Dr. Shyam P Lohani

There are increasing reports of persistent and prolonged effects of acute COVID-19 on humans. Several reports of a constellation of symptoms following COVID-19 infections have been published. In most cases, coronavirus symptoms may pass quickly, some people are showing long-term effects following COVID-19 infections. It has been seen that for some people, coronavirus infection can cause symptoms that last for weeks or months even after the infection has gone. The condition is called post-COVID-19 syndrome or long COVID. However, how long it takes to recover from COVID-19 is different for different people.
Post-COVID syndromes consist of a wide range of new, returning, or ongoing health problems that people experience more than four weeks after first being infected with the SARS Cov-2 virus that causes COVID-19. The syndromes have also been seen among people who did not have initial symptoms when they were infected but found to have suffered from post-COVID-19 syndromes. The conditions can be of different types and different health problems for varied durations among COVID-19 patients.

Combinations symptoms
Long COVID is usually consists of a constellation of symptoms that last weeks or months after first being infected with the virus that causes COVID-19 or can also appear weeks after initial infection. It was found that long COVID can occur to anyone who has had COVID-19 even if the illness was mild, or they had no initial symptoms.
People with long COVID have reported experiencing different combinations of the symptoms such as tiredness or fatigue, loss of smell or taste, difficulty thinking or concentrating, headache, dizziness on standing, fast-beating or pounding heart, chest pain, difficulty breathing or shortness of breath, cough, joint or muscle pain, depression or anxiety, fever and symptoms that may get worse after physical or mental activities such as post-exertional malaise. Female patients may experience menstrual cycle issues.
Even though COVID-19 is seen as a disease that primarily affects the lungs, it can damage many other organs as well. Organ damage may increase the risk of long-term health consequences. Organs that may be affected by COVID-19 include the heart, lungs, and brain.
There are several risk factors for the post COVID symptoms. Studies have found that older people, women, and people who had five or more symptoms in the first week of becoming ill with COVID-19 were more likely to develop long COVID. It was found that long COVID affects around ten per cent of 18-49-year-olds who catch COVID-19, and around 22 per cent of people over 70 years of age. It was also found that the people with asthma were more likely to develop long COVID. It also affects children as it was seen in almost 13 per cent of children aged between 2 and 11 and 14.5 per cent of children aged 12 to 16 may develop symptoms including fatigue, cough, headache, muscle aches, or loss of taste or smell five weeks after becoming sick with COVID-19.
Post-COVID conditions may also include the long-term effects of COVID-19 treatment or hospitalisation. As seen after hospitalisations with other respiratory infections or conditions, some of those longer-term effects are found to be similar. It is common for it to last five months or more among those who needed hospital treatment for the initial illness, and there are separate reports of it lasting 12 months or more for both people who did not need hospital treatment initially and those who did.
Post-intensive care syndrome (PICS), which refers to health effects that continue after a critical illness, is also seen among patients who had undergone COVID-19 treatment and hospitalisation. These effects can include severe weakness and post-traumatic stress disorder (PTSD). PTSD is long-term reactions to a very stressful event.
It has been reported that between 32.6 per cent and 87.4 per cent of patients with COVID-19 infection have at least one symptom persisting for several months. Another study found that more than one in 10 people who became infected with SARS-CoV-2 has gone on to get long COVID.
The actual reason for the development of long COVID is still unknown. However, there is evidence that fragments of the virus such as protein molecules can persist for months after COVID-19 infection, in which case they might disrupt the body in some way even if they cannot infect cells. A further possibility is that long COVID is caused by the immune system going erratic and attacking the rest of the body. In other words, long COVID could be an autoimmune response following COVID-19 infection. Moreover, long COVID is not contagious. Long COVID symptoms are caused by the response of our body to the virus continuing beyond the initial illness.

Management
At present, there is no specific treatment for long COVID, however, several measures such as taking a healthy diet, getting quality sleep, limiting alcohol and caffeine intake, not smoking, and practicing yoga may help.
Many patients with long COVID are getting better with time. They should talk to their healthcare providers about options for managing or treating symptoms and resources for support. It is called upon stakeholders to initiate post-COVID care clinics at different level hospitals to address patient needs. Equally important is to develop a support network for those suffering from mental health, financial and social well-being following COVID-19.
The best way to prevent long complications is to prevent ourselves from COVID-19. The proven public health measures include wearing masks, practicing social distancing, washing hands and/or using sanitizer, and avoiding large crowds. Getting vaccines when available is also an important strategy to keep COVID-19 at bay.

(Prof. Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)