6cffa526cf099851b6a1f91b78e0ec7b2d618f16b5e649bbc3</cites><orcidid>0000-0002-9427-1746 ; 0000-0001-5970-2427 ; 0000-0002-4381-1511</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8031743/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8031743/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33831043$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mahmud, Reaz</creatorcontrib><creatorcontrib>Rahman, Md Mujibur</creatorcontrib><creatorcontrib>Rassel, Mohammad Aftab</creatorcontrib><creatorcontrib>Monayem, Farhana Binte</creatorcontrib><creatorcontrib>Sayeed, S K Jakaria Been</creatorcontrib><creatorcontrib>Islam, Md Shahidul</creatorcontrib><creatorcontrib>Islam, Mohammed Monirul</creatorcontrib><title>Post-COVID-19 syndrome among symptomatic COVID-19 patients: A prospective cohort study in a tertiary care center of Bangladesh</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Post-coronavirus disease (COVID-19) syndrome includes persistence of symptoms beyond viral clearance and fresh development of symptoms or exaggeration of chronic diseases within a month after initial clinical and virological cure of the disease with a viral etiology. We aimed to determine the incidence, association, and risk factors associated with development of the post-COVID-19 syndrome.
We conducted a prospective cohort study at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. All the enrolled patients were followed up for a month after clinical improvement, which was defined according the World Health Organization and Bangladesh guidelines as normal body temperature for successive 3 days, significant improvement in respiratory symptoms (respiratory rate <25/breath/minute with no dyspnea), and oxygen saturation >93% without assisted oxygen inhalation.
Among the 400 recruited patients, 355 patients were analyzed. In total, 46% patients developed post-COVID-19 symptoms, with post-viral fatigue being the most prevalent symptom in 70% cases. The post-COVID-19 syndrome was associated with female gender (relative risk [RR]: 1.2, 95% confidence interval [CI]: 1.02-1.48, p = 0.03), those who required a prolonged time for clinical improvement (p<0.001), and those showing COVID-19 positivity after 14 days (RR: 1.09, 95% CI: 1.00-1.19, p<0.001) of initial positivity. Patients with severe COVID-19 at presentation developed post-COVID-19 syndrome (p = 0.02). Patients with fever (RR: 1.5, 95% CI: 1.05-2.27, p = 0.03), cough (RR: 1.36, 95% CI: 1.02-1.81, p = 0.04), respiratory distress (RR: 1.3, 95% CI: 1.4-1.56, p = 0.001), and lethargy (RR: 1.2, 95% CI: 1.06-1.35, p = 0.003) as the presenting features were associated with the development of the more susceptible to develop post COVID-19 syndrome than the others. Logistic regression analysis revealed female sex, respiratory distress, lethargy, and long duration of the disease as risk factors.
Female sex, respiratory distress, lethargy, and long disease duration are critical risk factors for the development of post-COVID-19 syndrome.</description><subject>Adult</subject><subject>Aged</subject><subject>Asthma</subject><subject>Asymptomatic</subject><subject>Bacterial diseases</subject><subject>Bangladesh</subject><subject>Bangladesh - epidemiology</subject><subject>Biology and Life Sciences</subject><subject>Blood coagulation</subject><subject>Chronic diseases</subject><subject>Chronic fatigue syndrome</subject><subject>Chronic infection</subject><subject>Clotting</subject><subject>Cohort analysis</subject><subject>Complications</subject><subject>Complications and side effects</subject><subject>Coronaviruses</subject><subject>COVID-19</subject><subject>COVID-19 - complications</subject><subject>COVID-19 - epidemiology</subject><subject>COVID-19 - therapy</subject><subject>Demographic aspects</subject><subject>Dyspnea</subject><subject>Epidemics</subject><subject>Etiology</subject><subject>Fatigue - epidemiology</subject><subject>Fatigue - etiology</subject><subject>Female</subject><subject>Fever</subject><subject>Headache</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Hypothalamus</subject><subject>Hypoxia</subject><subject>Infections</subject><subject>Male</subject><subject>Medical schools</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Middle Aged</subject><subject>Migraine</subject><subject>Myocardial