Long COVID common in Peru but not among Kenyan healthcare workers

Long COVID has emerged as a lingering problem for many people after SARS-CoV-2 infection, but we still do not fully understand how it behaves in populations exposed to other infectious diseases such as tuberculosis. Corresponding author Sara Suliman and colleagues set out to measure the prevalence and symptoms of long COVID — abbreviated LC in their report — in groups with differing exposure to Mycobacterium tuberculosis in Peru and Kenya. The researchers recruited HIV-uninfected pulmonary tuberculosis (TB) patients (n=36) and their household contacts (n=63) in Peru, and a larger group of healthcare workers (n=202) in Kenya. Study participants were sampled within two years of their SARS-CoV-2 diagnosis. To collect consistent clinical information, the team used study instruments adapted from a United States based study of LC. By comparing people with active or recent TB exposure to those without, and by looking across two countries with different healthcare settings and backgrounds, the study aimed to begin teasing apart whether TB comorbidity changes how often long COVID occurs or what it looks like.

The research used interviews and symptom questionnaires adapted from the United States based LC study to capture ongoing health problems after acute SARS-CoV-2 infection. In Peru, 41.4% of participants reported LC symptoms, and the most common complaints were neurological issues — for example headache and trouble sleeping — and musculoskeletal problems such as back pain. Importantly, the investigators did not find TB-associated significant differences in either the overall prevalence of LC or in the clinical phenotypes reported by participants in Peru. In Kenya, the healthcare worker cohort reported symptoms during the acute phase of COVID-19 and a decline in quality of life at that time, but they did not report persistent LC symptoms in the follow-up window. When the team compared quality-of-life measures before and after COVID-19 in Peru, the post-COVID-19 period was associated with a significant decline in all quality-of-life dimensions (p<0.01), with the exception of depression and anxiety, which did not change significantly (p=0.289).

Taken strictly from these results, the study shows that long COVID was common in the Peruvian sample and that those reporting LC tended to describe neurological and musculoskeletal symptoms. TB status in this group was not linked to a higher or different burden of long COVID symptoms, suggesting that TB exposure or active TB disease did not, in this sample, change the pattern or prevalence of LC. The lack of reported LC symptoms among Kenyan healthcare workers was an unexpected contrast, highlighting how findings can vary by location, population, or the way symptoms are reported and measured. The authors conclude that these preliminary observations underscore the need for long-term follow-up and larger studies in different geographic settings to dissect the impact of TB comorbidity on LC. Until more data are available, clinicians and public health teams should be aware that long COVID may appear differently across communities and that more research is needed to clarify these patterns.