A National Survey of Children, Adults, and the Elderly in the Fourth Wave of the COVID-19 Pandemic to Compare Acute and Post-COVID-19 Conditions in Saudi Arabia
Abstract
:1. Introduction
2. Subjects and Methods
2.1. Study Design and Setting
2.2. Study Population
2.3. The Assessment (Data Collection) Tool
2.3.1. Assessment (Data Collection), Tool Development, and Structure
2.3.2. Assessment (Data Collection) Tool Validation
2.3.3. The Structure of the Assessment (Data Collection) Tool
- (I)
- Informed consent after giving their permission to take part in the study;
- (II)
- The demographic, special habits, comorbidities, and medication;
- (III)
- The history and symptoms of acute COVID-19, as well as their classification into critical, severe (managed in hospital), and not severe (managed at home).
- (IV)
- Post-COVID conditions are associated with a spectrum of physical, social, and psychological consequences. Check the list for 50 COVID-19-related symptoms [21];
- (V)
- The post-COVID-19 clinical assessment through
- (VI)
- The recommended management plans: based on the clinical assessment
- Nothing; Reassurance; Patient education; Referral to primary care clinics (PHCCs); Referral to post-COVID-19 clinics in hospitals.
2.4. The Assessment (Data Collection) Tool Methods
2.5. Statistical Analysis
3. Results
3.1. As regards the Baseline Demographic of the COVID-19 Cases
3.2. The History of COVID-19 Vaccination, and Self-Reported Acute SARS-CoV-2 Infection Symptoms among Different Age Groups
3.3. Self-Reported PCCs among Different Age Groups
3.4. The Post-COVID-19 Clinical Assessment
3.5. Post-COVID-19 Clinical Management
3.6. Post-COVID-19 Infection, Several Factors Predict a Recovery to Baseline Health Status and Require Referral to PHCCs and Post-COVID-19 Clinics in Hospitals
4. Discussion
4.1. The Self-Reported Acute and PCCs among Different Age Groups
4.2. The Post-COVID-19 Clinical Assessment
4.3. The Post-COVID-19 Clinical Management
4.4. Strengths and Limitations
5. Conclusions
6. Recommendation
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
BMI | Body Mass Index |
CFS | Chronic fatigue syndrome questionnaire |
CIF | Chronic idiopathic fatigue |
F | Frequency |
GAD-2 | Generalized Anxiety Disorder-2 |
HESN | Health Electronic Surveillance Network |
IQR | Interquartile range |
KSA | Kingdom of Saudi Arabia |
MRC | Medical Research Council |
PHQ-2 scale | Patient Health Questionnaire |
% | Percentages |
PCCs | Post-COVID-19 conditions |
PHCCs | Primary health care Centers |
LRT | The Likelihood Ratio Test |
PCCs | Post-COVID-19 conditions |
WHO-5 | The World Health Organization-five well-being index |
UK | United Kingdom |
WHO | World Health Organization |
References
- World Health Organization. Weekly Operational Update on COVID-19—4 July 2021. Weekly Operational Update on COVID-19—10 August 2022. Available online: https://www.who.int/news-room/events/detail/2022/08/17/default-calendar/post-covid-19-condition--children-and-young-persons (accessed on 16 January 2022).
