Long Covid

Muhammad Umer


1st Year MBBS, Islamabad Medical and Dental College

Introduction

“Long covid” is a term used to define illness in people who have recovered from covid but are still reporting lasting effects or have had the usual symptoms for far longer than would be predicted. Many individuals have shared their subjective experiences on social media, in the traditional media, and through patients' groups.1

Classification of Long Covid

Long covid is continuous or relapsing and remitting in nature. There can be the persistence of symptoms of severe COVID, or presence of new symptoms. Majority of people with post-covid are PCR negative. Post COVID syndrome is the time pause between the microbiological recovery and clinical recovery. Majority of those with long COVID show every kind of recovery. Depending upon the duration of symptoms, post or long COVID can be divided into two stages, post and acute COVID where symptoms extend beyond three weeks, but less than 12 weeks, and chronic COVID where symptoms spread beyond 12 weeks.2

Figure 1: Classification of long covid

Risk Factors for Long Covid

The risk of long COVID is twice more common in women than in men. Growing age is a risk factor and it is found that patients with long COVID are around four years older than those without long covid. Occurrence of more than five symptoms in the acute stage of illness is related with amplified risk of developing long COVID. Symptoms that are associated with long COVID include fatigue, headache, dyspnea, hoarse voice and myalgia. Presence of long covid diseases also increases the risk of developing post COVID syndrome. Even those with mild symptoms at initial appearance were noted to develop long COVID.3

Figure 2: Risk factors for long covid

Cardiac Complications

A new research study has shown how patients with long Covid were more than twice as likely to be affected by cardiac complications. The University of Missouri revealed that there are seven long-term health symptoms that are directly associated with long-Covid and all symptoms can severely hinder day-to-day life. These symptoms included fast-beating of heart, chest pain, shortness of breath, fatigue, joint pain, hair loss and obesity.4

Management of patient with Long Covid

Treatment of people with long COVID requires a multi-disciplinary method including evaluation, symptomatic treatment, treatment of underlying problems, physiotherapy, occupational therapy and psychological support. Minor symptoms like cough, pain, myalgia can be treated symptomatically with paracetamol, cough syrup and oral antibiotics. The symptoms, if any, like pulmonary embolism, cerebrovascular accident, coronary artery disease, has to be treated as per the normal protocol. Chest physiotherapy and neuro rehabilitation is important in patients with pulmonary and neuromuscular disorders. Since it is a new disease, the knowledge regarding long term effects and treatment options is still increasing.5

  1. Garner P. Paul Garner: For 7 weeks I have been through a roller coaster of ill health, extreme emotions, and utter exhaustion. British Medical Journal (BMJ). 2020 May 5.
  2. Nabavi N. Long covid: How to define it and how to manage it.
  3. Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC, Pujol JC, Klaser K, Antonelli M, Canas LS, Molteni E. Attributes and predictors of long COVID. Nature medicine. 2021 Apr;27(4):626-31.
  4. Karishma Pranav Bhavsar. Scientists confirm long Covid impact on heart: These symptoms post Covid are alarming. Mint publications. 2023 Feb 25.
  5. Evans RA, McAuley H, Harrison EM, Shikotra A, Singapuri A, Sereno M, Elneima O, Docherty AB, Lone NI, Leavy OC, Daines L. Physical, cognitive, and mental health impacts of COVID-19 after hospitalisation (PHOSP-COVID): a UK multicentre, prospective cohort study. The Lancet Respiratory Medicine. 2021 Nov 1;9(11):1275-87.


Volume 5
2023


An Official Publication of Student Spectrum at
Islamabad Medical & Dental College


Address of Correspondence

Muhammad Umer