Long COVID in India

According to the World Health Organization (WHO), India ranks third in the cumulative number of notified COVID-19 cases globally – after the United States and China – and ranks first among low and middle-income countries (LMICs). The toll of COVID-19 in India is most likely much higher than what is reported for notified cases due to lack of or poor surveillance systems in most Indian states, with COVID-19 deaths estimated to be 8-10 times higher than officially recorded. COVID-19 morbidity in India is also likely to be underestimated, with Long COVID prevalence expected to be severely underestimated. Due to India’s size and diversity, and varying surveillance capacity, prevalence of Long COVID varies by region. In a population-based survey of 11 districts in Delhi, 79.7% participants who had COVID-19 reported at least one symptom of Long COVID. In a web survey with health care workers in India, 66% reported experiencing Long COVID, with 28% saying they faced daily health issues after COVID-19. At one year follow-up using clinical registry data from 31 hospitals in India, 11.9% of people who had been hospitalized for COVID-19 between September 2020 and October 2022 reported having Long COVID (Khumar, Balla, et al 2023). After the first Omicron wave in Eastern India, 8.2% of people who had tested positive for SARS-CoV-2 reported having Long COVID (Arjun, Singh 2022).

In India, Long COVID has also been associated with loss of quality of life and loss of income. A survey with undergraduate students with Long COVID in Kochi, southwest India, has shown that 61.5% have poor quality of life. A study of patients from the Long COVID clinic from the Kalinga Institute of Medical Sciences in Bhubaneswar, northeast India, demonstrated that Long COVID was associated with a 16.6% loss of family income, with 20% of people with Long COVID having lost their entire source of income.