This qualitative phenomenological study explored the lived experiences of adults living with post-acute sequelae of SARS-CoV-2 infection (PASC) in Rwanda. The primary aim was to describe how persistent post-COVID symptoms affected daily life and to identify context-appropriate interventions to improve quality of life for affected individuals.
Researchers used in-depth interviews and thematic analysis to capture participants' experiences. Data collection occurred across all provinces of Rwanda, including the City of Kigali, ensuring geographic representation across the country. Interviews continued until thematic saturation was reached.
Participants were adults who had tested positive for PASC during a prior nationwide prevalence study. The research team purposively sampled individuals across study sites to capture diverse experiences. A total of 30 people were interviewed before saturation.
Participants described a range of ongoing symptoms following acute COVID-19. Commonly reported problems included body weakness, persistent fatigue, breathlessness and memory loss. These symptoms were described as long-lasting and influential on participants' capacity to perform routine and occupational tasks.
Despite reporting clear changes in health and functioning since their COVID-19 illness, many participants remained uncertain about whether current symptoms were related to their previous infection. This uncertainty was amplified when healthcare providers did not ask about participants' COVID-19 history during consultations. The lack of routine clinical enquiry about prior infection contributed to ongoing confusion and hindered participants' understanding of their condition.
Persistent physical symptoms substantially affected participants' ability to work, particularly in physically demanding roles such as farming and manual labor that had previously provided income. Participants reported reduced capacity to perform these jobs, which led to loss of income and difficulty meeting basic household needs.
Financial consequences included hardship meeting costs for food and school fees. In many households the inability of an affected person to continue prior work translated directly into unmet basic needs and economic strain.
The combination of persistent symptoms, income loss and diagnostic uncertainty had significant psychosocial consequences. Participants reported feelings of frustration and sadness related to loss of productive capacity and role changes. Constant fear about the future, social isolation and depressive symptoms emerged as common experiences. Social stigma and limited access to specialist care further shaped the emotional burden.
Participants expressed clear requests for action: greater public awareness about PASC, more research into its symptoms and treatments, and for healthcare providers to routinely ask patients about prior COVID-19 infection during clinical encounters. These recommendations were grounded in participants' experiences of uncertainty and unmet needs.
Findings point to the need for comprehensive approaches that address the intertwined physical, emotional and socioeconomic dimensions of PASC. Specific implications reported in the study include:
The source emphasizes these system-oriented responses as priorities for mitigating the compounded burden experienced by people with PASC in Rwanda.
Individuals living with PASC in Rwanda face a compounded burden created by persistent symptoms, diagnostic uncertainty, limited specialist care and social stigma. The study calls for urgent action on provider education, public awareness and integrated psychosocial support. Future research should assess feasible, context-appropriate interventions to reduce the physical, emotional and socioeconomic impacts of PASC in low-resource settings. The source did not report specific intervention models or trial outcomes; it recommended further investigation to identify effective strategies.