Official Journal of the College of Nursing, University of Mosul

Author

Assist. Prof. Dr. Yousif Mohammed Younis/Adult NursingHawler Medical niversity/College of nursing

Abstract

 

The samples include patients who were recovered from acute COVID-19 with several symptoms. After discharging from Erbil hospitals still there were blame from some symptoms more than one month. Researcher aimed to find out the most common symptoms which are found in the first three months after discharging from hospitals.
Methods:
The study conducted on a descriptive cross-sectional study with a non-probability samples of 268 patients on post COVID-19 symptoms after recovery of patients in Erbil City Hospitals which specialized to manage infected person with corona virus disease. The data of this study was collected between February 2021 to July 2021.
Results: the results of 268 patients shows that the most samples were within age group (33-47) and was 44.4% which was more than other age group. The study found that female more than male. The most common patients were had Bachelor degree and more. Some of samples had all symptoms. Fatigue is the only symptom which found in the majority of patients. Most of the symptoms were found in the first month. Few symptoms show significant, highly significant and very highly significant relationship with some demographic characteristics, while other symptoms were show a non-significant relationship.
Conclusion: Female mostly got the disease, fatigue was the most common symptoms which found in the patients with COVID-19, then body ache and headache coming consequently. The majority of the COVID-19 symptoms occur in the first month, after this month symptoms gradually reduced in the second and third months.  

Keywords

Post Corona Virus Disease-19 Symptoms after recovery of Patients in Erbil City

¹ Yousif Mohammed Younis

1Assist. Prof. Dr. Yousif Mohammed Younis/Adult NursingHawler Medical niversity/College of nursing

ABSTRACT

The samples include patients who were recovered from acute COVID-19 with several symptoms. After discharging from Erbil hospitals still there were blame from some symptoms more than one month. Researcher aimed to find out the most common symptoms which are found in the first three months after discharging from hospitals.

Methods:

The study conducted on a descriptive cross-sectional study with a non-probability samples of 268 patients on post COVID-19 symptoms after recovery of patients in Erbil City Hospitals which specialized to manage infected person with corona virus disease. The data of this study was collected between February 2021 to July 2021.

Results: the results of 268 patients shows that the most samples were within age group (33-47) and was 44.4% which was more than other age group. The study found that female more than male. The most common patients were had Bachelor degree and more. Some of samples had all symptoms. Fatigue is the only symptom which found in the majority of patients. Most of the symptoms were found in the first month. Few symptoms show significant, highly significant and very highly significant relationship with some demographic characteristics, while other symptoms were show a non-significant relationship.

Conclusion: Female mostly got the disease, fatigue was the most common symptoms which found in the patients with COVID-19, then body ache and headache coming consequently. The majority of the COVID-19 symptoms occur in the first month, after this month symptoms gradually reduced in the second and third months.  

Keywords: COVID-19, Symptoms, Patients, Erbil.

Received: 03 October 2022, Accepted: 29 November 2022, Available online: 28  January 2023


INTRODUCTION

          Corona virus disease 19 is a pandemic viral disease with catastrophic global impact, its more contagious than normal influenza like that cluster outbreaks occur frequently. COVID-19 patients have symptoms similar to other common disease (1). COVID-19 is highly contagious virus that mainly attacks the lungs. It is transmitted through droplets created from sneezing and coughing from those infected, the virus enters the body via the nose, mouth and eyes. The coronavirus can directly infect a wide variety of cells in the body and trigger an overactive immune response which also causes damage throughout the body (2&3). Most patients feel a mild and brief disease with COVID-19, but some are felt struggling with symptoms include fatigue, chest pain, and breathlessness for months. The focus has been on saving lives during the pandemic, but there is now a growing recognition that patients are facing long term consequences of a COVID infection (4). Patients advocacy groups, many members of which identify themselves as long haulers, have helped contribute to the recognition of post-acute COVID-19, characterized by persistent symptoms and delayed or long term complications beyond 4 months from the onset of symptoms (5).  

