Respiratory, Cardiac, and Neuropsychiatric Manifestations of Postacute Sequelae of Coronavirus Disease 2019 in Lima, Peru

• Autores: Rahman, Rifat S., Tovar, Marco A., Peinado, Jesús, Palomino, J. Santiago, Ramirez, Claudio, Llanos-Zavalaga, Fernando, Peralta, Ernesto, Valderrama, Gissela, Ramos Cordova, Lourdes B., Sanchez Cortez, Lucero I., Rodriguez, German, Lahood, Allison N., Franke, Molly F., Mitnick, Carole D., Lecca, Leonid, Velásquez, Gustavo E.
• Formato: artículo
• Fecha de Publicación: 2023
• Institución: Universidad Peruana de Ciencias Aplicadas
• Repositorio: UPC-Institucional
• Lenguaje: inglés
• OAI Identifier: oai:repositorioacademico.upc.edu.pe:10757/673240
• Enlace del recurso: https://doi.org/10.1093/ofid/ofad320; http://hdl.handle.net/10757/673240
• Nivel de acceso: acceso abierto
• Materia: COVID-19; Peru; postacute; SARS-CoV-2; sequelae; https://purl.org/pe-repo/ocde/ford#3.00.00

Background: Few studies have examined the burden of postacute sequelae of coronavirus disease 2019 (COVID-19) (PASC) in low- and middle-income countries. We sought to characterize PASC with self-reported questionnaires and clinical examinations of end-organ function in Lima, Peru. Methods: From January to July 2021, we recruited participants at least 8 weeks after COVID-19 diagnosis from a case registry in Lima, Peru. We evaluated participants for PASC with questionnaires, neuropsychiatric evaluations, chest X-ray, spirometry, electrocardiogram, and echocardiogram. We used multivariable models to identify risk factors for PASC. Results: We assessed 989 participants for PASC at a median 4.7 months after diagnosis. Clinically significant respiratory symptoms were reported by 68.3% of participants, particularly those who had been severely ill during acute COVID-19, and were associated with cardiac findings of ventricular hypertrophy or dilation on echocardiogram. Neuropsychiatric questionnaires were consistent with depression in 20.7% and cognitive impairment in 8.0%. Female sex and older age were associated with increased risk of respiratory (adjusted odds ratio [aOR], 2.36 [95% confidence interval {CI}, 1.69-3.31] and aOR, 1.01 [95% CI, 1.00-1.03], respectively) and neuropsychiatric sequelae (aOR, 2.99 [95% CI, 2.16-4.18] and aOR, 1.02 [95% CI, 1.01-1.03], respectively). Conclusions: COVID-19 survivors in Lima, Peru, experienced frequent postacute respiratory symptoms and depression, particularly among older and female participants. Clinical examinations highlighted the need for cardiopulmonary rehabilitation among persons with severe COVID-19; psychosocial support may be required among all COVID-19 survivors.