Determinants of Post-acute COVID-19 Syndrome among hospitalized severe COVID-19 patients: a 2-year follow up study

Background Coronavirus disease-19 (COVID-19), emerged as a public health threat in December 2019. The number of COVID-19 cases worldwide is now more than 765 million with more than 6.9 million dead. During follow-up visits following discharge, a large percentage of patients were discovered to still be suffering from health issues that lower their quality of life and ability to return to work. This study assessed the prevalence and associated risk factors of post-acute COVID-19 syndrome (PACS) among severe COVID-19 patients who were discharged from Millennium COVID-19 care center, Addis Ababa, Ethiopia. Methods A cross-sectional study using data collected from patient charts and a follow-up telephone interview after two years of discharge. Systematic random samplingwas used to select a total of 400 patients. A structured questionnaire developed from the case report form for PACS of WHO was used. Frequency and cross-tabulation were used for descriptive statistics. Predictor variables with a p-value <0.25 in bivariate analyses were included in the logistic regression. Result Out of the 400 patients, 20 patients were dead, 14 patients refused to give consent, and 26 patients couldn’t be reached because their phone wasn’t working. Finally, 340 were included in the study. The majority (68.5%) were males and the mean age was 53.9 (±13.3 SD) years. Most of the patients (60%) has one or more comorbidity. The most common symptom at presentation was cough (93.5%), followed by shortness of breath (82.1%) and fatigue (69.7%). The mean duration of hospital admission was 12.3 (±6.5 SD) days. More than a third (38.1%) of the patients reported the persistence of at least one symptom after hospital discharge. The most common symptoms were fatigue (27.5%) and Cough (15.3%). older age (AOR 1.04, 95% CI 1.02 – 1.07), female sex (AOR 1.82, 95% CI 1.00 – 3.29), presence of comorbidity (AOR 2.38, 95% CI 1.35 – 4.19), alcohol use (AOR 3.05, 95% CI 1.49 – 6.26), fatigue at presentation (AOR 2.18, 95% CI 1.21 – 3.95), and longer hospital stay (AOR 1.06, 95% CI 1.02 – 1.10) were found to increase the odds of developing post-acute COVID-19 syndrome. Higher hemoglobin level was found to decrease the risk of subsequent post-acute COVID-19 syndrome (AOR 0.84, 95% CI 0.71 – 0.99). Conclusion establishing a dedicated PACS follow-up clinic, especially for those with a higher risk can help to provide comprehensive care for the patients and improve their quality of life.