Int J Pharm Pharm Sci, Vol 14, Issue 7, 1-5Original Article

ASSESSMENT OF QUALITY OF LIFE AND EFFECTS IN RECOVERED AND VACCINATED COVID-19 POPULATION: A CROSS-SECTIONAL OBSERVATIONAL STUDY

VANLALFAKZELI1, VARADHA PAYANGOTT1, ABUBAKER SIDDIQ2*

1Department of Pharmacy Practice, S J M College of Pharmacy, Chitradurga 577502, Karnataka, India, 2Department of Pharmacology, S J M College of Pharmacy, Chitradurga 577502, Karnataka, India
Email: siddiq.pharma@rediffmail.com

Received: 08 Apr 2022, Revised and Accepted: 03 Jun 2022

ABSTRACT

Objective: The main objective of this study was to assess the QOL (quality of life) and effects on the recovered and vaccinated COVID-19study population.

Methods: A cross-sectional observational study was carried out for six months among residential areas and selected individuals regardless of country. Demographic details and responses were collected through phone calls and also using google form questionnaires.

Results: A total of 264 subjects were enrolled in this study. In the selected study of recovered patients, it was found that females (mean score 21.9) experience high effects compared to males (mean score 39.6) since a low mean score means higher post-effects. In the evaluation of post-vaccination effects of the selected study population, it was found that males and females experience different levels of post-vaccination effects in which females(mean score 19.5) experience high effects comparatively to males (mean score 21.9). The result of the quality of life for both recovered patients and the vaccinated population infers that the younger age group was found to experience a high quality of life than the older age group who were>65 y of age.

Conclusion: The study concludes that the elderly population of>65 y of age and females based on gender were likely to suffer from post-COVID-19 effects and post-vaccination effects. It can also be concluded that the younger age group has a healthy standard of living compared to the age group>65 y.

Keywords: COVID-19 (Coronavirus disease 2019), Disease, Vaccine, Effects

© 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (https://creativecommons.org/licenses/by/4.0/)
DOI: https://dx.doi.org/10.22159/ijpps.2022v14i7.44882. Journal homepage: https://innovareacademics.in/journals/index.php/ijpps.

INTRODUCTION

COVID-19(Coronavirus disease 2019) is an infectious disease caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is a newly discovered coronavirus. The global pandemic caused by COVID-19 is ongoing, with a projected death toll of almost 3.5 million by 1st May 2021 [1].

The virus is typically rapidly spread from one person to another via respiratory droplets produced during coughing and sneezing. It is considered most contagious when people are symptomatic, although transmission may be possible before symptoms show in patients [2]. Time from exposure and symptom onset is generally between two and 14 d, with an average of five days. The first signs of the disease usually appear as dry cough and fever [3]. Common symptoms include fever, cough, sneezing, and shortness of breath. Other symptoms also include loss of taste or smell, nasal congestion, conjunctivitis(also known as red eye), sore throat, headache, muscle or joint pain, different types of skin rash, chills, or dizziness. Symptoms of severe COVID-19 disease include shortness of breath, confusion, persistent pain or pressure in the chest, and high temperature (above 38 degrees Celsius) [4].

The definitive diagnosis of COVID-19 is made by analyzing respiratory samples (collected by aspiration of the airways or sputum induction) [5]. The collection of nasopharyngeal aspirate, combined (nasal and oral) swab samples or samples of lower respiratory tract secretions (sputum, tracheal lavage fluid, or Bronchoalveolar lavage fluid) is recommended [6]. Coronavirus presence is also seen in feces and urine samples of the patient, some researchers are working on this for confirmation [7]. To confirm the disease, it is necessary to perform molecular biology tests that detect viral RNA. Severe cases should be transferred to a referral hospital for isolation and treatment. Individuals with mild symptoms should be followed at the primary health care level and should be advised to self-isolate at home [8]. Since there was limited knowledge of this new disease, the social distancing, use of face masks, and hand hygiene etiquettes were practiced as a general rule of thumb and the lesson learned from previous pandemic [9]. The use of PPE has been promoted to be used by health workers to decrease the transmission of the virus [10].

India is regarded as the vaccine manufacturing hub of the world and contributes about 60% to the global vaccine supply. The country can manufacture well over 3 billion COVID-19 vaccine doses annually [11]. Following the roll-out of COVID-19 vaccines across the globe, several countries have initiated large-scale vaccination programs to control the ongoing pandemic [12].