          The most frequent symptoms of Corona Virus Disease 19 at the onset are cough, fever, asthenia, myalgia, altered smell and shortness of breathing (5&6).

          Extreme fatigue, nausea, chest tightness, severe headache, brain fog, and limb pain are among the recurring symptoms described by sufferers of COVID-19 for weeks and even months, after their diagnosis (6&7).

         Many people who report continuing symptoms are older or have underlying health conditions, the same factors that put patient at risk for a more serious case of COVID-19, like heart disease, or lung disease. The more chronic conditions a person had, the more likely they were to say they were not fully recovered (8).

          A patient who has recovered from a severe Covid-19 infection rings a bell in a sign of victory as they leave hospital. But experts say people can continue to experience persistent symptoms two months after testing negative (9). This disease is typically characterized by acute symptoms of fever, cough, and shortness of breathing. Most of patients recover completely within 2 weeks of first symptoms, but recovery may take 3 to 6 weeks in severe cases.(10)

Objectives of the study:

1- To find out the major post COVID-19 symptoms after recovery of patients within first three months.

2- To describe the relation between post COVID-19 symptoms and some demographic characteristics of patients.

Methods and Patients:

A descriptive cross sectional study conducted on post COVID-19 symptoms after recovery of patients in Erbil City.

Samples:

The samples of the study included patients who recurred and discharged from hospitals in Erbil City which specialized to corona virus infections.

Setting and Duration of the study:

The study conducted in Erbil City at patient's home who recovered from disease and started on February, 2021 to July, 2021.

Sampling:

A non-probability convenience sample of patients with post covid-19 symptoms.

Sample inclusion criteria:

All patients who willing and have ability to participate the study.

Sample exclusion criteria:

Who reject to participate the study and very tired.

Ethical consideration:

The proposal of the study will submit to the research scientific committee of nursing college to get approval prior to beginning the study.

 

Results:

Table 1: Demographic characteristics of 268 patients

Demographic Characteristics

F

%

Age Group/year

18-32

115

42.9

33-47

119

44.4

48-62

30

11.2

63-77

4

1.5

Gender

Male

129

48.1

Female

139

51.9

Level of education

Illiterate

0

0

Primary school

4

1.5

Secondary school

8

3

Bachelor and more

256

95.5

Total

268

100

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 1 show that age group (33-47) was the major group, female more than male and the most common of the study sample were had bachelor and more degree.

 

 

 

 

 

Table 2: Show post corona virus-19 symptoms of 268 patients

Post Covid-19 Symptoms

          Yes

           No

Total

F

%

F

%

F

%

Have chest pain

92

34.3

176

65.7

268

100

Have diarrhea

63

23.5

205

76.5

268

100

Have headache

150

56

118

44

268

100

Have cough

111

41.4

157

58.6

268

100

Have sweating

144

53.7

124

46.3

268

100

Felt loose of smell

136

50.7

132

49.3

268

100

Felt fatigue

196

73.1

72

26.9

268

100

Felt shortness of breathing

106

39.6

162

60.4

268

100

Have insomnia

93

34.7

175

65.3

268

100

Have sore throats

112

41.8

156

58.2

268

100

Have Body aches

173

64.6

95

35.4

268

100

Have Anxiety

115

42.9

153

57.1

268

100

Have Heart palpitation

71

26.5

197

73.5

268

100

 

This table show us that most of the sample were had no chest pain, diarrhea, cough, shortness of breathing, anxiety and palpitation. While other symptoms found such as headache, sweating, loose of smell, fatigue and body ache on the patients.

