Posted on: October 7, 2021 Posted by: admin Comments: 0


People with Covid-19 who have no symptoms or have recovered from ICU treatment can have post-Covid syndrome, the rate of which ranges from 20 to 96%.

Similar to post-SARS or MERS (Middle East respiratory syndrome) syndromes, there are increasing reports of long-term effects following Covid-19 infection. This condition is recognized as a syndrome with multiple organ involvement, with persistent presenting symptoms.

What is Post-Covid Syndrome?

Prolonged Covid disease is a condition in which a patient has recovered from acute Covid-19 but symptoms persist for more than 4 weeks from the onset of infection. These symptoms may be present during the acute episode or appear after recovery.

Who will get post-Covid syndrome?

All acute Covid-19 patients can develop post-Covid syndrome, which ranges from asymptomatic to very severe patients requiring treatment in an intensive care unit (ICU).

Subjects at risk

Many studies have demonstrated that the severity of acute Covid-19 is related to risk factors, such as old age, male gender, obesity, coronary heart disease, chronic obstructive pulmonary disease, diabetes… However, no studies have shown that the risk of post-Covid syndrome is related to the above factors. The UK Office for National Statistics reports the two highest rates of post-Covid infection are women and the 35-49 age group.

Incidence

Prolonged Covid syndrome very popular. Many reports show that the prevalence of this syndrome ranges from 20-96%, depending on the study. Overall, it is estimated that about 80% of patients who recover will experience at least one post-Covid symptom.

Manifestations of disease

Like acute Covid-19, prolonged Covid syndrome causes damage and symptoms in many organs: respiratory, cardiovascular, neuropsychiatric, digestive, endocrine, kidney, skin and hair.

The most common symptoms are persistent fatigue, headache, musculoskeletal pain, cough, shortness of breath, especially dyspnea with exertion, hair loss, loss of taste and smell, decreased cognitive abilities, such as decreased concentration, confusion, or psychological disturbances, such as anxiety, depression, or sleep disturbances.

Prolonged Covid is not only manifested by the above-mentioned clinical symptoms, but also by subclinical abnormalities, such as laboratory abnormalities such as prolonged elevation of cardiac enzymes, blood sugar disorders, thyroid hormone disorders, etc. decreased glomerular filtration rate… ; respiratory dysfunction: decreased lung diffusion, limited lung capacity; Imaging abnormalities: pulmonary fibrosis, bronchiectasis on chest CT scan, ventricular dysfunction on echocardiography…

Disease mechanisms

Experts hypothesize three mechanisms to cause this condition. First, because the virus directly invades body cells during an acute illness, causing cell destruction and leaving permanent damage to many organ structures. Second, due to an excessive inflammatory response leading to an increase in the concentration of inflammatory substances (cytokines) in the blood and body tissues, causing chronic inflammation of many organs; and the body’s somewhat misguided immune response leads to the formation of autoantibodies against the human body’s own cells, thereby causing dysfunction of many organs. Third, severe medical conditions during an exacerbation such as respiratory failure, hypotension, embolism, and tissue hypoxia lead to irreversible cellular damage in many organs.

In addition, negative psychosocial factors from the pandemic: illness, bereavement, social isolation, isolation, financial worries, unemployment, etc. also cause psychological symptoms. protracted reason after Covid.

Is post-Covid syndrome dangerous?

Like acute Covid-19, prolonged Covid also manifests in multiple organs with varying degrees of severity, from very mild such as hair loss and fatigue to more severe medical conditions, such as honeycomb pulmonary fibrosis, sequelae. stroke, sequelae of myocardial infarction, or end-stage renal failure.

How long does the illness last?

Many symptoms are self-limited or manageable with standard treatments and persist for only 2-6 months, such as headache, musculoskeletal pain. But there are also permanent sequelae, such as stroke sequelae or heart attack sequelae.

Treatment

Treatment of prolonged Covid syndrome requires in-depth knowledge of the post-Covid disease as well as close, long-term planning and a combination of many specialties. Currently, Ho Chi Minh City has many facilities at hospitals specializing in the treatment of prolonged Covid diseases, combined with physical therapy.

Prevent

Post-Covid syndrome can occur in any Covid-19 patient from mild to severe, with diverse clinical manifestations, sometimes just abnormalities on the laboratory without symptoms. All recovered patients need to be monitored, screened for possible disorders, from which an active, long-term treatment plan is planned.

CT scan of the lungs for a patient with persistent cough and shortness of breath due to post-Covid syndrome at Saigon South Hospital. Photo. Hoang Khuong

Doctor Nguyen Thi Phuong Thy

Department of Internal Medicine – Respiratory, Saigon South International General Hospital

Source: VnExpress

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