- Chen, T.; Wu, D.; Chen, H.; Yan, W.; Yang, D.; Chen, G.; Ma, K.; Xu, D.; Yu, H.; Wang, H.; et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. BMJ 2020, 368, m1091. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Dennis, A.; Wamil, M.; Kapur, S.; Alberts, J.; Badley, A.D.; Decker, G.A.; Rizza, S.A.; Banerjee, R.; Banerjee, A. Multi-organ impairment in low-risk individuals with long COVID. MedRxiv 2020. [Google Scholar] [CrossRef]
- Del Rio, C.; Collins, L.F.; Malani, P. Long-term health consequences of COVID-19. JAMA 2020, 17, 1723–1724. [Google Scholar] [CrossRef] [PubMed]
- Pfaff, E.R.; Madlock-Brown, C.; Baratta, J.M.; Bhatia, A.; Davis, H.; Girvin, A.; Hill, E.; Kelly, E.; Kostka, K.; Loomba, J.; et al. Coding long COVID: Characterizing a new disease through an ICD-10 lens. BMC Med. 2023, 21, 58. [Google Scholar] [CrossRef] [PubMed]
- Buonsenso, D.; Munblit, D.; De Rose, C.; Sinatti, D.; Ricchiuto, A.; Carfi, A.; Valentini, P. Preliminary evidence on long COVID in children. Acta Paediatr. 2021, 110, 2208–2211. [Google Scholar] [CrossRef]
- Smane, L.; Stars, I.; Pucuka, Z.; Roge, I.; Pavare, J. Persistent clinical features in paediatric patients after SARS-CoV-2 virological recovery: A retrospective population-based cohort study from a single centre in Latvia. BMJ Paediatr. Open 2020, 4, e000905. [Google Scholar] [CrossRef]
- Osmanov, I.M.; Spiridonova, E.; Bobkova, P.; Gamirova, A.; Shikhaleva, A.; Andreeva, M.; Blyuss, O.; El-Taravi, Y.; DunnGalvin, A.; Comberiati, P.; et al. Risk factors for post-COVID-19 condition in previously hospitalised children using the ISARIC Global follow-up protocol: A prospective cohort study. Eur. Respir. J. 2021, 59, 2101341. [Google Scholar] [CrossRef]
- Characterising Long-Term COVID-19: A Rapid Living Systematic Review. Available online: https://www.researchgate.net/publication/347544771_Characterising_long-term_covid-19_a_rapid_living_systematic_review (accessed on 5 July 2021).
- National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases 1. Last Updated 8 April 2021. Available online: https://www.cdc.gov/ncird/index.html (accessed on 16 January 2022).
- Lopez-Leon, S.; Wegman-Ostrosky, T.; Perelman, C.; Sepulveda, R.; Rebolledo, P.A.; Cuapio, A.; Villapol, S. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. Sci. Rep. 2021, 11, 16144. [Google Scholar] [CrossRef]
- Nasserie, T.; Hittle, M.; Goodman, S.N. Assessment of the Frequency and Variety of Persistent Symptoms among Patients with COVID-19: A systematic review. JAMA Netw. Open 2021, 4, e2111417. [Google Scholar] [CrossRef]
- Thomson, H. Children with long covid. New Sci. 2021, 249, 10–11. [Google Scholar] [CrossRef]
- Kompaniyets, L.; Bull-Otterson, L.; Boehmer, T.K.; Baca, S.; Alvarez, P.; Hong, K.; Hsu, J.; Harris, A.M.; Gundlapalli, A.V.; Saydah, S. Post–COVID-19 Symptoms and Conditions Among Children and Adolescents—United States, March 1, 2020–January 31, 2022. MMWR. Morb. Mortal. Wkly. Rep. 2022, 71, 993–999. [Google Scholar] [CrossRef] [PubMed]
- USnews.com. CDC Expected to Release Guidance on Identifying, Managing Long COVID. 2021. Available online: https://www.usnews.com/news/health-news/articles/2021-05-07/cdc-to-release-clinical-guidance-on-identifying-managing-long-covid (accessed on 6 August 2022).
- Geddes, L. Why Strange and Debilitating Coronavirus Symptoms Can Last for Months. New Scientist 2020. Available online: https://www.newscientist.com/article/mg24632881-400-why-strange-and-debilitating-coronavirus-symptoms-can-last-for-months/ (accessed on 22 June 2021).
- Gemelli Against COVID-19 Post-Acute Care Study Group. Post-COVID-19 global health strategies: The need for an interdisciplinary approach. Aging Clin. Exp. Res. 2020, 32, 1613–1620. [Google Scholar] [CrossRef] [PubMed]
- WHO, H. Expanding Our Understanding of Post COVID-19 Condition: Children and Young Persons; Report of a WHO Webinar—17 August 2022. Post COVID-19 Condition: Children and Young Persons. Available online: https://www.who.int/news-room/events/detail/2022/08/17/default-calendar/post-covid-19-condition--children-and-young-persons (accessed on 23 December 2022).
