LONG TERM HEALTH CONSEQUENCES AS POST COVID-19 SEQUEL AND THEIR ASSOCIATION WITH RENAL, CARDIAC AND METABOLIC RISK FACTORS AMONG HEALTH CARE WORKERS IN BANGLADESH

 
LONG TERM HEALTH CONSEQUENCES AS POST COVID-19 SEQUEL AND THEIR ASSOCIATION WITH RENAL, CARDIAC AND METABOLIC RISK FACTORS AMONG HEALTH CARE WORKERS IN BANGLADESH
Ayub Ali
Chowdhury
Md Sharfuddin Ahmed vc@bsmmu.edu.bd BSMMU VC office Dhaka
ABM Abdullah abdullah_bsmmu@yahoo.com BSMMU Internal Medicine Dhaka
Sajal Krishna Banerjee drsajalk2003@yahoo.com BSMMU Cardiology Dhaka
Fazila-Tun-Nesa Malik fazilamalik@yahoo.com NHFH&RI Cardiology Dhaka
Sohel Reza Choudhury sohel_r_choudhury@hotmail.com NHFH&RI Epidemiology And Research Dhaka
Kazi S Alam kshahnoor@yahoo.com NIKDU Nephrology Dhaka
Mir Ishraquzzaman elanmir@gmail.com NHFH&RI Cardiology Dhaka
Dipal K Adhikary dka_1965@yahoo.com BSMMU Cardiology Dhaka
M Masud Iqbal masud_1232001@yahoo.com NIKDU & KDRG Nephrogy Dhaka
Md Omar Faruque ofaroque68@gmail.com BSMMU Nephrology Dhaka
G M Sadik Hasan gmsadik28@gmail.com BSMMU Nephrology Dhaka
Raquib Morshed raquibmorshed@gmail.com NIKDU Nephrology Dhaka
Zayeed Ahsan zayeedahsan@gmail.com NIKDU Nephrology Dhaka
Md Zahid Hassan mzhassan@buhs.ac.bd BUHS & BIHS Physiology and Molecular Biology Dhaka
M Sawkat Hassan mshassan1950@yahoo.com BIRDEM Immunology Dhaka

The COVID-19 outbreak affected health care workers (HCWs) by repeated exposure to large numbers of infected patients to a significant risk of being infected by this. Much remains unknown about the longer complications of covid in HCW. The situation clearly dictates the need for research to ensure the safety of HCWs. The aim of this study was to estimate the frequency of post COVID symptoms among HCW and the pattern of persisting symptom burdenover time.

This study involved retrospective cohort. The study population was physicians and non-physician health care workers (doctors, nurses, support staffs, cleaner and others those came in direct contact of the patients).Post-COVID-19 syndrome (long covid) is defined as-signs and symptoms that develop during or after an infection consistent with COVID‑19 continue for more than 12 weeks and are not explained by an alternative diagnosis. The included subjects are adult employee of selected four hospitals. Variable selected were- demographic and clinical like-age, sex, number of co-morbidities, severity of the disease (mild, moderate, severe), number of symptoms, duration of post covidsymptoms, etc. For evaluation a number of scales were added like - Cognitive status using the 6CIT scale;Dyspnoea by MRC scale, Fatigue by   WHO Performance Status Classification, Depression by the PHQ- 9 and Quality of Life by WHOQOL- BREF questionnaire.All data sheets was filled up by face-face interview by trained physicians.The data collection is done at 6 monthly interval starting from Jan 2021 and analyzed here up to 2 years in 1st phase

A total 803 healthcare workers (male/female ratio of 57%:43%), providing services to COVID patients, were selected from 4 tertiary hospitals. Among them 28% were doctors, 35% nurses and 37% others (supporting staffs, cleaner, guard, etc.). COVID was diagnosed in 44% HCW subjects ( 67% by positive RT-PCR, 30% based on symptoms with suggestive serology and rest on symptoms only) . Male/female were affected similarly. Among infected subjects, doctors were higher in covid group than non-covid group (39% vs. 19%, p<0.001). Among all around 8% were diabetic, 7% hypertensive, 6.3% nephropathy, 2% asthma and rest 70% were free from any known chronic disease. Persons with and without DM, HTN, Nephropathy were similarly affected by covid (P=NS). Long Covid symptoms like- body ache (fatigue, headache, sleep disturbances persisted for a year in 5-8%. Loss of smell and taste affected 50% subjects and that persisted for over a year in 5-6% (p<0.003). Respiratory symptom like cough persisted for a year post covid in 8%. Cardiac symptom namely palpitation continued to persist even after a year of covid in 9%. Neurological symptom complains like memory loss and poor concentration persisted in 15-18% post covid period of eighteen months. Some 14% developed visual disturbances that continued to persist year after covid. The 12% covid subjects compared to 4% non-covid developed depression (p<0.001) varying from mild to severe category. 

It is found that 5-18% subjects continued to suffer from different long covid symptoms  like fatigue, headache and sleep disturbances one year after covid diagnosis . Some of the complains likememory loss and poor concentration persisted in 15-18%  more than a  year after the active disease. Baseline co-morbidities like hypertension, diabetes or nephropathy did not show any association with added risk for long covid symptoms.

 

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