Improving Health and Well-Being of People With Post-COVID-19 Consequences in South Africa: Situation Analysis and Pilot Intervention Design.

BACKGROUND

Multisystemic complications post-COVID-19 infection are increasingly described in the literature, yet guidance on the management remains limited.

OBJECTIVES

This study aimed to assess the needs, preferences, challenges, and existing interventions for individuals with post-COVID-19 symptoms. Based on this, we aimed to develop a context-adapted intervention to improve the overall health and well-being of individuals with post-COVID-19 complications.

METHODS

We conducted a cross-sectional mixed-methods situation analysis assessing the needs, preferences, challenges, and existing interventions for patients with post-COVID-19 symptoms. We collected data through questionnaires, semistructured in-depth interviews, and focus group discussions (FGDs) from individuals diagnosed with COVID-19 within the previous 18-month period and health care providers who managed patients with COVID-19 in both inpatient and outpatient settings. Quantitative data were summarized using descriptive statistics, qualitative data were transcribed, and deductive analysis focused on suggestions for future interventions. Findings guided the development of a group intervention.

RESULTS

We conducted 60 questionnaires, 13 interviews, and 3 FGDs. Questionnaires showed limited knowledge of post-COVID-19 complications at 26.7% (16/60). Of those who received any rehabilitation for COVID-19 (19/60, 31.7%), 94.7% (18/19) found it helpful for their recovery. Just over half (23/41, 56%) of those who did not receive rehabilitation reported that they would have liked to. The majority viewed rehabilitation as an important adjunct to post-COVID-19 care (56/60, 93.3%) and that support groups would be helpful (53/60, 88.3%). Qualitative results highlighted the need for mental health support, structured post-COVID-19 follow-up, and financial aid in post-COVID-19 care. Based on the insights from the situation analysis, the theory of change framework, and existing post-COVID-19 evidence, we designed and conducted a pilot support group and rehabilitation intervention for individuals with post-COVID-19 complications. Our main objective was to assess the change in physical and psychological well-being pre- and postintervention. The intervention included 8 weekly themed group sessions supplemented by home tasks. Effectiveness of the intervention was evaluated by questionnaires pre- and postintervention on post-COVID-19 symptoms, quality of life with the EuroQoL 5-Dimension 5-Level, short Warwick-Edinburgh Mental Wellbeing Scale, and physical function by spirometry and 1-minute sit-to-stand test. We also assessed the feasibility and acceptability of the intervention by questionnaires and semistructured in-depth interviews. The intervention outcome analysis is yet to be conducted.

CONCLUSIONS

Insights from patients and health care providers on the characteristics of post-COVID-19 complications helped guide the development of a context-adapted intervention program with potential to improve health and well-being post-COVID-19.