      Table 3:Post corona virus-19 symptoms through months

Months of Post Covid-19 Symptoms

Not Applicable

First

Month

Second Month

Third Month

Total

F

%

F

%

F

%

F

%

F

%

Have chest pain

179

66.8

76

28.4

10

3.7

3

1.1

268

100

Have diarrhea

207

77.2

49

18.3

10

3.7

2

0.7

268

100

Have headache

127

47.4

124

46.3

11

4.1

6

2.2

268

100

Have cough

165

61.6

87

32.5

10

3.7

6

2.2

268

100

Have sweating

132

49.3

121

45.1

13

4.9

2

0.7

268

100

Felt loose of smell

141

52.6

120

44.8

3

1.1

4

1.5

268

100

Felt fatigue

82

30.6

155

57.8

19

7.1

12

4.5

268

100

Felt shortness of breathing

159

59.3

93

34.7

9

3.4

7

2.6

268

100

Have insomnia

174

64.9

83

31

4

1.5

7

2.6

268

100

Have sore throats

152

56.7

88

32.8

14

5.2

14

5.2

268

100

Have Body aches

100

37.3

139

51.9

17

6.3

12

4.5

268

100

Have Anxiety

157

58.6

89

33.2

16

6

6

2.2

268

100

Have Heart palpitation

194

72.4

56

20.9

10

3.7

8

3

268

100

 

 

 

 

 

 

 

 

 

 

 

 

 

Table 3 show that 66.8% were had no chest pain at all, but 28% were had chest pain in the first month while 3.7% and 1.1% in the second and third months. Regarding diarrhea 77.2% were had no diarrhea, but 18.3% were had this symptom in the first month and less in the other months. About headache, 47.4% were had no headache, but 46.3% , 4.1% and 2.2% were had headache in the first, second and third months consequently. Most of them 61.6% were had no cough, while 32.5%, 3.7% and 2.2% were has cough in the first, second and third months. Nearly half of the sample had sweating. Also 45.1%, 4.9% and 0,7% were had sweating during the first, second and third months consequently.

Table 4 Relationship between age groups and post corona viru-19 symptoms of 268 patients

 

Post Covid-19 Symptoms

                          Age Group/years

P-value

Chi-square

Test

18-32

33-47

48-62

63-77

F

%

F

%

F

%

F

%

Have chest pain

Yes

45

48.9

39

42.4

6

6.5

2

2.2

0.212

NS

No

70

39.8

80

45.5

24

13.6

2

1.1

Have diarrhea

Yes

29

46

28

44.4

5

7.9

1

1.6

0.808

NS

No

86

42

91

44.4

25

12.2

3

1.5

Have headache

Yes

70

46.7

69

46

11

7.3

0

0

0.012

S

No

45

38.1

50

42.4

19

16.1

4

3.4

Have cough

Yes

53

47.7

44

39.6

14

12.6

0

0

0.160

NS

No

62

39.5

75

47.8

16

10.2

4

2.5

Have sweating

Yes

59

41

71

49.3

13

9

1

0.7

0.204

NS

No

56

45.2

48

38.7

17

13.7

3

2.4

Felt loose of smell

Yes

61

44.9

61

44.9

13

9.6

1

0.7

0.577

NS

No

54

40.9

58

43.9

17

12.9

3

2.3

Felt fatigue

Yes

88

44.9

81

41.3

23

11.7

4

2

0.274

NS

No

27

37.5

38

52.8

7

9.7

0

0

Felt shortness of breathing

Yes

55

51.9

40

37.7

8

7.5

3

2.8

0.026

S

No

60

37

79

48.8

22

13.6

1

0.6

Have insomnia

Yes

47

50.5

38

40.9

6

6.5

2

2.2

0.132

NS

No

68

38.9

81

46.3

24

13.7

2

1.1

Have sore throats

Yes

54

48.2

47

42

11

9.8

0

0

0.194

NS

No

61

39.1

72

46.2

19

12.2

4

2.6

Have Body aches

Yes

70

40.5

74

42.8

25

14.5

4

2.3

0.049

S

No

45

47.4

45

47.4

5

5.3

0

0

Have Anxiety

Yes

69

60

35

30.4

9

7.8

2

1.7

 0.001

VHS

No

46

30.1

84

54.9

21

13.7

2

1.3

Have Heart palpitation

Yes

37

52.1

29

40.8

4

5.6

1

1.4

0.183

NS

No

78

39.6

90

45.7

26

13.2

3

1.5

 

This table show that there was a significant relationship in symptoms have headache, felt shortness of breathing and have body ache. Also there was a highly significant relationship in only item have anxiety, while the rest symptoms were show non-significant relationship.

