Burden of acute and long-term COVID-19: a nationwide study in Bahrain.

BACKGROUND

Coronavirus disease 2019 (COVID-19) may lead to long-term sequelae. This study aimed to understand the acute and post-acute burden of SARS-CoV-2 infection and to identify high-risk groups for post-COVID-19 conditions (PCC).

METHODS

A retrospective observational study of the Bahraini population was conducted between 1 May 2021 and 30 April 2023, utilizing the national administrative database. PCC cases were defined according to WHO guidelines. All COVID-19 cases were confirmed using real-time polymerase chain reaction (PCR).

RESULTS

Of 13,067 COVID-19 cases, 12,022 of them experienced acute COVID-19, and 1,045 of them developed PCC. Individuals with PCC tended to be older women with risk factors and instances of SARS-CoV-2 reinfection. The incidence rates per 100,000 individuals during the Alpha pandemic surge (2020), Delta pandemic surge (2021), and Omicron pandemic surge (2022) were 2.2, 137.2, and 222.5 for acute COVID-19, and 0.27, 10.5, and 19.3, respectively, for PCC cases. The death rates per 100,000 individuals during the Alpha, Delta, and Omicron pandemic surges were 3, 112, and 76, respectively, for acute COVID-19 and 1, 10, and 8, respectively, for PCC. The death rate was highest among those aged 65 and older during the Delta pandemic surge.

CONCLUSION

These findings suggest the need for a timely national vaccination program prior to new COVID-19 surges to prevent complications related to SARS-CoV-2 infection, particularly in the older adult and in non-older adult individuals with risk factors.