- Briggs, A.; Vassall, A. Count the cost of disability caused by COVID-19. Nature 2021, 593, 502–505. [Google Scholar] [CrossRef] [PubMed]
- Tleyjeh, I.M.; Kashour, T.; Riaz, M.; Amer, S.A.; AlSwaidan, N.; Almutairi, L.; Halwani, R.; Assiri, A. Persistent COVID-19 symptoms at least one month after diagnosis: A national survey. J. Infect. Public Health 2022, 15, 578–585. [Google Scholar] [CrossRef]
- Algaissi, A.A.; Alharbi, N.K.; Hassanain, M.; Hashem, A.M. Preparedness and response to COVID-19 in Saudi Arabia: Building on MERS experience. J. Infect. Public Health 2020, 13, 834–838. [Google Scholar] [CrossRef] [PubMed]
- Bestall, J.C.; Paul, E.A.; Garrod, R.; Garnham, R.; Jones, P.W.; Wedzicha, J.A. Usefulness of theMedical Research Council (MRC) dyspnoea scale as a measure of disability in patients withchronic obstructive pulmonary disease. Thorax 1999, 54, 581–586. [Google Scholar] [CrossRef] [Green Version]
- Timbol, C.R.; Baraniuk, J.N. Chronic fatigue syndrome in the emergency department. Open Access Emerg. Med. 2019, 11, 15–28. [Google Scholar] [CrossRef] [Green Version]
- Topp, C.W.; Østergaard, S.D.; Søndergaard, S.; Bech, P. The WHO-5 Well-Being Index: Asystematic review of the literature. Psychother. Psychosom. 2015, 84, 167–176. [Google Scholar] [CrossRef]
- Fleisher, L.A.; Beckman, J.A.; Brown, K.A.; Calkins, H.; Chaikof, E.L.; Fleischmann, K.E.; Freeman, W.K.; Froehlich, J.B.; Kasper, E.K.; Kersten, J.R.; et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery). J. Am. Coll. Cardiol. 2007, 50, e159–e241. [Google Scholar]
- Kroenke, K.; Spitzer, R.L.; Williams, J.B.W. The PHQ-9. J. Gen. Intern. Med. 2001, 16, 606–613. [Google Scholar] [CrossRef]
- Swinson, R.P. The GAD-7 scale was accurate for diagnosing generalised anxiety disorder. BMJ Evid.-Based Med. 2006, 11, 184. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Saudi Ministry of Health Portal. MOH Minister to Launch the 937-Service (MOH Emergency Call Center) Tomor-row. 2013. Available online: https://www.moh.gov.sa/en/937/Pages/default.aspx (accessed on 5 March 2019).
- Funk, A.L.; Kuppermann, N.; Florin, T.A.; Tancredi, D.J.; Xie, J.; Kim, K.; Finkelstein, Y.; Neuman, M.I.; Salvadori, M.I.; Yock-Corrales, A.; et al. Post–COVID-19 Conditions Among Children 90 Days After SARS-CoV-2 Infection. JAMA Netw. Open 2022, 5, e2223253, Erratum in JAMA Netw. Open. 2022, 5, e2231131. [Google Scholar] [CrossRef] [PubMed]
- Molteni, E.; Sudre, C.H.; Canas, L.S.; Bhopal, S.S.; Hughes, R.C.; Antonelli, M.; Murray, B.; Kläser, K.; Kerfoot, E.; Chen, L.; et al. Illness duration and symptom profile in symptomatic UK school-aged children tested for SARS-CoV-2. Lancet Child Adolesc. Health 2021, 5, 708–718. [Google Scholar] [CrossRef]
- Miller, F.; Nguyen, V.; Navaratnam, A.M.; Shrotri, M.; Kovar, J.; Hayward, A.C.; Fragaszy, E.; Aldridge, R.W.; Hardelid, P.; on behalf of the VirusWatch Collaborative. Prevalence and Characteristics of Persistent Symptoms in Children During the COVID-19 Pandemic: Evidence From a Household Cohort Study in England and Wales. medRxiv 2021. [Google Scholar] [CrossRef]
- Stephenson, T.; Pereira, S.M.; Shafran, R.; De Stavola, B.L.; Rojas, N.; McOwat, K.; Simmons, R.; Zavala, M.; O’Mahoney, L.; Chalder, T.; et al. Long COVID—The Physical and Mental Health of Children and Non-Hospitalised Young People 3 Months after SARS-CoV-2 Infection; a National Matched Cohort Study (The CLoCk) Study. Research Square. Posted August 10, 2021. Available online: https://assets.researchsquare.com/files/rs-798316/v1/82480913-3b6d-47fc-9d50-096244918954.pdf?c=1632402660 (accessed on 13 October 2021).