Long-term monitoring of adverse drug reactions and an urgent need for monitoring by pharmacovigilance is necessary for each country. It looks like such mild side effects are acceptable during COVID-19 vaccinations as the body will need some time to adopt the vaccination dose and to trigger the immune system to induce protective antibodies [13]. The short-term side effects of vaccines vary in their clinical presentation; however, they are commonly related to prophylactic vaccines’ humoral immune response. Hence, further independent studies on vaccine safety are strongly required to strengthen public confidence in the vaccine [14].

It is imperative to understand the possible outcome of COVID-19 recovered patients and the vaccinated population to safeguard their life in the future. As it is an ongoing pandemic at the moment, innumerable research still needs to be done to have more distinct knowledge and information regarding this disease [15].

MATERIALS AND METHODS

This study was a cross-sectional observational study and was conducted in selected residential areas in Kerala and Mizoram and selected individuals regardless of the country who got recovered from COVID-19 and got vaccinated with COVID-19 vaccines. This study was conducted for six months. The inclusion criteria include recovered COVID-19 patients and people who got vaccinated including both genders while people not infected with COVID-19 and those who are not vaccinated are excluded from this study. The study was approved by the Institutional Ethical Committee of SJM College of Pharmacy, Chitradurga with vide Ref: No. SJMCP/685/2021-22.

Statistical analysis

Evaluation of questionnaires was done using Google sheets. Quantitative data were expressed in frequency, percentage, p-value, degree of freedom, standard deviation, and confidence interval by using student t-test, one-way ANOVA, and Pearson's correlation in IBM SPSS version 28.9 software and Google sheets.

RESULTS

In the study of recovered COVID-19 patients, based on age, patients were mainly divided into 4 groups. This includes pediatric, young, young-old/middle age, and geriatric. Out of 122 patients, 13 were below 15 y, followed by 32 patients who were in 16-25 y, 30 patients were in 26-35 y, 16 patients were in 36-45 y, 13 patients were in 46-55 y, 10 patients were in 56-65 y and 8 patients were above 65 y of age group. The age group of 16-25 was found to have the highest number of recovered patients. The observations are shown in table 1.

Table 1: Distribution of patients according to age group

S. No. Age group Age group (Y) Frequency (n=122) Percent (%)
1 Pediatric ≤15y 13 10.7
2 Young 16-25 32 26.2
26-35 30 24.6
36-45 16 13.1
3 Young old/Middle age 46-55 13 10.7
56-65 10 8.2
4 Geriatric >65 y 08 6.6
Total 122 100

Among the 122 patients, 53 (43.5%) were females and 69 (56.5%) were males. In this study, female patients were more prone to COVID-19 than males. The results are shown in table 2.

Table 2: Distribution of patients according to gender

S. No. Gender Frequency Percent
1 Males 53 43.5
2 Females 69 56.5
Total 122 100

Out of 122 patients in the study, 53 were males and 69 were females and by pairing the samples, it can be inferred that males and females experience different levels of post-COVID effects and can be summarised that females experience high effects comparatively to males (mean score 21.9) since low mean score means higher post-COVID effects as shown in table 3.

Fig. 1: Pie chart representation of the distribution of post-vaccination effects in the total vaccinated population

Table 3: Distribution of post-COVID effects in COVID-19 recovered patients

Gender Mean N Std. deviation Std. error mean
Males 39.6667 53 3.37773 .50352
Females 21.9333 69 4.46909 .66621

Responses provided by the subjects for post-COVID effects

The post-COVID effects observed in patients show that fatigue was mostly identified in more common symptoms. Sleeplessness, loss of appetite, sadness, fear, and laziness were mostly occurring in less common symptoms and among the serious symptoms, increased heartbeat had the highest percentage. The results are shown in table 4.

