Chaudhry Dhruva, Khandelwal Shweta, Bahadur Chandrika, Daniels Benjamin, Bhattacharyya Malay, Gangakhedkar Raman, Desai Sapna, Das Jishnu
Dept of Pulmonary & Critical Care Medicine, Pt BDS Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana, India.
Public Health Foundation of India, Gurugram, Haryana, India.
Lancet Reg Health Southeast Asia. 2024 Mar 29;25:100395. doi: 10.1016/j.lansea.2024.100395. eCollection 2024 Jun.
Emerging research indicates growing concern over long COVID globally, although there have been limited studies that estimate population burden. We aimed to estimate the burden of long COVID in three districts of Haryana, India, using an opportunity to link a seroprevalence study to follow-up survey of symptoms associated with long COVID.
We used a population-based seroprevalence survey for COVID-19 conducted in September 2021 across Haryana, India. Adults from three purposively selected districts (Rohtak, Gurugram, and Jhajjar) were eligible to participate; 2205 of 3213 consented to participate in a survey on health status. Trained investigators administered a structured questionnaire that included demographic characteristics, self-reported symptoms of illness in the last six months before the survey, mental health, and history of COVID-19.
Unadjusted regression estimates indicated positive correlations between symptomatic complaints and COVID-19 exposure, suggesting lingering effects of COVID-19 in this population. The overall physical morbidity index was higher among those who tested positive for COVID-19, as was the incidence of new cases. However, both morbidity and incidence became statistically insignificant after adjustment for multiple comparisons. Cough emerged as the only statistically significant individual persistent symptom. Sex-stratified analyses indicated significant estimates only for physical morbidity in women.
This study is one of the first from India that uses a large population-based sample to examine longer term repercussions of COVID infections. The burden of long COVID should primarily be addressed in clinical settings, where specialised treatment for individual cases continues to evolve. Our analyses also provide insight into the size and nature of studies required to assess the population-level burden of long COVID.
This paper was produced under the auspices of the Lancet COVID 19 Commission India Task Force, which was supported financially by the Reliance Foundation. The Lancet COVID 19 Commission was set up in July 2020 and submitted its final report by October 2022. This report by the India Task Force was prepared during the same period.
新出现的研究表明,全球对长期新冠的担忧日益增加,尽管估计人群负担的研究有限。我们旨在利用一项血清流行率研究与长期新冠相关症状随访调查相联系的机会,估计印度哈里亚纳邦三个地区的长期新冠负担。
我们采用了2021年9月在印度哈里亚纳邦进行的一项基于人群的新冠病毒血清流行率调查。从三个特意选择的地区(罗塔克、古鲁格拉姆和贾贾尔)选取的成年人有资格参与;3213名成年人中有2205人同意参与一项健康状况调查。经过培训的调查人员发放了一份结构化问卷,其中包括人口统计学特征、调查前最后六个月的自我报告疾病症状、心理健康状况以及新冠病毒感染史。
未经调整的回归估计表明,症状主诉与新冠病毒暴露之间存在正相关,这表明新冠病毒在该人群中存在持续影响。新冠病毒检测呈阳性者的总体身体发病率指数较高,新病例的发病率也是如此。然而,在进行多重比较调整后,发病率和新病例发病率在统计学上均无显著意义。咳嗽是唯一在统计学上有显著意义的持续性个体症状。按性别分层的分析表明,仅女性的身体发病率估计值有统计学意义。
本研究是印度首批使用大量基于人群的样本研究新冠病毒感染长期影响的研究之一。长期新冠的负担应主要在临床环境中解决,针对个别病例的专门治疗仍在不断发展。我们的分析还为评估长期新冠人群负担所需研究的规模和性质提供了见解。
本文由《柳叶刀》新冠委员会印度特别工作组主持撰写,该工作组由信实基金会提供资金支持。《柳叶刀》新冠委员会于2020年7月成立,并于2022年10月提交了最终报告。印度特别工作组的这份报告是在同一时期编写的。