Understanding the long term Clinical and Social Consequences of COVID-19 in Guinea and Cameroon - COHORT 3CSC

Long term effect of COVID-19 is poorly documented in Africa where the epidemiology of the disease is different than the one in other regions of the world. The principal objective of our project is to describe the clinical and immuno-virological evolution 12 months after the diagnosis of SARS-Cov-2 infection and the socio-anthropological consequences for infected people in Guinea and Cameroon. Specific objectives include: To describe the prolonged clinical and neuro-psychological signs. To identify risk factors of these symptoms. To describe the dynamic of the markers of the infection (IgG against protein Spike and Nucleocapsid) and autoantibodies in blood. To describe the presence or persistence of the virus in stools and nasopharyngeal swabs during the course of the study. To describe the prevalence of known and emerging SARS-Cov-2 variants of interest of the virus. To document the potential reinfections. To analyse the perception of the COVID-19 by the Guinean and Cameroon populations through discourses (aetiology, complaints) and practices of care. To study the societal construction of the disease using the existing care offer and the recognition of the prolonged symptoms. To study the socio-economical and gendered inequalities that structure the recognition of the disease. We propose a multidisciplinary multicentre observational cohort study over 12 months, among SARS-Cov-2 infected adults. We will enrol 3 groups of participants at the time diagnosis of the infection (group 1 asymptomatic (N=500), group 2 with moderate symptoms (N=500) and group 3 with severe symptoms (N=250)), and a control group of non-infected participants (N=250). Participants will be enrolled in centres of OCentral African Republic and central hospital Yaoundé (Yaoundé, Cameroon) and centres of Gbessia and Kenien (Conakry, Guinea), and will be followed at the central hospital Yaoundé and the "Centre de Recherche de Formation en Infectiologie de Guinée" (CERFIG). A clinical and neurocognitive exam and psychological interview, using standardised questionnaires and scores, and a 6 min walking test will be done at enrolment and after 3, 6 and 12 months follow-up. Biological tests, a chest X-ray and an electrocardiogram will be done at enrolment. All these tests, and also spirometry and CT scan will be performed during follow-up based on clinical condition. Detection of the virus will be done in nasopharyngeal swab and stools at enrolment using real-time PCR, with genotyping of the virus in a sample of 260 participants per country. PCR will be repeated after 3 month in stools, and in case of suspicion of new infection. Serology will be done at enrolment and after 6 and 12 months. All analyses will be done in Cameroon and Guinea. For the anthropological assessment, observation of consultation will be done at each visit to observe how symptoms are expressed by the participants, and will be completed by interviews with healthcare providers to question the legitimacy of the prolonged symptoms within the health system. Observations and interviews will be done at participants' home to study the place of the COVID-19 within the ordinary family interactions. Considering that a major part of the therapeutic offer is self-medication and traditional medicine, we will conduct interviews with pharmacists and traditional healers to identify the available cares for people with prolonged symptoms of COVID-19. This study will be one of the first studies to document the evolution of people infected by the SARS-Cov-2 virus in sub-Saharan Africa using a multidisciplinary approach. It will improve the visibility and understanding of the problematic of the long term effect of the COVID-19 by countries' policy makers, which should improve its recognition and management.