Evidence map›Paper›PMID 38954717›Full record

ArticlePloS one2024

Clinical characteristics and factors associated with long COVID among post-acute COVID-19 clinic patients in Zambia, August 2020 to January 2023: A cross-sectional and longitudinal study design.

Warren Malambo, Duncan Chanda, Lily Besa, Daniella Engamba, Linos Mwiinga, Mundia Mwitumwa, Peter Matibula, Neil Naik, Suilanji Sivile, Simon Agolory and 4 more

Abstract read
In one paragraph

Article in PloS one, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Warren MalamboDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia.ORCID 0000-0002-4811-9831
Duncan ChandaDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.ORCID 0000-0001-5477-9054
Lily BesaMinistry of Health, Lusaka, Zambia.
Daniella EngambaDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.
Linos MwiingaDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia.
Mundia MwitumwaDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.
Peter MatibulaDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.
Neil NaikDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.
Suilanji SivileDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.
Simon AgoloryDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia.
Andrew AuldDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia.
Lloyd MulengaMinistry of Health, Lusaka, Zambia.
Jonas Z HinesDivision of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Global Health Center, Lusaka, Zambia.ORCID 0000-0002-4877-0333
Sombo FwoloshiDepartment of Internal Medicine, University Teaching Hospital Adult and Emergency Hospital, Lusaka, Zambia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionA number of seroprevalence studies in Zambia document the extent of spread of acute SARS-CoV-2 infection, yet knowledge gaps still exist on symptoms and conditions that continue or develop after acute COVID-19 (long COVID). This is an important gap given the estimated prevalence of long COVID in other African countries. We assessed factors associated with long COVID at the initial visit to a post-acute COVID-19 (PAC-19) clinic and longitudinally among a cohort of patients with ≥2 review visits.

methodsWe implemented a cross-sectional and longitudinal analysis of PAC-19 clinic patients from Aug-2020 to Jan-2023. The study outcome was long COVID; defined as the presence of new, relapsing, or persistent COVID-19 symptoms that interfere with the ability to function at home or work. Explanatory variables were demographic and clinical characteristics of patients which included sex, age group, presence of new onset medical conditions, presence of pre-existing comorbidities, vaccination status and acute COVID-19 episode details. We fitted logistic and mixed effects regression models to assess for associated factors and considered statistical significance at p<0.05.

resultsOut of a total 1,359 PAC-19 clinic patients in the cross-sectional analysis, 548 (40.3%) patients with ≥2 PAC-19 clinic visits were in the longitudinal analysis. Patients' median age was 53 (interquartile range [IQR]: 41-63) years, 919 (67.6%) were hospitalized for acute COVID-19, and of whom 686 (74.6%) had severe acute COVID-19. Overall, 377 (27.7%) PAC-19 clinic patients had long COVID. Patients with hospital length of stay ≥15 days (adjusted odds ratio [aOR]: 5.37; 95% confidence interval [95% CI]: 2.99-10.0), severe acute COVID-19 (aOR: 3.22; 95% CI: 1.68-6.73), and comorbidities (aOR:1.50; 95% CI: 1.02-2.21) had significantly higher chance of long COVID. Longitudinally, long COVID prevalence significantly (p<0.001) declined from 75.4% at the initial PAC-19 visit to 26.0% by the final visit. The median follow-up time was 7 (IQR: 4-12) weeks.

conclusionFactors associated with long COVID in Zambia were consistent both cross-sectionally at the initial visit to PAC-19 clinics and longitudinally across subsequent review visits. This highlights the importance of ongoing monitoring and tailored interventions for patients with comorbidities and severe COVID-19 to mitigate the long-term impacts of COVID-19.

Indexed as

COVID-19SARS-CoV-2AdolescentAdultAgedComorbidityCross-Sectional StudiesFemaleHumansLongitudinal StudiesMaleMiddle AgedPost-Acute COVID-19 SyndromePrevalenceRisk FactorsYoung Adult

Identifiers

PMID38954717
PMCPMC11219000

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.