- Buonsenso, D.; Munblit, D.; De Rose, C.; Sinatti, D.; Ricchiuto, A.; Carfi, A.; Valentini, P. Preliminary evidence on long COVID in children. medRxiv 2021. [Google Scholar] [CrossRef] [PubMed]
- Say, D.; Crawford, N.; McNab, S.; Wurzel, D.; Steer, A.; Tosif, S. Post-acute COVID-19 outcomes in children with mild and asymptomatic disease. Lancet Child Adolesc. Health 2021, 5, e22–e23. [Google Scholar] [CrossRef] [PubMed]
- Radtke, T.; Ulyte, A.; Puhan, M.A.; Kriemler, S. Long-term Symptoms After SARS-CoV-2 Infection in Children and Adolescents. JAMA 2021, 326, 869–871. [Google Scholar] [CrossRef] [PubMed]
- Sudre, C.H.; Murray, B.; Varsavsky, T.; Graham, M.S.; Penfold, R.S.; Bowyer, R.C.; Pujol, J.C.; Klaser, K.; Antonelli, M.; Canas, L.S.; et al. Attributes and predictors of long COVID. Nat. Med. 2021, 27, 626–631. [Google Scholar] [CrossRef]
- Epstein, D.; Andrawis, W.; Lipsky, A.M.; Abu Ziad, H.; Matan, M. Anxiety and Suicidality in a Hospitalized Patient with COVID-19 Infection. Eur. J. Case Rep. Intern. Med. 2020, 7, 001651. [Google Scholar] [CrossRef]
- Enns, M.W.; Larsen, D.K.; Cox, B.J. Discrepancies between self and observer ratings of depression: The relationship to demographic, clinical and personality variables. J. Affect. Disord. 2000, 60, 33–41. [Google Scholar] [CrossRef]
- Dunstan, D.A.; Scott, N.; Todd, A.K. Screening for anxiety and depression: Reassessing the utility of the Zung scales. BMC Psychiatry 2017, 17, 329. [Google Scholar] [CrossRef] [PubMed]
- Liu, L.; Wang, X.; Hao, Y.; Yang, J.; Yang, D.; Duan, X.; Fang, G.; Han, B.; Jiang, C.; Li, J.; et al. The Gaps Between the Self and Professional Evaluation in Mental Health Assessment of COVID-19 Cluster Cases. Front. Psychol. 2021, 12, 614193. [Google Scholar] [CrossRef] [PubMed]
- Poenaru, S.; Abdallah, S.J.; Corrales-Medina, V.; Cowan, J. COVID-19 and post-infectious myalgic encephalomyeli-tis/chronic fatigue syndrome: A narrative review. Ther. Adv. Infect. Dis. 2021, 8, 20499361211009385. [Google Scholar]
- Simani, L.; Ramezani, M.; Darazam, I.A.; Sagharichi, M.; Aalipour, M.A.; Ghorbani, F.; Pakdaman, H. Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19. J. Neurovirology 2021, 27, 154–159. [Google Scholar] [CrossRef]
- Wong, T.L.; Weitzer, D.J. Long COVID and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS)-a systemic review and comparison of clinical presentation and symptomatology. Medicina 2021, 57, 5. [Google Scholar] [CrossRef] [PubMed]
- Davis, H.E.; Assaf, G.S.; McCorkell, L.; Wei, H.; Low, R.J.; Re’em, Y.; Redfield, S.; Austin, J.P.; Akrami, A. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021, 38, 101019. [Google Scholar] [CrossRef] [PubMed]
- Huang, C.; Huang, L.; Wang, Y.; Li, X.; Ren, L.; Gu, X.; Kang, L.; Guo, L.; Liu, M.; Zhou, X.; et al. 6-month consequences of COVID-19 in patients discharged from hospital: A cohort study. Lancet 2021, 397, 220–232. [Google Scholar] [CrossRef] [PubMed]