infarction</subject><subject>Myocarditis</subject><subject>Oxygen saturation</subject><subject>Patients</subject><subject>Physiological aspects</subject><subject>Pneumonia</subject><subject>Polymerase chain reaction</subject><subject>Prospective Studies</subject><subject>Recovery</subject><subject>Respiratory distress syndrome</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>SARS-CoV-2</subject><subject>Sepsis</subject><subject>Severe acute respiratory syndrome coronavirus 2</subject><subject>Signs and symptoms</subject><subject>Syndrome</subject><subject>Tertiary Care Centers</subject><subject>Viral diseases</subject><subject>Viral 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syndrome among symptomatic COVID-19 patients: A prospective cohort study in a tertiary care center of Bangladesh</title><author>Mahmud, Reaz ; Rahman, Md Mujibur ; Rassel, Mohammad Aftab ; Monayem, Farhana Binte ; Sayeed, S K Jakaria Been ; Islam, Md Shahidul ; Islam, Mohammed Monirul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-70b3be5288df93a6cffa526cf099851b6a1f91b78e0ec7b2d618f16b5e649bbc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Asthma</topic><topic>Asymptomatic</topic><topic>Bacterial diseases</topic><topic>Bangladesh</topic><topic>Bangladesh - epidemiology</topic><topic>Biology and Life Sciences</topic><topic>Blood coagulation</topic><topic>Chronic diseases</topic><topic>Chronic fatigue syndrome</topic><topic>Chronic infection</topic><topic>Clotting</topic><topic>Cohort analysis</topic><topic>Complications</topic><topic>Complications and side effects</topic><topic>Coronaviruses</topic><topic>COVID-19</topic><topic>COVID-19 - complications</topic><topic>COVID-19 - epidemiology</topic><topic>COVID-19 - therapy</topic><topic>Demographic aspects</topic><topic>Dyspnea</topic><topic>Epidemics</topic><topic>Etiology</topic><topic>Fatigue - epidemiology</topic><topic>Fatigue - etiology</topic><topic>Female</topic><topic>Fever</topic><topic>Headache</topic><topic>Health risks</topic><topic>Heart diseases</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypothalamus</topic><topic>Hypoxia</topic><topic>Infections</topic><topic>Male</topic><topic>Medical schools</topic><topic>Medicine and Health Sciences</topic><topic>Mental disorders</topic><topic>Middle Aged</topic><topic>Migraine</topic><topic>Myocardial infarction</topic><topic>Myocarditis</topic><topic>Oxygen saturation</topic><topic>Patients</topic><topic>Physiological aspects</topic><topic>Pneumonia</topic><topic>Polymerase chain reaction</topic><topic>Prospective Studies</topic><topic>Recovery</topic><topic>Respiratory distress syndrome</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>SARS-CoV-2</topic><topic>Sepsis</topic><topic>Severe acute respiratory syndrome coronavirus 2</topic><topic>Signs and symptoms</topic><topic>Syndrome</topic><topic>Tertiary Care Centers</topic><topic>Viral diseases</topic><topic>Viral infections</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahmud, Reaz</creatorcontrib><creatorcontrib>Rahman, Md Mujibur</creatorcontrib><creatorcontrib>Rassel, Mohammad Aftab</creatorcontrib><creatorcontrib>Monayem, Farhana Binte</creatorcontrib><creatorcontrib>Sayeed, S K Jakaria Been</creatorcontrib><creatorcontrib>Islam, Md Shahidul</creatorcontrib><creatorcontrib>Islam, Mohammed 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Jakaria Been</au><au>Islam, Md Shahidul</au><au>Islam, Mohammed Monirul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Post-COVID-19 syndrome among symptomatic COVID-19 patients: A prospective cohort study in a tertiary care center of Bangladesh</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-04-08</date><risdate>2021</risdate><volume>16</volume><issue>4</issue><spage>e0249644</spage><epage>e0249644</epage><pages>e0249644-e0249644</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Post-coronavirus disease (COVID-19) syndrome includes persistence of symptoms beyond viral clearance and fresh development of symptoms or exaggeration of chronic diseases within a month after initial clinical and virological cure of the disease with a viral etiology. We aimed to determine the incidence, association, and risk factors associated with development of the post-COVID-19 syndrome.
