Mapping burden of long Covid: Work commences on review of studies

The healthcare sector in India still doesn't know the exact nature of the burden of long Covid with OPDs seeing a surge in patients but no proper documentation. That's the gap researchers in Gandhinagar have set out to fill with a review of various studies so the big picture becomes clear.

Researchers from the Indian Institute of Public Health Gandhinagar (IIPHG) are in the process of identifying studies to be included for the review to help discern an overall pattern in trends, including effects and risk factors. The review is funded by the Indian Council of Medical Research (ICMR).

Despite visible, grave symptoms, long Covid continues to evade diagnosis, as scientists have found no significant laboratory markers that could indicate its presence.

"Long Covid is definitely a chronic condition, but we do not know the exact nature of its burden," said Komal Shah, associate professor at the IIPHG.

"Studies report a surge in out-patient department (OPD) cases, especially among those with high risk of the condition -- these are the people with co-morbid conditions, the elderly, or those who had severe Covid-19 infection. However, this is not very well documented," Shah told PTI.

According to her, there must be more than 30 studies. But these need to be collated.

"This will be finalised once we are done with the screening (of the studies)," the co-lead researcher said.

The protocol outlining the methodology of the review is listed in an article, published in the journal Frontiers in 'Rehabilitation Sciences'.

Though the world is well past the emergency of Covid-19 pandemic, the disease continues to be studied, especially for the long Covid symptoms, such as fatigue and cognitive disturbances, noted to persist beyond the acute infection period.

A recent study by researchers from Germany, published in the journal PLOS Medicine, showed that nearly two-thirds of patients with long Covid continue to grapple with symptoms, including a reduced capacity for exercise, in the second year of illness.

However, studies emerging from India in this regard carry scattered data. For example, a study by researchers at Maulana Azad Medical College, New Delhi, found that the most common long Covid symptoms included joint pain, a persistent dry cough, anxiety, recurring headaches and forgetfulness. It was published in the journal Osong Public Health and Research Perspectives in May 2024.

"Long Covid is a cluster of conditions and the affected organ or system or disease might be different in different individuals. Studies report increase in chronic disorders, including diabetes, after Covid-19 pandemic. Our attempt is to map all of this and try to see where we are headed. A long-term strategy is required to manage this burden," Shah said.

"The anticipated findings will contribute to a refined understanding of this condition and its lingering symptoms, guiding healthcare interventions and future research endeavors to mitigate the impact of long Covid in the Indian population," the IIPHG authors write in the Frontiers article.

The review is tentatively expected to be complete by May this year.