Does Long COVID Exist in Sub-Saharan Africa?

Round 1

Reviewer 1 Report

This opinion titled “Does Long Covid Exist in Sub-Saharan Africa?” it is well structured and well written. The Authors show a correct and balanced review of the current literature analyzing the main aspects of "Long COVID". The conclusions are appropriate and shareable. In my opinion it is appropriate to accept it in its current form.

Author Response

Thank you very much for your positive comments and feedback. We appreciate the time you took to review our article.

Reviewer 2 Report

This manuscript designed as opinion is very poor description of scientific problem and not be of huge novelty in the scientific areas. 

English language presented in this manuscript must be fundamentally corrected. 

Author Response

Thank you for your comments, we have made some edits to the English in this paper. The novelty of this work is in highlighting the lack of sufficient data and insight into post infectious syndromes in diverse populations. We are highlighting the need to further extend research into long COVID in Africa. This is critical given the extensive immunogenetic diversity in Africa, limited data on exposure to other coronaviruses and limited data on post-infectious syndromes in this population.

Reviewer 3 Report

Post-viral syndromes have gained significant attention in recent years, particularly in relation to the COVID-19 pandemic. Long COVID, a cluster of persistent symptoms that occur weeks to years after the initial infection, has emerged as a distinct syndrome. While there is still a lack of consensus on its definition, medical institutions and societies are actively working to understand and address this condition.

 

The prevalence of Long COVID varies widely, ranging from 6% to 85%. It is important to note that diagnosing Long COVID can be challenging, often relying on exclusion criteria. However, the most commonly reported symptoms include fatigue or weakness, shortness of breath, chest pain or tightness, cough, and cognitive changes. These symptoms may persist for months and impact various aspects of daily life.

 

The concept of post-viral syndromes is not new, as similar symptoms were observed in survivors of past respiratory viral pandemics such as the 1918 Influenza pandemic, SARS, and MERS. Research has shown long-term consequences on cardiopulmonary health and persistent symptoms in a large proportion of survivors. Comparisons have been made with other post-viral syndromes like chronic fatigue syndrome and myalgic encephalomyelitis, providing valuable insights into the pathophysiology of Long COVID.

 

Studies investigating the impact of Long COVID across different racial groups are still limited, but some suggest that Hispanic race may be a risk factor for its development. Additionally, certain phenotypes of Long COVID, such as respiratory, fatigue-related, and neurocognitive symptoms, appear consistent across different countries.

 

Understanding the mechanisms behind Long COVID is crucial, and several proposed mechanisms include long-term organ damage, autonomic dysfunction, autoimmune responses, and alterations in gut microbiota. Risk factors for developing Long COVID include factors such as female sex, older age, existing lung disease, and hospital/ICU admission. Vaccination against COVID-19 has shown a potential protective effect, with some studies indicating a reduction in Long COVID among vaccinated individuals.

 

The impact of Long COVID on daily living has been profound, with a significant reduction in functional status and impairment in social functioning reported by a large number of affected individuals. The economic consequences of Long COVID have been a concern, with studies highlighting employment-related effects and substantial economic losses resulting from the pandemic.

 

Diagnosis and treatment of Long COVID remain challenging, and research on treatment options is still limited. Multimodal treatment approaches, including pharmacotherapy, physical and occupational therapy, rehabilitation, and complementary-alternative medicine, have been reported. Encouragingly, some studies suggest a decrease in symptoms over time, particularly respiratory symptoms.

 

Addressing Long COVID will continue to be a significant challenge for the global healthcare system, as there is currently a lack of consensus on how to identify, diagnose, monitor, and treat this condition. Moreover, the majority of research on Long COVID has been conducted in high-income countries, highlighting the need to adapt findings to an international setting and understand the specific characteristics and challenges within different populations.

 

In conclusion, despite the complexities surrounding Long COVID, the global medical community has made significant progress in recognizing and addressing this syndrome. Ongoing research and collaboration are crucial to develop effective diagnostic criteria, treatment options, and support systems for individuals affected by Long COVID. By leveraging our collective knowledge and expertise, we can provide hope and improve the lives of those experiencing the long-term effects of COVID-19.

 

Hovewer pplease add referenced to discussion:

doi: 10.1080/23744235.2021.1924397.

doi: 10.5603/CJ.a2021.0155.

doi: 10.1093/ehjqcco/qcab067.

doi: 10.1016/j.msard.2021.103268.

doi: 10.1016/j.ajem.2022.04.023. 

doi: 10.5603/CJ.a2021.0028. 

 

Author Response

Thank you very much for your thorough and thoughtful summary of our paper. We appreciate your reflections on the need for collaboration amongst global researchers and the potential impact of this research on the care and quality of life for people with Long COVID. We have added this point to the discussion section. Thank you for providing additional references on the clinical manifestations of Long COVID, I have added these references to our paper.