Post COVID-19 condition among individuals hospitalized during Wave 1 and Wave 2 at Mulago National Referral Hospital and Entebbe Regional Referral Hospital, Uganda, 2020-2021

Abstract Introduction: The presence of long-term symptoms among COVID-19 survivors is referred to as Post COVID-19 condition (PCC). In Uganda, the burden of PCC is unknown. We described the spectrum of and risk factors for PCC among persons hospitalized with COVID-19 to inform decision-making. Methods We conducted a retrospective cohort study among randomly-selected COVID-19 survivors hospitalized at Mulago and Entebbe Referral Hospitals during Wave 1 (October 2020-December 2020) and Wave 2 (May 2021-June 2021) of the pandemic in Uganda. A PCC case was defined as persistent, returning, or new COVID-19 symptoms occurring during the 4–12 weeks after onset for non-severe disease and during the 8–12 weeks from onset for severe disease, without an alternative diagnosis in a person with confirmed SARS-CoV-2 infection. Patients were contacted by phone, and risk factors for PCC were established using modified Poisson regression. Findings: Among 798 COVID-19 survivors (Wave 1: 391; Wave 2: 407), we identified 63 (16%) cases of PCC in Wave 1 and 81 (20%) in Wave 2. In Wave 1, common PCC symptoms included chest pain (14; 18%) and cough (11; 14%), while Wave 2 patients reported fatigue (16; 20%) and cough (16; 20%). Severe disease (aIRR = 2.0, 95%CI: 1.4–2.6) and any comorbidity (aIRR = 1.9, 95%CI: 1.2–2.8) during Wave 1 and any comorbidity (aIRR = 2.6, 95% CI 2.1–3.3) during Wave 2 were associated with PCC. Interpretation: Approximately 1 in 5 previously-hospitalized COVID-19 survivors experienced PCC during both waves, emphasizing the need for close follow-up and appropriate post-COVID-19 care.