Almost half of COVID-19 survivors in African countries are reporting at least one ongoing symptom that cannot be explained by other medical conditions, data suggests.
Researchers say fatigue and other ongoing symptoms are already affecting people's quality of life and could impair their ability to work, with economic consequences.
"Long COVID poses a significant burden in Africa, particularly concerning psychiatric conditions. The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients." – Dr Luisa Frallonardo, University of Bari, Italy
In October 2021, the World Health Organization (WHO) issued a consensus definition of Long COVID as a condition lasting at least two months in people who have been diagnosed with COVID-19 at least three months earlier. Studies have suggested that around 10–20% of people who are infected with SARS-CoV-2 will go on to develop such symptoms, although many of these studies have been conducted in higher-income countries.
The scale of the burden is less clear in low-income countries because of a significant number of asymptomatic or undisclosed infections, and difficulties in accessing testing. With 9.5 million cases of COVID‐19 recorded across the 47 countries of the WHO African Region up to June 2023, it is likely that many individuals there are suffering from Long COVID, but the incidence and type of symptoms are unclear.
To investigate, Dr Luisa Frallonardo at the University of Bari in Italy and colleagues pooled the results of 25 studies from African countries that have reported on the incidence of various types of Long COVID symptoms, including a total of 29,213 participants.
The study, published in Scientific Reports, found the incidence of any Long COVID symptoms was 48.6%. Symptoms were more common in older individuals and people who had been hospitalised. The researchers did not find that women were any more likely than men to report ongoing symptoms.
Fatigue was the most reported symptom
Fatigue was the most reported symptom, affecting 35.4% of study participants. Frequently debilitating, this is often the first reason patients seek medical assistance, the researchers said. "In Africa, it has the potential to lead to important impairments in productivity and further loss of economic agency," they added.
Up to a quarter of patients experienced mental health issues such as post-traumatic stress disorder (PTSD) or anxiety. This is concerning, because African health systems are largely unprepared to address mental health conditions.
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Cognitive impairment, difficulty concentrating and headaches affected 10–15% of participants, while 18% of them reported shortness of breath, and 11% experienced heart palpitations.
The researchers called for further studies to understand the long-term impact on quality of life and workforce activity; and to develop optimal therapeutic and prevention strategies for people living in Africa.
"Long COVID poses a significant burden in Africa, particularly concerning psychiatric conditions. The study recommends identifying at-risk people and defining treatment strategies and recommendations for African long-COVID patients," Frallonardo wrote.
"Low- and middle-income countries do not generally have social safety nets, and the impact of chronic sequelae on the workforce and on families' livelihoods remain a concern. In these countries, health care systems need to also establish post-acute care services where physical, cognitive, and mental health disabilities will be recognised."
This article was originally published on VaccinesWork.
