PERSISTENCE AND SPECTRUM OF LONG COVID IN INDIA: A CRITICAL REVIEW OF EVIDENCE UP TO FOUR YEARS POST SARS-CoV-2 INFECTION

Long COVID (LC), also referred to as Post-Acute Sequelae of COVID-19 (PASC), has emerged as a prolonged, multisystem health condition following acute SARS-CoV-2 infection. While global evidence on LC is expanding, long-term data from low- and middle-income countries remain limited. This review critically examines recent Indian evidence on long COVID, with particular focus on findings from Western India reporting persistence of symptoms up to four years post-infection. The reviewed literature highlights fatigue, respiratory complaints, neuro-psychiatric symptoms, and cardiovascular manifestations as dominant features, with severity of acute illness, mechanical ventilation, and antiviral therapy emerging as important correlates. The review synthesizes epidemiological patterns, symptom trajectories, clinical associations, lifestyle determinants, and variant-specific influences on long COVID. Methodological strengths, limitations, and public health implications are discussed. The review underscores the need for long-term surveillance, multidisciplinary care models, and India-specific policy responses to mitigate the sustained burden of long COVID.