Table 4: Distribution of responses provided by subjects for post-COVID effects

Category Symptoms experienced by the subject Response received
YES NO
Freq. (%) Freq. (%)
More common symptoms Fever 16 13.1 106 86.9
Cough 58 47.5 64 52.5
Cold 62 50.8 60 49.2
Fatigue/tiredness 68 55.7 54 44.3
Nausea/Vomiting 2 1.6 120 98.4
Diarrhea 5 4.1 117 95.9
Sore throat 17 13.9 105 86.1
Less common symptoms Sleeplessness 34 27.9 88 72.1
Dizziness 13 10.7 109 89.3
Headache 29 23.8 93 76.2
Pain under the eye 1 0.8 121 99.2
Sinus Congestion 9 7.4 113 92.6
Temporary vision loss 1 0.8 121 99.2
Blurry vision 3 2.5 119 97.5
Difficulty in concentrating 21 17.2 101 82.8
Memory Loss 12 9.8 110 90.2
Poor attention 15 12.3 107 87.7
Slow thinking 22 18.0 100 82.0
Poor executing of functions 21 17.2 101 82.8
A small amount of urine output 1 0.8 121 99.2
Confusion 11 9.0 111 91.0
Joint Pain 15 12.3 107 87.7
Back Pain 13 10.7 109 89.3
Muscle Pain 16 13.1 106 86.9
Joint Stiffness 3 2.5 119 97.5
Dry Mouth 18 14.8 104 85.2
Joint Swelling 1 0.8 121 99.2
Skin Lumps/Red Rashes 5 4.1 117 95.9
Finger Swelling 00 00 122 100.0
Pain in Abdomen 11 9.0 111 91.0
Feeling thirsty 21 17.2 101 82.8
Urine is dark yellow and smelly 6 4.9 116 95.1
Feeling light-headed and dizzy 7 5.7 115 94.3
Less urine flow 5 4.1 117 95.9
Swelling in the face 3 2.5 119 97.5
Swelling in the belly region, feet, or ankles 4 3.3 118 96.7
Puffiness around the eye especially in the morning 1 0.8 121 99.2
Sadness 56 45.9 66 54.1
Fear 62 50.8 60 49.2
Sluggishness 32 26.2 90 73.8
Weight loss 32 26.2 90 73.8
Blurred vision 3 2.5 119 97.5
Laziness 38 31.1 84 68.9
Less/no appetite 37 30.3 85 69.7
Pus production from cuts or wounds 1 0.8 121 99.2
NIL/low wound healing 7 5.7 115 94.3
Necrosis of wounds 3 2.5 119 97.5
Allergic reaction 6 4.9 116 95.1
Serious symptoms Breathlessness 32 26.2 90 73.8
chest pain 8 6.6 114 93.4
Trouble waking up 17 13.9 105 86.1
Increased heartbeat 34 27.9 88 72.1

In the study of 122 subjects, the COVID-19 recovered patient's QOL scores were assessed based on age group. The number of recovered patients in each age group is noted and the mean score is taken as the overall QOL score of each group. It can be inferred that comparatively, the age group of 16-25 y experiences high QOL than other age groups while the age group of>65 y experiences low QOL. The results are represented in table 5.

Table 5: Distribution of QOL scores in the different age groups

One-sample statistics
Age group N Mean Std. deviation Std. error mean
≤15yrs 13 70.3438 13.28984 2.34933
16-25 32 81.3077 12.57898 3.48878
26-35 30 62.7813 15.83531 2.79931
36-45 16 69.2667 15.86761 4.09700
46-55 13 72.1667 16.14048 4.65936
56-65 10 59.9000 18.46588 5.83943
>65 Y 8 38.8750 10.81583 3.82397

Post-vaccination effects in the vaccinated population

The COVID-19 vaccinated populations were identified and their demographic details, medical, clinical condition, and other relevant details such as comorbid conditions were collected through questionnaires. A total of 142 vaccinated subjects were enrolled in the study. The 142 vaccinated population is compared based on post-vaccinated effects in which body ache, dizziness, fever and redness, and pain at the site of injection are the most common side effects, while diarrhea, difficulty in breathing, and nausea/vomiting are among the least side effects. The results are shown below in fig. 1.

Out of 142 vaccinated population in the study, 96 were females and 46 were males and by pairing the samples, it can be inferred that males and females experience different levels of post-vaccination effects, the lesser the mean score higher the effects. The results are represented below in table 6.

Table 6: Distribution of post-vaccination effects in vaccinated population based on gender

Gender Mean N Std. deviation Std. error mean
Males 21.9541 46 2.4961 .24769
Females 19.5486 96 1.7590 .34120

Out of 142 vaccinated population, the effects of post-COVID vaccination is inferred based on age group and vaccination brand. In this table, we can see that Covishield has the highest post-vaccination effects in all age groups compared to other brands and ages. The results are shown in table 7.

