Prevalence of Long COVID Symptoms: An Observational, Cross-Sectional Follow-Up Study in Haryana, India

Background: 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 at the population level in India, using an opportunity to link a seroprevalence study to follow-up survey of symptoms associated with long COVID.Methods: We used a population-based seroprevalence survey for COVID-19 conducted in 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 month before the survey, mental health and COVID-19 history.Findings: Unadjusted regression estimates indicated positive correlations between symptomatic complaints an 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 (0.3, unadjusted 95% CI: [0.04 to 0.56]), as was the incidence of new diseases (0.06, unadjusted 95% CI: [0.00 to 0.12]). However, both became statistically insignificant after adjustment for multiple comparisons. Cough emerged as the only statistically significant individual persistent symptom (cough +9.7p.p., adjusted 95% CI: [0.3—19.0]). Sex-stratified analyses indicated significant estimates only for physical morbidity in women.Interpretation: This study is the first from India that uses a large population-based sample to examine longer term repercussions from Covid infections. At the population level, LC burden may be of limited intensity and proportion in India. The burden of LC should primarily be addressed in clinical settings, where specialized 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 LC.Funding Information: This paper was produced under the auspices of the Lancet COVID 19 Commission India Task Force, which was supported through a gift from the Reliance Foundation.Declaration of Interests: None to declare. Ethics Approval Statement: The study was reviewed and granted ethics approval (BREC/21/98) dated 5th Oct 2021 by the Biomedical Research Ethics Committee (BREC) Pandit Bhagwat Dayal Sharma, Post Graduate Institute of Medical Sciences (PGIMS/UHS), Rohtak institutional review board.