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Post-COVID Syndrome: The Stranger Ghost of Culprit COVID-19
Sudhir Bhandari1, Govind Rankawat2, Shashank Joshi3
1Professor Emeritus, Sawai Man Singh Medical College and attached Hospitals; Vice Chancellor, Rajasthan University of Health Sciences;Corresponding Author.
Insights
The delta variant of COVID-19 caused more severe initial symptoms and a higher risk of post-COVID complications compared to alpha and omicron variants. Omicron infections presented the lowest risk for developing long COVID-19 syndrome.
Area of Science:
- Infectious Diseases
- Virology
- Public Health
Background:
- Post-COVID syndromes represent a significant global health burden following coronavirus disease 2019 (COVID-19) infection.
- Differences in acute and post-COVID phases are observed between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants like alpha, delta, and omicron.
- Even with vaccination, the long-term effects of prior COVID-19 infections remain a substantial health concern.
Purpose of the Study:
- To compare the incidence and types of post-COVID complications among patients infected with different SARS-CoV-2 variants (alpha, delta, omicron).
- To analyze the relationship between COVID-19 variant type and the severity of acute symptoms and long-term sequelae.
- To identify the most prevalent post-COVID syndromes and their association with specific variants.
Main Methods:
- A prospective, observational, comparative study involving 3,840 COVID-19 patients.
- Categorization of patients based on SARS-CoV-2 variant: 1,150 (alpha), 1,845 (delta), and 815 (omicron).
- Data collection included hospital stay, vaccination status, and a 6-month follow-up to compare post-COVID thrombotic and other events.
Main Results:
- Delta variant infections were associated with more severe onset symptoms (fever, dyspnea, cough, etc.) compared to alpha and omicron (p < 0.01).
- Post-COVID syndrome developed in 7.48% of patients, with higher rates in delta (82.38%) and omicron (73.37%) variant groups compared to alpha (60.34%) (p < 0.05).
- Most common post-COVID syndromes included mucormycosis (11.41%), new-onset diabetes (9.89%), and pulmonary fibrosis (7.67%).
Conclusions:
- The delta variant caused more severe initial symptoms and a higher risk of post-COVID complications, while the alpha variant showed more neurological symptoms.
- Patients infected with the delta variant face a greater risk of post-COVID complications, with the omicron variant posing the minimal risk.
- Long COVID-19 requires dedicated management strategies regardless of the specific SARS-CoV-2 variant involved.
Background:
Post-COVID syndromes are the most abundant sequel of coronavirus disease of 2019 (COVID-19) infection, which affects millions of people around the whole world. There is a significant difference observed during the acute phase as well as during the post-COVID period between patients hospitalized with (alpha, delta, or omicron) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant. In the present scenario, when most people are vaccinated, COVID-19 disease is less likely, but the remnants of previous COVID-19 infections are still a vast health burden.
Materials And Methods:
This prospective, observational, comparative, and analytical study included a total of 3,840 COVID-19-infected patients who visited the hospital. We included 1,150 patients of alpha variants, 1,845 patients of delta variants, and 815 patients of omicron variants, from June 2020 to November 2020, March 2021 to July 2021, and January 2022 to May 2022, respectively. All medical data of the study population, including hospital stay and vaccination status, were collected, and all patients were followed up for 6 months of duration. All collected data were compiled and analyzed to compare the post-COVID thrombotic and other events among different variants of COVID-19.
Results:
Patients infected during the delta variant are the most symptomatic at onset (higher prevalence of fever, dyspnea, cough, myalgia, headache, or gastrointestinal problems) than those infected with the alpha or omicron variant (p < 0.01). A total of 2,830 patients (7.48%) [1,520 (82.38%) of delta variant, 598 (73.37%) of omicron variant, and 712 (60.34%) of omicron variant] developed post-COVID syndrome during their follow-up period out of 3,220 enrolled patients and the difference was statistically significant when compared among variants (p < 0.05). In this study, the highly prevalent post-COVID syndrome was mucormycosis (11.41%), followed by new-onset diabetes (9.89%), pulmonary fiosis (7.67%), ischemic heart disease (6.46%), ain stroke (3.29%), and other thromboembolic disorders (2.37%).
Conclusion:
COVID-19-associated onset symptoms during the delta variant were more severe and highly prevalent, while neurological symptoms (aguesia and anosmia) were more common during the alpha variant. Patients infected with the delta variant of COVID-19 are more prone to develop post-COVID-associated complications with minimal risk in the omicron variant and intermediate risk in the alpha variant. Long COVID-19 requires specific attention for management, irrespective of the SARS-CoV-2 variant.
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