Table 7: Distribution of post-vaccination effects based on age group and vaccination brand

Age group Covaxin Covishield Pfizer Sinoform
Freq. % Freq. % Freq. % Freq. %
18-34 13 65.0 42 38.9 01 8.3 01 50.0
35-54 05 25.0 32 29.6 11 91.7 01 50.0
55-64 02 10.0 21 19.4 00 0.0 00 0.0
Above 65 00 0.0 13 12.0 00 0.0 00 0.0
Total 20 100 108 100 12 100 02 100

In the study of 142 vaccinated subjects, the COVID vaccinated subject QOL scores are assessed based on age group. The mean score is taken as the overall QOL score of each group. It can be inferred that comparatively, the age group of 35-54 y experiences high QOL than other age groups, while the age group of>65 y experiences low QOL. The result is shown in table 8.

Table 8: Age group and QOL scores comparison in overall COVID-19 vaccinated population

One-sample statistics
Age group N Mean Std. deviation Std. error mean
18-34 57 73.2480 12.41206 3.98730
35-54 49 76.9541 10.14577 2.74212
55-64 23 72.1975 17.36474 4.96421
Above 65 13 57.3475 11.14790 2.24852

DISCUSSION

In our study, the majority of the sample collections were from several states of India, and the remaining were collected from different countries like UAE, Saudi Arabia, and the USA. A total of 264 samples were collected for the study using 4 questionnaires which of the following questionnaire is QOL analysis using a short-form survey of 36 questionnaires (SF36). A total of 519 responses were collected. 122 samples were collected from COVID-19 recovered patients. The same population was analyzed for quality of life (QOL) using the SF36 questionnaire. The rest of the samples were analyzed for effects of vaccination in the population which had a sample size of 142 in which 133 samples were analyzed for QOL in the vaccinated population. It has been revealed that older age group who are>65 y of age were more vulnerable to post-COVID-19 effects than those of younger age. The results are comparable to the study conducted by Vahia I et al., who found that older adults experienced disproportionately greater adverse effects from the pandemic, including more severe complications and higher mortality [16]. Similarly, Jaarsveld V et al. showed that the elderly population has been hit with some of the worst effects of the pandemic, with an increased risk of mental and physical health problems [17].

In the precis of QOL in recovered COVID-19 patients, it was visible that the younger age group 16-25 y experience high QOL than other groups while the age group>65 y experience low QOL which is comparable to the study done by Hansen M et al., in which the results suggest awareness of the long-term functional decline in older COVID-19 patients [18]. In the study of the effects of the COVID-19 vaccine on the population, females experience high post-vaccination effects compared to males. This study co-relates with the study conducted by McCartney P, which concludes that women exhibit a greater immune response that can facilitate vaccine efficacy, but they also experience more frequent and more severe adverse events [19]. As for the study of QOL in a vaccinated population, it was found that the age group>65 y experience low QOL while the age group 35-54 y experience high QOL.

The post-COVID effects observed in patients show that fatigue was mostly identified in more common symptoms that can be compared to the study done by Townsend L et al., in which the study highlights a lengthy post-infection fatigue burden that will impair quality of life and will have a significant impact on individuals, employers and healthcare systems [20]. The post-vaccination effects mostly perceived among the population include body ache, dizziness, fever and redness, and pain at the site of injection. This study can be related to the research conducted by Menni C et al., in which the research findings conclude that systemic and local side effects were reported by individuals after the first dose of BNT162b2 and after the first dose of ChAdOx1 nCoV-19 [21].

CONCLUSION

Gleaned from the study population, it was perceived that the elderly population of>65 y of age and females based on gender are likely to suffer from post-COVID-19 effects and post-vaccination effects. It was inferred that the 18-34 age group who got vaccinated with covishield shows more effects compared to other brands and ages. It can also be concluded that the younger age group has a healthy standard of living compared to the age group>65 y.

LIMITATION OF STUDY

The patients interviewed varied from children of 4 y of age to senior patients of 90 y, so the information collected from these patients may not be accurate because they may not be able to process what exactly is happening in their bodies. The samples collected for different brands of vaccine varied largely in the number of samples collected and some brands of vaccine samples were obtained in very few numbers.

ACKNOWLEDGEMENT

The authors would like to thank all the participants who had participated in the research activity, our family, friends, and the management for their continuous support and encouragement and for providing the necessary facilities to carry out this work through the Principal, SJMCP, Chitradurga.

FUNDING

Nil

AUTHORS CONTRIBUTIONS

All the authors have contributed equally.

CONFLICT OF INTERESTS

Declared none

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