        Table 5 Relationship between gender and post corona virus-19 symptoms of 268 patients

 

Post Covid-19 Symptoms

Gender

P-value

Chi-square

Test

Male

Female

Yes

No

Yes

No

F

%

F

%

F

%

F

%

Have chest pain

37

28.7

92

71.3

55

39.6

84

60.4

0.061   S

Have diarrhea

23

17.8

106

82.2

40

28.8

99

71.2

0.035   S

Have headache

70

54.3

59

45.7

80

57.6

59

42.4

0.588  NS

Have cough

53

41.1

76

58.9

58

41.7

81

58.3

0.915  NS

Have sweating

73

56.6

56

43.4

71

51.1

68

48.9

0.366  NS

Felt loose of smell

68

52.7

61

47.3

68

48.9

71

51.1

0.535  NS

Felt fatigue

89

69

40

31

107

77

32

23

0.141  NS

Felt shortness of breathing

47

36.4

82

63.6

59

42.4

80

57.6

0.315  NS

Have insomnia

34

26.4

95

73.6

59

42.4

80

57.6

0.006  HS

Have sore throats

45

34.9

84

65.1

67

48.2

72

51.8

0.027    S

Have Body aches

92

71.3

37

28.7

81

58.3

58

41.7

0.026    S

Have Anxiety

39

30.2

90

69.8

76

54.7

63

45.3

 0.001 VHS

Have Heart palpitation

27

20.9

102

79.1

44

31.7

95

68.3

0.047    S

 

Table 5 show that there was a significant relationship in items have diarrhea, have sore throats, have body ache and heart palpitation. And also there was a highly significant relationship in item have insomnia and very highly significant in item have anxiety. While other items were show non-significant relationship. 

Table 6 Relationship between level of education and post corona virus-19 symptoms of 268 patients

 

Post Covid-19 Symptoms

Level of education

P-value

Chi-square

Test

Primary school

Secondary school

Bachelor and more

Yes

No

Yes

No

Yes

No

F

%

F

%

F

    %

F

%

F

%

F

%

Have chest pain

2

50

2

50

2

25

6

75

88

34.4

168

65.6

0.689 NS

Have diarrhea

2

50

2

50

2

25

6

75

59

23

197

77

0.449 NS

Have headache

0

0

4

100

4

50

4

50

146

57

110

43

0.070 NS

Have cough

2

50

2

50

2

25

6

75

107

41.8

149

58.2

0.599 NS

Have sweating

2

50

2

50

4

50

4

50

138

53.9

118

46.1

0.965 NS

Feel loose of smell

2

50

2

50

5

62.   5

3

37.5

129

50.4

127

49.6

0.796 NS

Feel fatigue

4

100

0

0

5

62.5

3

37.5

187

73

69

27

0.381 NS

feel shortness of breathing

4

100

0

0

2

25

6

75

100

39.1

156

60.9

0.033 S

Have insomnia

2

50

2

50

4

50

4

50

87

34

169

66

0.523 NS

Have sore throats

2

50

2

50

2

25

6

75

108

42.2

148

57.8

0.590 NS

Have Body aches

4

100

0

0

4

50

4

50

165

64.5

91

35.5

0.230 NS

Have Anxiety

4

100

0

0

5

62.5

3

37.5

106

41.4

150

58.6

0.033 S

Have Heart palpitation

1

25

3

75

2

25

6

75

68

26.6

188

73.4

0.993 NS

 

This table show us that there was a significant relationship in items felt shortness of breathing and have anxiety. While the rest symptoms were show non-significant relationship


Discussion:

         This study found that patients who had recovered from COVID-19, which involving 268 patients, the symptoms of COVID-19 in table 1, were show the most common within age group (33-47), while most of them were female and they had bachelor degree or more. Journal PLOS Medicine found that long COVID-19 symptoms were more common in women (11).

