Predictors of Long COVID-19 Syndrome and Hospital Admissions Among COVID-19-Diagnosed Adult Patients Who Self-Isolated at Home in KwaZulu-Natal Province, South Africa.

Long COVID-19 (LC) syndrome is a complex systemic illness that is currently recognised to have a high morbidity rate and hospitalisations. The study analysed factors linked to LC in adults self-isolated during COVID-19 infection in KwaZulu-Natal Province, South Africa, focusing on two densely populated districts (uMgungundlovu and eThekwini Metro Municipality). We employed a cross-sectional study among individuals aged 18 years and above who self-isolated at home. Demographic data, COVID-19 vaccination status, and post-COVID-19 health symptoms were collected using a standardised questionnaire. The National Health and Nutrition Survey's Physical Functioning Questionnaire was adapted to evaluate health and functional outcomes six months after a COVID-19 diagnosis, addressing both physical and psychosocial symptoms during that timeframe. A modified Poisson regression model was used to determine the predictors of LC and hospitalisation. Of the 280 participants, 46% (n = 130) reported having at least one health-related symptom, while 36% (n = 47) had ≥ five symptoms. Approximately half of the participants (50%, n = 139) had at least one hospital admission following infection due to persistent symptoms. Older age (aIRR 1.5; 95% CI: 1.2-3.2; p = 0.021), reinfection (aIRR 2.0; 95% CI: 1.3-3.0; p = 0.001), having positive household contacts (aIRR 2.1; 95% CI: 1.4-3.2; p < 0.001) and hospitalisation (aIRR 7.7; 95% CI: 3.8-15.6; p < 0.001) increased the risk of developing LC. Post-infection hospitalisation was significantly associated with symptoms such as anxiety (aIRR 1.4; 95% CI: 1.1-1.7; p = 0.009), depression (aIRR 1.9; 95% CI: 1.6-2.3; p < 0.001), sore throat (aIRR 1.5; 95% CI: 1.7-2.0; p = 0.002) and weight loss (aIRR 1.8; 95% CI: 1.4-2.4; p < 0.001). A considerable percentage of participants with post-SARS-CoV-2 infections presented with long-term complications and required medical intervention. Postpandemic healthcare planning and resource allocation need to be considered since increased morbidities associated with LC place a burden on the already inadequately funded healthcare system.