- Xiong, Q.; Xu, M.; Li, J.; Liu, Y.; Zhang, J.; Xu, Y.; Dong, W. Clinical sequelae of COVID-19 survivors in Wuhan, China: A sin-gle-centre longitudinal study. Clin. Microbiol. Infect. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis. 2021, 27, 89–95. [Google Scholar] [CrossRef] [PubMed]
- Munblit, D.; Bobkova, P.; Spiridonova, E.; Shikhaleva, A.; Gamirova, A.; Blyuss, O.; Nekliudov, N.; Bugaeva, P.; Andreeva, M.; DunnGalvin, A.; et al. Incidence and risk factors for persistent symptoms in adults previously hospitalized for COVID-19. Clin. Exp. Allergy J. Br. Soc. Allergy Clin. Immunol. 2021, 51, 1107–1120. [Google Scholar] [CrossRef]
- Augustin, M.; Schommers, P.; Stecher, M.; Dewald, F.; Gieselmann, L.; Gruell, H.; Horn, C.; Vanshylla, K.; Di Cristanziano, V.; Osebold, L.; et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: A longitudinal prospective cohort study. Lancet Reg. Health Eur. 2021, 6, 100122. [Google Scholar] [CrossRef]
- Menditto, V.G.; Fulgenzi, F.; Bonifazi, M.; Gnudi, U.; Gennarini, S.; Mei, F.; Salvi, A. Predictors of readmission requiring hos-pitalization after discharge from emergency departments in patients with COVID-19. Am. J. Emerg. Med. 2021, 46, 146–149. [Google Scholar] [CrossRef] [PubMed]
- Burgers, J. “Long COVID”: The Dutch response. BMJ 2020, 370, m3202. [Google Scholar] [CrossRef] [PubMed]
- Visco, V.; Vitale, C.; Rispoli, A.; Izzo, C.; Virtuoso, N.; Ferruzzi, G.J.; Santopietro, M.; Melfi, A.; Rusciano, M.R.; Maglio, A.; et al. Post-COVID-19 Syndrome: Involvement and Interactions between Respiratory, Cardiovascular and Nervous Systems. J. Clin. Med. 2022, 11, 524. [Google Scholar] [CrossRef] [PubMed]
<18 Y T = 1245 F (%) | 18–65 y T = 4399 F (%) | ≥65 y T = 265 F (%) | (p) | |
---|---|---|---|---|
Age (y) | 11 | 37 | 70 | |
Median (mean ± SD) | (1–17) | (18–64) | (65–98) | (0.00 *) |
Nationality | ||||
Saudi | 1150(92.4) | 3880(88.2) | 246(92.8) | |
Non-Saudi | 95(7.6) | 519(11.8) | 19(7.2) | (<0.001 *) |
Marital status | ||||
Child | 501(40.2) | 0(0.0) | 0(0.0) | |
Single | 731(58.7) | 1058(24.1) | 1(0.4) | |
Married | 13(1.0) | 3224(73.3) | 246(92.8) | (<0.001 *) |
Divorced/widow | 0(0.0) | 117(2.7) | 18(6.8) | |
Occupation | (<0.001 *) | |||
Child | 355(28.5) | 0(0.0) | 0(0.0) | |
Student | 874(70.2) | 298(6.7) | 0(0.0) | |
Housewife/not working/retired | 12(1.0) | 1101(25.0) | 235(88.7) | |
Work in contact with public | 1(0.1) | 2011(45.7) | 12(4.5) | |
Don’t work in contact with public | 3(0.2) | 739(16.8) | 17(6.4) | |
Level of education | (<0.001 *) | |||
Child | 303(24.3) | 0(0.0) | 0(0.0) | |
Illiterate | 15(1.2) | 67(1.5) | 25(9.4) | |
Primary/read and write | 407(32.7) | 234(5.3) | 106(40.0) | |
Preparatory | 224(18.0) | 232(5.3) | 16(6.0) | |
Secondary | 286(23.0) | 903(20.5) | 18(6.8) | |
University or higher | 11(0.9) | 2963(67.4) | 53(20.0) | |
Sex | ||||
Male | 601(49.3) | 1921(43.7) | 149(56.2) | (<0.001 *) |
Female | 644(51.7) | 2477(56.3) | 116(43.8) | |
Smoking | ||||
Not-smokers | 1147(6.80 | 3125(71.0) | 218(82.3) | |
