As the number of COVID-19 cases start to decline in India, we are seeing a rise in post COVID-19 complications which the medical world has termed with names like –
- Long COVID
- Post-acute COVID syndrome
- Chronic COVID
- Long haul COVID
- Long term effects of COVID
Available data and reports reveal that some patients are developing a “post-acute COVID-19 syndrome”. Such individuals are experiencing recurrent symptoms after recovery from the initial infection. Notably, “post-acute COVID-19 syndrome” has been detected among those with mild as well as moderate-to-severe infection and illness. However, till date the occurrence, natural history and etiology of such symptoms have not been identified.
In the broadest sense, “post-acute COVID-19 syndrome” is the lack of return to a usual state of health following COVID-19 illness. It might also include development of new or recurrent problems that occur after the acute illness, and lasts two weeks. Common complications that have been reported by those recovered from Covid-19 are issues with the lungs, kidneys, heart. Also seen, albeit uncommonly, are cases of a black fungal infection, called mucormycosis. This last condition is usually prevalent in patients with diabetes, on steroids, with high sugars.
For simplicity of this blog, we will refer to any problem after ‘acute COVID’ or the 14 days after onset of COVID-19 as ‘Post COVID’. These problems may last up to weeks from first symptom or test date to 12 weeks and in rare cases even longer.
How common is it?
Around 10% of patients who have tested positive for Sars-CoV-2 virus remain unwell beyond three weeks, and a smaller proportion for months. This is based on the UK COVID Symptom Study, in which people enter their ongoing symptoms on a smartphone app. Another US study found that only 65 percent of people had returned to their previous level of health 14-21 days after a positive test.
Clinicians and researchers are still in the early stage of understanding the long COVID. To date, the most commonly reported persistant symptoms include –
- Difficulty thinking or concentrating (sometimes referred to as ‘brain fog’)
- Difficulty in breathing (with and without low oxygen levels on pulse oximeter)
- Painful joints or muscles
- Chest pain
- Depression or anxiety
- Loss of smell or taste
- Dizziness or standing
- Skin rashes
- Post-exertional malaise (PEM), a worsening of symptoms after physical or mental activities.
Multi-organ effects of COVID-19
Covid can exhibit a multi-organ effect, with the potential for most, if not all, body parts or systems like heart, lung, kidney, skin, and brain functions –being affected. Similar effects are also being noticed after recovery from COVID-19, which include multisystem inflammatory syndrome (MIS) and autoimmune conditions.
In case of MIS, different parts of the body get swollen. On the other hand, in case of autoimmune condition the immune system mistakenly attacks healthy cells in the body. As a result you can get painful swelling in the affected parts. Medical practitioners are yet to find out the time period for which multi-organ system effects can last or if such effects can result in chronic health conditions.
Also read: Symptoms Of Covid – Do I Have Covid?
Health Ministry’s protocol for post-Covid management
Here are the recommendations-
- First follow-up visit, be it, a physical visit or an online or telephonic one, in case of recovered patients must be done within seven days after discharge from a health facility.
- “Subsequent treatment/follow-up visits may be with the nearest qualified allopathic/AYUSH practitioner/medical facility of other systems of medicine.
- Poly-therapy (use of multiple medications) is to be avoided due to the potential for unknown drug-drug interaction, which may lead to Serious Adverse Events (SAE) or Adverse Effects (AE),” the protocol says.
- If there is a persistent dry cough or sore throat, saline gargles (with turmeric and salt) and steam inhalation. Cough medication should be taken on the advice of a doctor.
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Precautions after recovering from Covid-19
Those with co-morbidities like hypertension, diabetes and cardiovascular diseases would have continued their medicines and should look out for changes to their sugar and BP during and after Covid. But people have in many cases stopped their regular treatment while being affected with COVID-19. However, in reality conditions like diabetes or blood pressure issues need constant monitoring to be on the safe side. After recovering from COVID, you must consult your doctor immediately and go for tests to check the health indicators and if needed to adjust medicine dosing. Also you must get your vaccine 6 months after recovery from the infection as per current GOI Guidelines, to be on the safe side, keep checking the advise on vaccinations at least monthly after getting Covid.
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Other precautions include:
- Drinking plenty of fluids in order to stay hydrated
- Breathing exercises and meditation
- Taking a nutritious diet
- Ensuring adequate sleep
- Avoiding alcohol and smoking
Post-COVID complications can also include prolonged treatment or even hospitalization for respiratory infections or other conditions. They can also include post-intensive care syndrome (PICS), which means health effects after a critical illness and can cause severe weakness and post-traumatic stress disorder (PTSD).
Who’s at risk?
At this point, medical practitioners are not sure of any classified group of people who are at risk of having ‘Post COVID’ symptoms. It has been seen that those with mild disease had developed long-term side effects as well. The best thing to do would be to have a healthy lifestyle, gently get back into your normal routine and if there are any bothersome or worsening symptoms get in touch with your doctor.
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