The Chronic Effects of COVID-19 or “Long COVID”
Keywords:
long COVID, post acute COVID-19, chronic COVID-19, atigue, thromboembolism, dyspnoea, pulmonary fibrosis
Abstract
The term “long COVID” is used to refer to patients who have persisting symptoms for 4 weeks or more after onset of COVID-19. The prevalence of these ymptoms is reported to range from 10-80%. The commonest symptoms include fatigue, dyspnoea, chest pain, hair loss, loss of sense of taste and smell, cognitive difficulties, anxiety and depression. Serious complications in this period include thrombo embolic events (stroke, myocardial infarction, limb ischemia and venous
thromboembolism), infections, pulmonary fibrosis and multi system inflammatory syndrome. Patients with post COVID-19 symptoms should be first evaluated in primary care and those with serious issues referred to appropriate specialties. The others should be provided with supportive and symptomatic care including respiratory care, nutrition, immunization, mental health support, management of comorbidities and if indicated anticoagulation and treatment of infections. The routine use of steroids, antifibrotics, anticoagulants, anti depressents and antibiotics in these patients should be avoided.
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20:1–9.
2. The Lancet. Facing up to long COVID. Lancet. 2020; 396(10266):1861.
3. Jacobson KB, Rao M, Bonilla H, Subramanian A, Hack I, Madrigal M et al. Patients with uncomplicated COVID-19 have long-term persistent symptoms and functional impairment similar to patients with severe COVID-19: a cau- tionary tale during a global pandemic. Clin Infect Dis. 2021 Feb 7:ciab103.
4. Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS et al. Post-acute COVID-19 syndrome. Nat Med. 2021 Mar 22.
5. Lopez-Leon S, Wegman-Ostrosky T, Perelman C, Sepulveda R, Rebolledo P, Cuapio A et al. More Than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta- Analysis. Res Sq [Preprint]. 2021 Mar 1:rs.3.rs-266574. doi: 10.21203/rs.3.rs-266574/v1
6. Office for National Statistics [Internet]. 2020. Prevalence of long COVID symptoms and COVID-19 complications. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/ healthandsocialcare/healthandlifeexpectancies/ datasets/prevalenceoflongcovidsymptomsandcovid19complications.
7. WHO COVID-19 dashboard [Internet]. [Cited 2021April 4]. Available at https://covid19.who.int/.
8. Chopra V, Flanders SA, O’Malley M, Malani AN, Prescott HC. Sixty-Day Outcomes Among Patients Hospitalized With COVID-19. Ann Intern Med. 2020 Nov 11:M20-5661.
9. Halpin SJ, McIvor C, Whyatt G, Adams A, Harvey O, McLean L, Walshaw C, Kemp S, Corrado J, Singh R, Collins T, O’Connor RJ, Sivan M. Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation. J Med Virol. 2021 Feb;93(2):1013- 1022.
10. Huang C, Huang L, Wang Y, Li X, Ren L, Gu X et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021 Jan 16;
397(10270):220-232.
11. Sudre CH, Murray B, Varsavsky T, Graham MS, Penfold RS, Bowyer RC et al. Attributes and predictors of long COVID. Nat Med. 2021 Mar 10.
12. White P. Long COVID: don’t consign ME/CFS to history. Nature. 2020; 587(7833):197.
13. Singhania SV, Simon C, Raut A, Parvatkar N. Pulmonary sequelae of moderate to severe COVID pneumonia, a 3-month follow-up study. Lung India 2021.
14. Soman R, Rote S, Singh J, Jadhav K, Eashwarnath R, Chavan D. COVID-19 and Meningoencephalitis with Cerebellitis. In: Case Book of COVID-19. Eds Rajeev Soman and Tanu Singhal. Kothari Publishers, 2021. Mumbai; 226-231.
15. Agrawal R.Alarming Life-threatening MUCORMYCOSIS rises in this Covid-19 Pandemic in India. 2020 Dec 26. [Cited 2021 April 4]. Available from:https://www.pediatriconcall. com/pediatric-news/alarming-life-threatening-mucormycosis- rises-in-this-covid-19-pandemic-in-india/37
16. Garg D, Muthu V, Sehgal IS, Ramachandran R, Kaur H, Bhalla A et al. Coronavirus Disease (Covid-19) Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature. Mycopathologia. 2021 Feb 5:1–10.
17. Whittaker E, Bamford A, Kenny J, Kaforou M, Jones
CE, Shah P et al. PIMS-TS Study Group and EUCLIDS and PERFORM Consortia. Clinical Characteristics of 58 Children With a Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2. JAMA. 2020 Jul 21; 324(3):259-269.
18. Varyani U, Singhal T, Sheth S, Shetty K, Harshe P, Shah S. An unusual cause of fever and jaundice. Indian J Med Microbiol. 2021 Feb 20:S0255-0857(21)00016-5.
19. Khaund Borkotoky R, Banerjee Barua P, Paul SP, Heaton PA. COVID-19-Related Potential Multisystem Inflammatory Syndrome in Childhood in a Neonate Presenting as Persistent Pulmonary Hypertension of the Newborn. Pediatr Infect Dis J. 2021 Apr 1; 40(4):e162-e164.
20. Venkatesan P. NICE guideline on long COVID. Lancet Respir Med. 2021; 9(2):129.
21. Greenhalgh T, Knight M, A’Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ. 2020 Aug 11; 370:m3026.
22. Vollbracht C, Kraft K. Feasibility of Vitamin C in the Treatment of Post Viral Fatigue with Focus on Long COVID, Based on a Systematic Review of IV Vitamin C on
Fatigue. Nutrients. 2021; 13(4):1154.
23. Barker-Davies RM, O’Sullivan O, Senaratne KPP, Baker P, Cranley M, Dharm-Datta S, Ellis H, Goodall D, Gough M, Lewis S, Norman J, Papadopoulou T, Roscoe D, Sherwood D, Turner P, Walker T, Mistlin A, Phillip R, Nicol AM, Bennett AN, Bahadur S. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Br J Sports Med. 2020 Aug;54(16):949-959.
24. National Institute of Health [Internet]. Antithrombotic Therapy in Patients with COVID-19. [Cited 2021 April 4]. Available from:https://www.covid19treatmentguidelines. nih.gov/antithrombotic-therapy/#:~:text=For%20nonhospitalized% 20patients%20with%20COVID,a%20clinical%20
trial%20(AIII).
25. Kabeerdoss J, Pilania RK, Karkhele R, Kumar TS, Danda D, Singh S. Severe COVID-19, multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms, clinical manifestations and management. Rheumatol Int. 2021;41(1):19-32.
Published
2021-04-24
How to Cite
Dr Tanu Singhal. (2021). The Chronic Effects of COVID-19 or “Long COVID”. The Indian Practitioner, 74(4), 24-31. Retrieved from https://articles.theindianpractitioner.com/index.php/tip/article/view/1151
Section
Review article