Passive smokers | 85(6.8) | 220(5.0) | 7(2.6) | |
Smokers | 13(1.0) | 927(21.1) | 16(6.0) | (<0.001 *) |
Ex-smoker | 0(0.0) | 127(2.9) | 24(9.1) | |
BMI (kg/m2) | (<0.001 *) | |||
Underweight | 96(7.7) | 128(2.9) | 7(2.6) | |
Normal | 873(70.1) | 1933(43.9) | 109(41.1) | |
Overweight | 95(7.6) | 815(18.5) | 25(9.4) | |
Obese | 10(0.8) | 38(0.9) | 1(0.4) | |
Don’t know/not sure | 171(13.7) | 1485(33.9) | 123(46.4) | |
Co-morbidity | 35(2.8) | 470(10.7) | 144(54.3) | (0.00 *) |
On regular medications | 47(3.8) | 765(17.4) | 169(63.8) | (0.00 *) |
<18 y T = 1245 F (%) | 18–65y T = 4399 F (%) | ≥65 y T = 265 F (%) | (p) | |
---|---|---|---|---|
COVID-19 vaccination | (<0.001 *) | |||
Unvaccinated | 619(49.7) | 80(1.8) | 17(6.4) | |
Received only one dose | 35(2.8) | 65(1.5) | 12(4.5) | |
Received only two doses | 525(42.2) | 2826(64.2) | 91(34.3) | |
Received only three doses | 66(5.3) | 1417(32.2) | 139(52.5) | |
Received four doses | 1(0.1) | 11(0.3) | 6(2.3) | |
The acute COVID-19 symptoms | (<0.001 *) | |||
Asymptomatic | 127(10.2) | 388(8.8) | 41(15.5) | |
Symptomatic | 1118(89.8) | 4011(91.2) | 224(84.5) | |
Acute COVID-19 symptoms | ||||
Fever | 986(79.2) | 2977(67.7) | 155(58.5) | |
Nasal congestion | 399(32.0) | 896(20.4) | 32(12.1) | (<0.001 *) |
Fatigue | 79(6.3) | 667(15.2) | 20(7.5) | (<0.001 *) |
Sore throat | 298(23.9) | 1322(30.1) | 54(20.4) | (<0.001 *) |
Nausea and vomiting | 62(4.9) | 115(2.6) | 5(1.9) | (<0.001 *) |
Dyspnea | 93(7.5) | 561(12.8) | 50(18.9) | (<0.001 *) |
Cough | 474(38.1) | 1668(37.9) | 115(43.4) | (<0.001 *) |
Myalgia | 95(7.6) | 1094(24.9) | 49(18.5) | (0.20) |
Dizziness | 23(1.8) | 143(3.3) | 8(3.0) | (<0.001 *) |
Diarrhea | 37(2.9) | 108(2.5) | 4(1.5) | (0.33) |
Loss of appetite | 13(1.04) | 27(0.6) | 4(1.5) | (0.09) |
Loss of smell | 20(1.6) | 285(6.5) | 8(3.0) | (<0.001 *) |
Loss of taste | 32(2.3) | 371(8.4) | 10(3.8) | (<0.001 *) |
Headache | 175(14.1) | 1226(27.9) | 30(11.3) | (<0.001 *) |
Stomachache | 18(1.4) | 40(0.9) | 7(2.6) | (0.01 *) |
Chest pain | 0(0.0) | 103(2.3) | 6(2.3) | (<0.001 *) |
Night sweats | 2 (0.2) | 16(0.4) | 0(0.0) | (0.53) |
Conjunctivitis | 2(0.2) | 14(0.3) | 0(0.0) | (<0.001 *) |
Blurring of vision | 0(0.0) | 0(0.0) | 5(1.9) | (0.02 *) |
Poor concentration | 0(0.0) | 5(0.11) | 2(0.8) | (0.76) |
Others | 10(0.8) | 33(0.8) | 1(0.4) | |
Complications | (0.89) | |||
No | 1244(99.9) | 4394(99.9) | 260(98.1) | |
Pulmonary complications | 1(0.1) | 0(0.0) | 3(1.2) | |
Cardiovascular complications | 0(0.0) | 2(0.0) | 1(0.4) | |
Neurological complications | 0(0.0) | 3(0.0) | 0(0.0) | |
Psychiatric complications | 0(0.0) | 0(0.0) | 1(0.4) | |
Severity of infection | (0.00 *) | |||
Critical | 6(0.5) | 11(0.3) | 6(2.3) | |
Severe (managed at hospital) | 15(1.2) | 32(0.7) | 25(9.4) | |
Not severe (managed at home) | 1224(98.3) | 4356(99.0) | 234(88.3) | |
Post-recovery management | (0.00 *) | |||
Nothing | 1227(98.6) | 4370(99.3) | 249(94.0) | |
Re-hospitalized | 4(0.3) | 13(0.3) | 0(0.0) | |
