Health News

Symptoms and long-term sequelae in patients with severe Covid-19 disease and effects on physical and mental health

The most common symptoms and sequelae of COVID-19 (SARS-Cov-2) in survivors of the acute phase of the disease and vulnerable populations. Currently reported symptoms after 60 days of follow-up are: Chest pain-cough, shortness of breath-cough, anxiety-tachycardia, abdominal pain-nausea and lumbar joint pain.

In recent years, although the Covid-19 epidemic (or SARS-Cov-2) has been classified as a dangerous level B epidemic, people who have had the disease and survived the acute stage of the disease can persistent symptoms. for many months to come. There is no clear indication whether these symptoms last for a short time before remitting or can last for a long time, greatly affecting physical and mental health . In this article, we will describe symptoms that persist over time and possible predictors of persistence in the acute phase. Based on the literature available to date, fatigue/weakness, dyspnea, joint pain, depression, anxiety, memory loss, drowsiness, difficulty concentrating, and insomnia are the persistent symptoms reported. most common fox. How long-term these are remains unclear as there is currently no reliable research. Current evidence suggests that female subjects are more likely to have long-term sequelae one year after the acute episode.

The epidemiological and clinical characteristics and acute complications of patients with COVID-19 have been described in detail, but the long-term impact remains largely unclear. They mentioned persistent symptoms such as fatigue, shortness of breath, lung failure, and abnormalities on chest X-rays after discharge, but the full characteristics were not yet known.

What is post-Covid-19 syndrome?

Post-COVID-19 syndrome is considered a clinical condition in which symptoms persist for at least 2 months after the onset of acute illness or at and for at least 3 months after acute infection, except when diagnosed differently. According to a retrospective study, the rate of post-acute sequelae of SARS-CoV-2 is 11%, equivalent to 3/4 of patients without symptoms after 30 days of follow-up. Five of the specific symptoms highlighted at days 0-30, represent post-acute sequelae of SARS-CoV-2. The model identified 27% of cases with symptoms that predicted long-term illness. Women are more likely to work long-distance jobs than men and are present at all ages, with ages 50 to 20 accounting for 72% of cases. Symptoms after 60 days of monitoring to determine post-Covid-19 syndrome are: chest pain-cough, shortness of breath-cough, anxiety-tachycardia, abdominal pain-nausea and lumbar joint pain.

Detailed symptoms and who is susceptible to the disease

In a recent study , 76% of patients reported at least 1 of 6 symptoms 6 months after symptom onset, with higher rates in women. The most common symptoms are fatigue or muscle weakness and difficulty sleeping. Additionally, 23% of patients reported anxiety and depression at follow-up. The proportion of patients with pulmonary diffusion abnormalities at follow-up was higher in patients with more severe disease during the acute phase. Suspected cases of post-COVID-19 sequelae have a variety of symptoms affecting different organ groups and combinations. These symptoms cannot be attributed to any other cause, as the only significant event is recent COVID-19. Research in this area is scarce: nearly 90% of COVID-19 survivors have sequelae, including not only general symptoms such as fatigue but also severe neurological, cardiac, and neurological manifestations. kidney or respiratory system. However, persistent sequelae of COVID-19 are said to be common in people with the following risk factors: the elderly (over 50 years old), smokers and people with comorbidities such as hypertension, obesity, diabetes, chronic lung disease, cardiovascular disease, chronic kidney disease, chronic liver disease, cerebrovascular disease, cancer. and immunodeficiency.

After milder SARS-CoV-2 infection, infectious sequelae have been observed in observational studies that collected prescription data or electronic health records after 6 months of follow-up. Persistent shortness of breath is often associated with lung damage and decreased lung function in postmortem lung tissue. Furthermore, fatigue as a sequela of COVID-19 does not appear to be associated with dysfunction, although SARS-CoV-2 has also been detected in endothelial cells. About 90% of survivors are left with sequelae, including not only general symptoms such as fatigue but also severe neurological, cardiac, renal and respiratory manifestations.

According to a UK Biobank study, COVID-19 is also associated with long-term changes in brain structure. In a telephone survey of adults who tested positive for SARS-CoV-2, 95 (35%) of 274 respondents were symptomatic, including 22 (26%) in 85 subjects, aged 18–34, reported that they had not returned. with their usual health condition two weeks or more after the test.

Comments from world organizations on post-COVID-19 symptoms

The Pan American Health Organization has issued an epidemiological warning about the need for information on this issue. The World Health Organization (WHO) has added the term “post-COVID-19 condition” to the International Classification of Diseases to describe a condition that occurs as a result of possible SARS-CoV-2 infection or has been confirm, have symptoms that have lasted at least two months and cannot be explained by any other diagnosis. Persistent sequelae include increased body mass index, dyslipidemia findings, and decreased physical activity for months after infection with decreased aerobic threshold. The state’s anxiety and depression scale showed greater psychological consequences at short-term compared with long-term follow-up (180 days). In general, 10 months after infection, the patient will completely recover from sequelae and most complications will disappear, but some complications will disappear. Metabolic complications can still occur. Only young patients previously considered healthy and not requiring hospitalization fully recover from mild infections, as multisystem disease is less common in older adults or those hospitalized. The most common sequelae after COVID-19 are observed in older women, especially in those with severe complications during the acute phase of infection. More than 200 sequelae have been reported, the most common being dyspnea, changes in taste and smell, fatigue, and neuropsychological symptoms such as memory loss, anxiety, and depression. Associated risk factors also include female gender, more than 5 initial symptoms during the acute phase of COVID-19, early dyspnea, previous psychiatric disorders, and changes in D-dimer, reactive protein C and lymphocyte count.

An additional study reported that only 65% ​​of referred patients recovered to their preinfectious health status within 2–3 weeks. Although some complications of COVID-19 often resolve on their own, they can still cause severe disability, leading to prolonged bed rest and further limitation of daily activities, impairment of functioning, and increased mobility. physical activity, increased fatigue and shortness of breath. On the other hand, atypical persistent chest pain is reported in about 1 in 7 patients, as is an inability to concentrate, also known as “brain fog,” in 1 in 4 patients, although Although this symptom was reported in only 4 studies, other neurocognitive deficits were shown in equal proportions.

Related Articles

Back to top button