         Regarding table 2, show that most of the samples were had no chest pain, no diarrhea, no cough, no shortness of breathing, no anxiety and no heart palpitation. But some symptoms were found among samples such as headache, sweating, loose of smell, fatigue and body ache. A study show that most common lingering symptoms were shortness of breathing, fatigue and sleep disorders, also reported loss of taste and smell, anxiety and chest pain (12). According to the WHO, the most common symptoms of COVID-19 are fever, cough, fatigue, loss of taste and smell, while less common symptoms reported by WHO include sore throat, headache, body ache, diarrhea (13).

         About symptoms which found in the first three months of post COVID-19 symptoms after recovery patients in table 3, the majority of the study sample were had no chest pain, but 28.4% of them were had chest pain in the first month and the level of pain reduced in the second and third months. Also the majority of the samples were had no diarrhea, while 18.3% of the study samples were had diarrhea in the first month and this symptom reduced in the second and third months. Less than half of them had no headache, while near of half of the study samples were had headache in the first month and this symptom less occur in the second and third months.

         Most of them were had no cough, but more than quarter of the study samples were had cough in the first month, and less occur in the second and third months. Other symptoms such as sweating, loss of smells, shortness of breathing, insomnia, sore throats, anxiety and heart palpitation were had not occur. While most of them were had sweating, loss of smells, shortness of breathing, insomnia, sore throats, anxiety and heart palpitation in the first month and less occur in the other months. A study found in acute COVID-19, symptoms up to 4 weeks to more than 8 weeks such as fatigue, dyspnea, chest pain, and cough (14). Another study found that fatigue (12%), cough (10%), sore throat (9%) and headache (9%) were the most frequently reported symptoms (15).               Regarding fatigue and body aches more than half of them were had these two symptoms in the first month, but less occur in the second and third months. A study shows some symptoms in the first days of the time onset of the disease which found that 53.1% had fatigue, 43.4% had dyspnea, and 21.7% had chest pain.(16). Another study shows the symptoms during follow-up in the first three months after discharges in the hospitals, 20% of patients had fever, 60% of sample complained of cough, 62% of patients had chest pain and palpitation, 60% of samples complained of fatigue and 26% of them had diarrhea (17).

           Regarding relationship between age group and post COVID-19 in table4, show that there was very highly significant relationship in item have anxiety and show significant relationship in items have headache, felt shortness of breathing, have body ache. While other items were show non-significant relationship among symptoms and samples age groups. A study reported that the most common symptoms were dyspnea followed by cough and loss of taste among 32% of patients who reported symptoms during the first and second days of 488 patients after hospitalization from COVID-19.(18). Furthermore, table 5 show the relationship between gender and COVID-19 symptoms, researcher found that there was very highly significant relationship between gender and item have anxiety and show highly significant in item have insomnia. Also show the significant relationship in items have chest pain, diarrhea, sore throats, body ache and heart palpitation, while the results show that there was non-significant relationship among the rest items of COVID-19 symptoms and gender. About level of education table 6 show significant relationship in items felt shortness of breathing and have anxiety. While show non-significant relationship in rest items. To support this result a study found that there were non-significant relationship among COVID-19 symptoms such as fever, cough, sore throat, body ache, headache, while showed a significant relationship with symptom such as diarrhea (19).

References

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2-Joseph R. etal.  Modeling the Onset of Symptoms of COVID-19. 13 August, 2020. Available at www.http://doi.org. Accessed on 3,Jan. 2021.

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1-Coronavirus: The Long Term COVID-19 symptoms no one is talking about. TIMESOFINDIA.COM, Jan.18. 2022. Available at www.timesofindia.com. Accessed on June,6.2022.
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