Follow up plan | 11(0.9) | 15(0.3) | 15(5.7) | |
Referred to PHCCs | 3(0.2) | 1(0.0) | 1(0.4) |
<18 y T = 1245 F (%) | 18–65 T = 4399 F (%) | ≥65 y T = 265 F (%) | (p) | |
---|---|---|---|---|
Post-COVID-19 symptoms | ||||
Nothing | 1146(92.0) | 3612(82.1) | 215(81.1) | |
Cough | 38(3.1) | 191(4.3) | 17(6.4) | (<0.001 *) |
Dizziness | 3(0.24) | 23(0.5) | 0(0.0) | (0.03 *) |
Dyspnea | 23(1.8) | 176(4.0) | 10(3.8) | (0.42) |
Loss of appetite/loss of weight | 15(1.2) | 25(0.6) | 3(1.1) | (0.001 *) |
Nausea/vomiting | 1(0.08) | 12(0.3) | 3(1.1) | (0.04 *) |
Pain | 0(0.0) | 138(3.1) | 9(3.4) | (0.01 *) |
Chest pain | 3(0.24) | 29(0.7) | 2(0.8) | (<0.001 *) |
Stomachache | 5(0.4) | 91(2.1) | 5(1.9) | (0.21) |
Joint pain | 3(0.2) | 10(0.22) | 1(0.4) | (<0.001 *) |
Fatigue | 19(1.5) | 173(3.9) | 9(3.4) | (0.88) |
Sleep disturbances | 10(0.8) | 103(2.3) | 3(1.1) | (<0.001 *) |
Diarrhea | 1(0.00) | 10(0.22) | 1(0.4) | (0.002 *) |
Loss of smell | 4(0.3) | 75(1.7) | 1(0.4) | (0.484) |
Loss of taste | 0(0.0) | 0(0.0) | 1(0.4) | (<0.001 *) |
Loss of hearing/tetanus | 2(0.2) | 6(1.4) | 1(0.4) | ---- |
Headache | 5(0.4) | 76(1.7) | 0(0.0) | (0.61) |
Recurrent fever | 5(0.4) | 4(0.9) | 3(1.1) | (<0.001 *) |
Memory impairment | 5(0.4) | 129(2.9) | 00(0.0) | (0.364) |
Poor concentration | 8(0.7) | 38(0.9) | 4(1.6) | (0.001 *) |
Psychiatric impairment | 8(0.7) | 93(2.1) | 2(0.8) | (0.02 *) |
Hair loss | 6(0.4) | 60(1.4) | 1(0.4) | (0.51) |
Skin rash | 2(0.2) | 5(0.1) | 0(0.0) | (0.02 *) |
Menstrual disturbances | 3(0.2) | 44(1.0) | 0(0.0) | (<0.001 *) |
Others | 7(0.6) | 31(0.7) | 19(7.2) | |
Return to the pre-infection health status | ||||
Resolved | 1175(94.4) | 3899(88.6) | 227(85.7) | |
Unresolved | 70(5.6) | 500(11.4) | 38(14.3) | (0.00 *) |
Duration to return to the pre-infection health status (d) | ||||
Median (IQR) | 5(0–30) | 7(0–71) | 7.9(0–74) | (0.00 *) |
<18 y T = 1245 F (%) | 18–65 y T = 4399 F (%) | ≥65 y T = 265 F (%) | (p) | |
---|---|---|---|---|
Medical research council (MRC) dyspnea scale | ||||
Mild dyspnea | 1231(98.9) | 4335(98.5) | 256(96.7) | (<0.001 *) |
Moderate dyspnea | 13(1.0) | 59(1.4) | 4(1.5) | |
Severe dyspnea | 0(0.0) | 5(0.1) | 5(1.9) | |
None | 1(0.1) | 0(0.0) | 0(0.0) | |
WHO-5 well-being score | ||||
Mean (SD) | 75.9(13.1) a | 65.9(13.9) b | 60.9(24.3) c | (0.00 *) |
Chronic fatigability | ||||
No/unapplicable | 1155(92.8) | 3669(83.4) | 219(82.6) | |
Short-term memory impairment | 41(3.3) | 306(6.9) | 19(7.2) | |
Sore throat | 25(2.0) | 82(0.9) | 10(3.8) | |
Lymph node | 16(1.3) | 24(0.5) | 5(1.9) | |
Muscle pain | 36(2.9) | 225(5.1) | 54(20.3) | |
Difficult sleep | 36(2.9) | 200(4.5) | 52(19.6) | |
Extreme fatigability | 42(3.4) | 271(5.8) | 75(28.3) | |
Joint pain | 35(2.9) | 231(5.3) | 63(23.8) | |
Chronic fatigability scale | ||||
Median (IQR) | 1a(0–15) | 1b(0–21) | 2b(0–22) | (0.00 *) |
Depression (PHQ-2) | ||||
Median (IQR) | 0(0–6) | 0(0–6) | 0(0–6) | (0.00 *) |
Anxiety (GAD-2) | ||||
Median (IQR) | 0(0–6) | 0(0–6) | 0(0–6) | (0.00 *) |
