Recovery and long-term health outcomes of SARS-CoV-2 infection in a prospective cohort in an urban setting, Kenya
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Background
Evidence on Long COVID remains limited in sub-Saharan countries. This study aimed to explore the occurrence of COVID-19-related symptoms and factors affecting recovery and Long COVID severity in Nairobi, Kenya.
Methods
A prospective cohort of individuals testing positive for SARS-CoV-2 between February 2022 and February 2023 were followed until June 2023. COVID-19-related symptoms were assessed every three months. Time to recovery was analyzed using survival analysis, while factors affecting recovery and Long COVID severity using Cox proportional hazard and Poisson regression, respectively.
Results
42/291 (14%) participants had severe/critical SARS-CoV-2 infection, 59.1% were female and median age was 34. At 6 and 12 months post-positive PCR, 53.1% and 33.5% of participants had ≥1 COVID-19-related symptoms, respectively. Fatigue (40.2%), pain (36.8%), sore throat (36.8%), headaches (36.4%), and loss of strength (31.6%) were the most frequently reported COVID-19-related symptoms. Median time to recovery was longer in symptomatic participants with severe/critical SARS-CoV-2 infection than those with mild/moderate (234 vs 206 days respectively, p=0.016). Participants aged 40-64 years experienced slower recovery than those aged <40 years (aHR=0.635 [95%CI, 0.429;0.941]) and those with tertiary education recovered faster than those with primary education (aHR=1.869 [95%CI, 1.050;3.327]). Long COVID severity was associated with female sex (aIRR=1.413 [95%CI; 1.089;1.833]), tertiary education (aIRR, 0.525 [95%CI, 0.350;0.786]), and ≥1 comorbidity (aIRR=2.540 [95%CI, 1.377;4.687]).
Conclusions
Our findings suggest Long COVID presents a substantial, under-researched disease burden in Kenya. Risk factors for Long COVID are similar to those in high-income countries (HICs). Tailored prevention and support strategies for high-risk groups are needed.
