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POST COVID-19 SYNDROME - HOW REAL IS LONG COVID?

Dr. Mersad Alimoradi 29 Jun 2022
POST COVID-19 SYNDROME - HOW REAL IS LONG COVID?

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Article Updated on 29 June 2022

This article is continuously updated.

Have you been infected with COVID-19? Are you still feeling tired? Have trouble sleeping? Trouble concentrating? In pain? Out of breath?

Post-acute COVID-19 syndrome is a constellation of symptoms that remain after a person recovers from a novel coronavirus infection. Studies show that the majority of people infected with COVID-19 end up with post-acute COVID-19 syndrome. These patients are usually referred to as corona long-haulers or as having long COVID.

Patients with long COVID usually have a wide variety of symptoms that interfere with their quality of life. These symptoms include anxiety, trouble concentrating, insomnia, depression, stress, fatigue, breathlessness, and chest pain. Long COVID can be even more severe in some cases, irreversibly damaging some vital organs, and leading to chronic sequelae.

Keep reading to learn more about persistent COVID-19, its symptoms, risk factors, and how you can deal with it.

What Is Long COVID?

Post-acute COVID-19 syndrome (also known as long COVID-19 syndrome, persistent COVID, and post-COVID syndrome) is a condition where a patient continues experiencing symptoms from a coronavirus infection after initial recovery.

In most cases, a mild or moderate COVID-19 infection usually lasts 2 weeks. In some cases, however, patients may experience persistent health problems even after they are no longer testing positive for the coronavirus illness.

Referred to as “long haulers”, these patients have coronavirus symptoms that persist or return three months after first testing positive for the COVID-19 virus. A post-COVID condition may involve a wide range of lasting health problems that can go on for weeks, months, and even years.

A similar post-viral syndrome was seen in the 2003 SARS epidemic and the 2012 MERS outbreak both of which were also caused by coronavirus infections. This strongly supported speculations that COVID-19 was no different.

As of  July 2021, long COVID is considered a disability under the Americans with Disabilities Act (ADA).

What Are the Symptoms Of Long COVID?

Post-COVID symptoms are symptoms that can come and go and cannot be explained by a different health condition.

The symptoms of long COVID can interfere with your daily functioning and can affect different organ systems. People who experience persistent COVID symptoms commonly report:

General symptoms such as:

  • Fatigue
  • fever
  • Post-exertional malaise (the worsening of symptoms even after minor physical or mental effort)

Respiratory symptoms such as:

  • Cough
  • Shortness of breath
  • Persistent need for oxygen

Cardiac symptoms such as:

  • Chest pain
  • Heart palpitations (fast or pounding heartbeats)

Neurological symptoms such as:

  • Headaches
  • Sleep disturbance
  • Brain fog (trouble thinking or concentrating)
  • Lightheadedness
  • Changes in taste and smell
  • Depression or anxiety
  • Post-traumatic Stress Disorder (PTSD) symptoms
  • Paresthesia (pins and needles sensation)

Digestive symptoms such as:

  • Diarrhea
  • Stomach aches

Other symptoms:

  • Joint pain
  • Muscle weakness
  • Hairloss
  • Changes in the menstrual cycle
  • Rashes

The frequency and prevalence of these symptoms are highly variable between studies. But overall, the most common symptoms are fatigue, anxiety, sleeping disorders, dyspnea, and chest pain.

Other complications and conditions can also develop after a coronavirus infection. These are usually called “sequalae” and are also included within the spectrum of the post-acute COVID-19 syndrome. Sequalae of COVID-19 include:

Who Is At Risk Of Developing Post-COVID?

Anyone who catches the novel coronavirus can be at risk of developing persistent COVID, even patients with mild symptoms or no symptoms at all.

Nevertheless, post-COVID conditions are more common in patients who had severe COVID-19 symptoms and people who are not vaccinated against the COVID-19 virus and become infected.

People more likely to develop long COVID may be:

  • Patients who experience more severe COVID-19 symptoms
  • Patients who were hospitalized or entered an intensive care unit due to a COVID-19 infection
  • Patients who required ventilation because of a COVID-19 infection
  • Patients with health problems prior to a novel coronavirus infection
  • Patients who develop multisystem inflammatory syndrome (MIS) before or during COVID-19 illness
  • Patients who are females (females are more likely to develop post-COVID anxiety and depression)
  • Patients with a higher body mass index (BMI)
  • Patients who are older
  • Patients of Black, Asian, or Minority Ethnicity (BAME)

It’s now clear that organ transplant recipients and patients with pre-existing health conditions such as cardiovascular disease, chronic kidney disease (CKD), and diabetes mellitus are more likely to develop severe COVID-19. Nonetheless, it’s still unclear whether these health problems increase the risk of developing long COVID as well.

Although less common, long-term effects of COVID-19 can occur in children and adolescents.

Intensive care unit admission and long COVID

Post-intensive care syndrome, or PICS, is a condition where a patient continues to experience health effects after they leave the intensive care unit (ICU).

These health problems may include muscle weakness, trouble with thinking and judgment, and PTSD symptoms.

Post-ICU syndrome is already recognized as an independent syndrome that can cause physical, psychiatric, and mental disturbances. Since these overlap with Long COVID, the post-ICU syndrome is thought to be an independent cause of long hauling COVID symptoms.

