Long-Term Health Effects of COVID-19 in Tunisia, 2020–2021
Background
Some patients suffer from persistent symptoms following a COVID-19 infection, referred to as long COVID. The aims of the study were to estimate the prevalence of long COVID and study its determinants in Tunisia.
Methods
We conducted a nationwide cross-sectional study among a representative sample of COVID-19 survivors residing in Tunisia between June and August 2022. We selected a random sample, stratified by age and region, among residents registered in the national surveillance database with a SARS-CoV-2 positive test taken from September 2020 to September 2021 (n = 479,743). The expected sample size was 384.
We defined a patient with long COVID as having at least one self-reported symptom persisting for more than four weeks after the first confirmation of SARS-CoV-2 infection (RT-PCR or Ag-RDT) and not explained by an alternative diagnosis. Trained healthcare workers interviewed consenting respondents by phone using a structured questionnaire.
We described continuous variables using median and interquartile range (IQR). We measured the prevalence of long COVID and its 95% confidence interval (95% CI). We estimated the association between explanatory variables (socio-demographic, lifestyle and comorbidities, SARS-CoV-2 history infection, COVID-19 vaccination status) and long COVID using a log-binomial model, reporting adjusted prevalence ratios (a-PR) and its 95% CI.
Results
Of 1094 persons contacted, 416 were enrolled (response rate: 38%). Long-COVID prevalence was 64% (267/416); 95% CI [59–69%]. The sex ratio (M:F) was 0.72. Age ranged from 1 to 101 years, with a median of 41 years (IQR:31–55 years).
The most common symptoms were fatigue (63%), myalgia/arthralgia (33%), and cognitive symptoms (52%). Median duration of long-COVID symptoms was 11 months (IQR: 3–14 months).
In multivariate analysis, experiencing acute COVID-19 (a-PR = 1.5; 95% CI [1.0–2.1]), being a woman of childbearing age (a-PR = 1.2; 95% CI [1.0–1.4]) and residing in the central region (a-PR = 1.5; 95% CI [1.1–2.0]) were significantly associated with a higher prevalence of long COVID.
Conclusions
Long COVID is prevalent in Tunisia affecting patients with multiple symptoms initially, those residing in the central region and young women. We recommend to enhance healthcare access and medical follow-up both during and after the infection, focusing on identified risk groups. We also recommend to conduct further research to optimize management of long-COVID patients.
Web | DOI | PDF | International Journal of Environmental Research and Public Health | Open Access
Dhaouadi, Sonia; Bouguerra, Hind; Hechaichi, Aicha; Letaief, Hejer; Safer, Mouna; Aichouch, Chaima; Zouayti, Amenallah; Bougatef, Myriam; Neffati, Arwa; El Mili, Nawel; Mhadhbi, Rim; Bouafif ép Ben Alaya, Nissaf
Background
Some patients suffer from persistent symptoms following a COVID-19 infection, referred to as long COVID. The aims of the study were to estimate the prevalence of long COVID and study its determinants in Tunisia.
Methods
We conducted a nationwide cross-sectional study among a representative sample of COVID-19 survivors residing in Tunisia between June and August 2022. We selected a random sample, stratified by age and region, among residents registered in the national surveillance database with a SARS-CoV-2 positive test taken from September 2020 to September 2021 (n = 479,743). The expected sample size was 384.
We defined a patient with long COVID as having at least one self-reported symptom persisting for more than four weeks after the first confirmation of SARS-CoV-2 infection (RT-PCR or Ag-RDT) and not explained by an alternative diagnosis. Trained healthcare workers interviewed consenting respondents by phone using a structured questionnaire.
We described continuous variables using median and interquartile range (IQR). We measured the prevalence of long COVID and its 95% confidence interval (95% CI). We estimated the association between explanatory variables (socio-demographic, lifestyle and comorbidities, SARS-CoV-2 history infection, COVID-19 vaccination status) and long COVID using a log-binomial model, reporting adjusted prevalence ratios (a-PR) and its 95% CI.
Results
Of 1094 persons contacted, 416 were enrolled (response rate: 38%). Long-COVID prevalence was 64% (267/416); 95% CI [59–69%]. The sex ratio (M:F) was 0.72. Age ranged from 1 to 101 years, with a median of 41 years (IQR:31–55 years).
The most common symptoms were fatigue (63%), myalgia/arthralgia (33%), and cognitive symptoms (52%). Median duration of long-COVID symptoms was 11 months (IQR: 3–14 months).
In multivariate analysis, experiencing acute COVID-19 (a-PR = 1.5; 95% CI [1.0–2.1]), being a woman of childbearing age (a-PR = 1.2; 95% CI [1.0–1.4]) and residing in the central region (a-PR = 1.5; 95% CI [1.1–2.0]) were significantly associated with a higher prevalence of long COVID.
Conclusions
Long COVID is prevalent in Tunisia affecting patients with multiple symptoms initially, those residing in the central region and young women. We recommend to enhance healthcare access and medical follow-up both during and after the infection, focusing on identified risk groups. We also recommend to conduct further research to optimize management of long-COVID patients.
Web | DOI | PDF | International Journal of Environmental Research and Public Health | Open Access