We conducted a prospective cohort study at Dhaka Medical College Hospital between June 01, 2020 and August 10, 2020. All the enrolled patients were followed up for a month after clinical improvement, which was defined according the World Health Organization and Bangladesh guidelines as normal body temperature for successive 3 days, significant improvement in respiratory symptoms (respiratory rate <25/breath/minute with no dyspnea), and oxygen saturation >93% without assisted oxygen inhalation.
Among the 400 recruited patients, 355 patients were analyzed. In total, 46% patients developed post-COVID-19 symptoms, with post-viral fatigue being the most prevalent symptom in 70% cases. The post-COVID-19 syndrome was associated with female gender (relative risk [RR]: 1.2, 95% confidence interval [CI]: 1.02-1.48, p = 0.03), those who required a prolonged time for clinical improvement (p<0.001), and those showing COVID-19 positivity after 14 days (RR: 1.09, 95% CI: 1.00-1.19, p<0.001) of initial positivity. Patients with severe COVID-19 at presentation developed post-COVID-19 syndrome (p = 0.02). Patients with fever (RR: 1.5, 95% CI: 1.05-2.27, p = 0.03), cough (RR: 1.36, 95% CI: 1.02-1.81, p = 0.04), respiratory distress (RR: 1.3, 95% CI: 1.4-1.56, p = 0.001), and lethargy (RR: 1.2, 95% CI: 1.06-1.35, p = 0.003) as the presenting features were associated with the development of the more susceptible to develop post COVID-19 syndrome than the others. Logistic regression analysis revealed female sex, respiratory distress, lethargy, and long duration of the disease as risk factors.
Female sex, respiratory distress, lethargy, and long disease duration are critical risk factors for the development of post-COVID-19 syndrome.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33831043</pmid><doi>10.1371/journal.pone.0249644</doi><tpages>e0249644</tpages><orcidid>https://orcid.org/0000-0002-9427-1746</orcidid><orcidid>https://orcid.org/0000-0001-5970-2427</orcidid><orcidid>https://orcid.org/0000-0002-4381-1511</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-04, Vol.16 (4), p.e0249644-e0249644 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2510234089 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry; Public Library of Science (PLoS) |
| subjects | Adult Aged Asthma Asymptomatic Bacterial diseases Bangladesh Bangladesh - epidemiology Biology and Life Sciences Blood coagulation Chronic diseases Chronic fatigue syndrome Chronic infection Clotting Cohort analysis Complications Complications and side effects Coronaviruses COVID-19 COVID-19 - complications COVID-19 - epidemiology COVID-19 - therapy Demographic aspects Dyspnea Epidemics Etiology Fatigue - epidemiology Fatigue - etiology Female Fever Headache Health risks Heart diseases Hospitals Humans Hypothalamus Hypoxia Infections Male Medical schools Medicine and Health Sciences Mental disorders Middle Aged Migraine Myocardial infarction Myocarditis Oxygen saturation Patients Physiological aspects Pneumonia Polymerase chain reaction Prospective Studies Recovery Respiratory distress syndrome Risk analysis Risk Factors SARS-CoV-2 Sepsis Severe acute respiratory syndrome coronavirus 2 Signs and symptoms Syndrome Tertiary Care Centers Viral diseases Viral infections |
| title | Post-COVID-19 syndrome among symptomatic COVID-19 patients: A prospective cohort study in a tertiary care center of Bangladesh |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T15%3A06%3A10IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Post-COVID-19%20syndrome%20among%20symptomatic%20COVID-19%20patients:%20A%20prospective%20cohort%20study%20in%20a%20tertiary%20care%20center%20of%20Bangladesh&rft.jtitle=PloS%20one&rft.au=Mahmud,%20Reaz&rft.date=2021-04-08&rft.volume=16&rft.issue=4&rft.spage=e0249644&rft.epage=e0249644&rft.pages=e0249644-e0249644&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0249644&rft_dat=%3Cgale_plos_%3EA657819766%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2510234089&rft_id=info:pmid/33831043&rft_galeid=A657819766&rft_doaj_id=oai_doaj_org_article_1f03476d7c2c443e8eb2a7042aa8ebf9&rfr_iscdi=true |