# Deep learning analysis of long COVID and vaccine impact in low- and middle-income countries (LMICs): development of a risk calculator in a multicentric study

## TL;DR

This study uses deep learning to analyze long-term effects of COVID-19 and vaccine impact in low- and middle-income countries, developing a risk calculator for chronic symptoms.

## Contribution

A novel deep learning-based risk calculator for predicting chronic fatigue, depression, and prolonged symptoms in post-COVID patients in LMICs.

## Key findings

- 68.1% of patients experienced symptoms lasting longer than 2 weeks, with common symptoms including loss of smell and dry cough.
- Vaccinated individuals had lower odds of prolonged symptoms, chronic fatigue syndrome, and depression.
- Predictive models achieved high AUC scores (0.87 for chronic fatigue, 0.82 for depression, and 0.74 for prolonged symptoms).

## Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global pandemic affecting millions worldwide. This study aims to bridge the knowledge gap between acute and chronic symptoms, vaccination impact, and associated factors in patients across different low- and middle-income countries (LMICs).

The study included 2,445 participants aged 18 years and older, testing positive for COVID-19. Data collection involved screening for medical histories, testing records, symptomatology, and persistent symptoms. Validated instruments, including the DePaul Symptom Questionnaire (DSQ-2) and the Patient Health Questionnaire-9 (PHQ-9), were used. We applied a self-supervised and unsupervised deep neural network to extract features from the questionnaire. Gradient boosted machines (GBM) model was used to build a risk calculator for chronic fatigue syndrome (CFS), depression, and prolonged COVID-19 symptoms.

Out of the study cohort, 68.1% of the patients had symptoms lasting longer than 2 weeks. The most frequent symptoms were loss of smell (46.8%), dry cough (40.1%), loss of taste (37.8%), headaches (37.2%), and sore throat (28.9%). The patients also reported high rates of depression (47.7%), chronic fatigue (6.5%), and infection after vaccination (23.7%). Factors associated with CFS included sex, age, and smoking. Vaccinated individuals demonstrated lower odds of experiencing prolonged COVID-19 symptoms, CFS, and depression. The predictive models achieved a high area under the curve (AUC) scores of 0.87, 0.82, and 0.74, respectively.

The findings underscore the significant burden of long-term symptoms such as chronic fatigue and depression, affecting a considerable proportion of individuals post-infection. Moreover, the study reveals promising insights into the potential benefits of vaccination in mitigating the risk of prolonged COVID-19 symptoms, CFS, and depression. Overall, this research contributes valuable knowledge towards comprehensive management and prevention efforts amidst the ongoing global pandemic.

Clinical trials.gov, NCT05059184.