How Common Is Long COVID?

According to most studies, long-COVID occurs in the majority of people recovering from the infection and is not uncommon at all. Since the syndrome is still being heavily investigated, different reports from around the world cite different prevalence rates.

One study done in Wuhan, China, estimated that 76% of patients suffer from at least one post-covid symptom, with fatigue and muscular weakness being the most commonly reported ones (63%). Sleep difficulties and anxiety/depression were seen in 26% and 23% of patients respectively.

A different study done in Italy showed that up to 87.3% of patients had at least one post-COVID symptom 60 days after their infection. The most common persistent symptoms were fatigue, dyspnea, joint pain, and chest pain.

Another study done in the US found that 32.6% of patients had persistent symptoms 2 months after being infected with the coronavirus. Included were 18.9% who even reported worse symptoms than before. In this study, dyspnea, cough, and loss of taste and smell were the most common post-acute COVID symptoms.

A more comprehensive global study was made to examine the worldwide prevalence of post-COVID syndrome using a systematic review and meta-analysis. This study estimated that up to 95% of patients experienced one or more persistent COVID-19 symptoms with fatigue and memory problems being the most common reported symptoms.

It’s obvious that there’s still some discrepancy between studies. The numbers and reported long corona symptoms differ depending on the criteria and goals of the authors. Nevertheless, combined together, these studies give a more general idea of what post-acute COVID syndrome is as a whole.

What Causes Post-COVID Syndrome?

The COVID-19 virus has wreaked havoc in the world, causing a devastating pandemic that brought the healthcare sector to its knees. The virus was as aggressive when it comes to the human body itself.

The SARS-CoV-2 attacks nearly every body system we have, causing acute and long-term damage, some of which is irreversible.

Doctors are not entirely sure what causes long COVID-19. They believe that it’s probably multifactorial, with various dysfunctions causing it at the same time.

It is thought that a continued state of widespread inflammation could be the cause of post-acute COVID syndrome. The continued inflammation can affect each organ system in our body, causing a wide range of symptoms. So, long COVID is caused by an interplay of several factors:

  • Continued inflammatory response: Inflammation itself affects our cognition and behavior, causes fatigue, and weakness, and can lead to damage to different body parts. One study found that nearly 60% of patients had heart muscle inflammation (myocarditis) more than 2 months after their infection.
  • Sustained damage: The organ damage sustained during acute COVID-19 infection can persist for a long time, causing a wide variety of symptoms. During an inflammation response, endothelial and epithelial damage may occur due to the invasion of monocytes and neutrophils which are recruited to fight off the invading pathogen. Consequently, lung tissue becomes damaged resulting in acute respiratory distress syndrome (ARDS) and dyspnea after COVID.
  • Physiologic disruption: The SARS-CoV-2 virus causes disruption of many physiological processes, which can lead to serious aftermath. One example is the coagulation system. The coronavirus causes a persistent hypercoagulable state, putting patients at higher risk of developing emboli (blood clots).
  • Other factors: Medications and treatments used to combat the acute COVID-19 infection might play a role in later disturbances. One example is the post-Intensive care syndrome.

In addition, immobilization during disease, steroid use, and vitamin D deficiency because of COVID might contribute to bone demineralization. This condition causes bone pain and muscle weakness which are common post-COVID symptoms.

All of these factors, and more, come together to cause the long COVID syndrome. 

Is There a Treatment For Long COVID?

Since post-acute COVID-19 syndrome is still new, there are still no strict guidelines on how it can be treated.

The best way to treat hauling COVID-19 symptoms is by detecting them early. Several health authorities are already implementing screening algorithms in certain patient populations that are at high risk of developing long COVID. Follow-up after 4-6 weeks with these patients can include a wide variety of tests, depending on their risk factors and disease course:

  • Imaging studies
  • Breathing studies (pulmonary function tests)
  • Psychiatric evaluation
  • Kidney tests
  • Cardiac evaluation
  • Evaluation of clotting risk

Based on this, your physician can recommend therapy, rehabilitation, medications, and follow-up testing to lead you safely to a full recovery.

Multidisciplinary clinics are emerging to support patients who’ve had COVID-19 with their recovery. Physical therapy, breathing exercises, and other treatment options seem to be helpful.

Moreover, several clinical trials are testing different drugs and interventional therapies that may be able to treat the symptoms of long-haul COVID. For example, one clinical trial is testing a novel immune-modulating drug for patients who developed postural orthostatic tachycardia syndrome (POTS) after a SARS-CoV-2 infection.

Final Word

The best treatment for long COVID is the prevention of COVID-19 altogether. So, to avoid post-COVID-19 syndrome, and even more potentially dangerous outcomes, get your COVID-19 vaccine once you get the chance and take appropriate health precautions. 

To search for the best healthcare providers that offer either COVID-19 Treatment, or vaccines, please use the Mya Care search engine.

About the Author:
Dr. Mersad is a medical doctor, author, and editor based in Germany. He's managed to publish several research papers early in his career. He is passionate about spreading medical knowledge. Thus, he spends a big portion of his time writing educational articles for everyone to learn.

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