Functional Impairment, Pain, and Fatigue Among Long COVID Survivors in Bangladesh: A Multisite Cross-Sectional Study
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Background
Long COVID can involve persistent symptoms, functional limitations, pain, and fatigue. Evidence describing these inter-related outcomes in Bangladeshi survivors remains limited. This study examined functional status and factors associated with pain and fatigue among long COVID survivors in Bangladesh.
Methods
A multisite cross-sectional study included 240 adults with persistent symptoms after COVID-19 who were recruited from five healthcare facilities in Bangladesh using convenience sampling. Data were collected using a structured questionnaire, the Post-COVID-19 Functional Status scale, the Brief Pain Inventory, and the Brief Fatigue Inventory. Adjusted ordinal logistic regression models were used for functional-status domains, multiple linear regression models were used for pain and fatigue outcomes, and Spearman rank correlation analysis assessed relationships among continuous measures.
Results
The mean age was 50.3 years (SD 14.5), and 176 participants (73.3%) were female. Slight limitation was most common for constant care (138 [57.5%]), instrumental activities of daily living (120 [50.0%]), and social roles (125 [52.1%]), whereas moderate limitation predominated for basic activities of daily living (149 [62.1%]). Cough (177 [73.8%]), lack of appetite (170 [70.8%]), chest pain (161 [67.1%]), and pain (155 [64.6%]) were the most frequently reported persistent symptoms. Older age was associated with greater ADL impairment (aOR 1.02, 95% CI 1.00–1.05; Wald χ 2 =3.95, p=0.047). In adjusted linear models, booster vaccination was associated with lower pain and fatigue scores across all reported BPI and BFI outcomes, while tobacco non-use was associated with lower scores across several domains. Pain and fatigue measures showed strong positive correlations.
Conclusions
Long COVID survivors in this Bangladeshi multisite cohort experienced substantial functional limitations together with prominent pain and fatigue. The observed associations with vaccination status, tobacco use, sociodemographic factors, and physiotherapy exposure should be interpreted as observational associations rather than causal effects. Prospective studies are needed to clarify determinants of recovery and the effectiveness of rehabilitation strategies.
Preprint status
This manuscript is a preliminary research report that has not undergone peer review.