Patient self-report functional status (PCFS) scale | 1216(97.7) | 4132(93.3) | 248(93.6) | (<0.0001 *) |
No functional status limits | 0(0.0) | 0(0.0) | 0(0.0) | |
Little functional status limits | 1(0.1) | 13(0.3) | 5(1.9) | |
Mild restriction | 10(0.8) | 127(2.9) | 4(1.5) | |
Moderate restriction | 2(0.2) | 11(0.3) | 3(1.1) | |
Severe restriction | 16(1.3) | 116(2.6) | 5(1.9) |
Variables | Univariable Analyses | Multiple Logistic Regression Model (Adjusted ORs) | ||
---|---|---|---|---|
Demographics | OR (95% CI) | p | OR (95% CI) | p |
Age (groups) | ||||
Adult (18 y to less than 65 y) | Reference | - | - | - |
Less than 18 y | 0.50 (0.34–074) | 0.025 * | 0.74 (0.62–0.88) | 0.020 * |
65 y or more | 12.68 (1.71–4.20) | <0.001 | 12.63 (1.64–4.23) | <0.001 |
Female gender | 0.55 (0.48–0.61) | <0.001 | 0.72 (0.62–0.82) | <0.001 |
Severity of SARS-CoV-2 infection | 4.83 (3.72–6.97) | 0.023 * | 1.93 (1.78–5.10) | 0.372 |
Smoking status | ||||
Never smoked | Reference | - | - | - |
Ex-smoker | 1.22 (1.00–1.49) | 0.050 | - | - |
Current smoker | 1.23 (1.05–1.45) | 0.012 * | - | - |
Unknown | 1.01 (0.60–1.69) | 0.975 | - | - |
Vaccination status | ||||
Unvaccinated | ||||
Received only one dose | 3.7 (1.34–6.74) | <0.001 * | 1.75 (1.48–2.16) | 0.001 * |
Received only two doses | 0.84 (0.77–0.91) | <0.001 * | 0.60 (0.46–0.77) | <0.001 |
Received only three doses | 0.27 (0.08–0.94) | 0.040 * | 0.47 (0.12–1.81) | 0.274 |
Received four doses | References | -- | -- | - |
BMI (kg/m2) | 1.97 (0.99–3.11) | <0.001 * | 1.91 (1.00–2.2) | <0.001 |
Comorbidities | 3.7(1.9–11.7) | <0.001 * | 2.1(1.0–3.6) | <0.001 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Alsagheir, A.; Amer, S.; Alzubaidi, L.; Alenezi, F.; Alamaa, T.; Asiri, A. A National Survey of Children, Adults, and the Elderly in the Fourth Wave of the COVID-19 Pandemic to Compare Acute and Post-COVID-19 Conditions in Saudi Arabia. J. Clin. Med. 2023, 12, 2242. https://doi.org/10.3390/jcm12062242
Alsagheir A, Amer S, Alzubaidi L, Alenezi F, Alamaa T, Asiri A. A National Survey of Children, Adults, and the Elderly in the Fourth Wave of the COVID-19 Pandemic to Compare Acute and Post-COVID-19 Conditions in Saudi Arabia. Journal of Clinical Medicine. 2023; 12(6):2242. https://doi.org/10.3390/jcm12062242
Chicago/Turabian StyleAlsagheir, Aeshah, Samer Amer, Lamya Alzubaidi, Fasial Alenezi, Tareef Alamaa, and Abdullah Asiri. 2023. "A National Survey of Children, Adults, and the Elderly in the Fourth Wave of the COVID-19 Pandemic to Compare Acute and Post-COVID-19 Conditions in Saudi Arabia" Journal of Clinical Medicine 12, no. 6: 2242. https://doi.org/10.3390/jcm12062242
APA StyleAlsagheir, A., Amer, S., Alzubaidi, L., Alenezi, F., Alamaa, T., & Asiri, A. (2023). A National Survey of Children, Adults, and the Elderly in the Fourth Wave of the COVID-19 Pandemic to Compare Acute and Post-COVID-19 Conditions in Saudi Arabia. Journal of Clinical Medicine, 12(6), 2242. https://doi.org/10.3390/jcm12062242