Understanding Post-COVID-19 Syndrome: Symptoms, Risks & Global Impact | The Planet Journal

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Understanding Post-COVID-19 Syndrome: Symptoms, Risks & Global Impact | The Planet Journal

Understanding Post-COVID-19 Syndrome: Symptoms, Risks & Global Impact

An Editorial from The Planet Journal | Volume 06, No. 02, July - December 2022

ISSN (Print): 2663-9491 | ISSN (Online): 2789-6897 | DOI: dx.doi.org

By HN Sarker 1

1 Professor (Ex), Medicine, Sher-E-Bangla Medical College, Barishal, Bangladesh and Sheikh Sayera Khatun Medical College, Gopalganj, Bangladesh

Published: June 30, 2023

Published by: Sheikh Sayera Khatun Medical College (SSKMC), Gopalganj, Bangladesh

Cite this article: Sarker DH. Mental health disorder is an important aspect of post-COVID condition - An editorial. The Insight [Internet]. [cited yyyy mm dd];5(02). Available from: bdjournals.org/insight/article/view/235

The Lingering Shadow: What is Post-COVID-19 Syndrome?

Post-COVID-19 syndrome, often referred to as "Long COVID," describes a complex condition where individuals experience new, recurring, or persistent symptoms for more than four weeks after their initial COVID-19 infection. For some, these debilitating effects can unfortunately linger for months or even years, leading to significant impairment in daily life.

The journey of COVID-19 began on December 31, 2019, with the discovery of the novel coronavirus (SARS-CoV-2) outbreak in Wuhan, China. This virus rapidly escalated into a global pandemic, declared by the World Health Organization (WHO) on March 11, 2020. By May 7, 2021, the world had witnessed over 157 million confirmed cases and more than 3.2 million fatalities [1].

The pandemic's second wave, in particular, posed an unprecedented public health crisis, challenging scientific, medical, and public health communities worldwide [2]. While the WHO estimated that 80% of infections were mild or asymptomatic, a significant 15% presented with moderate to severe symptoms requiring oxygen, and 5% developed critical infections necessitating intensive care [2]. Even in Bangladesh, between January 2020 and October 2022, over 2 million cases and nearly 30,000 deaths were reported [3]. Crucially, clinical investigations consistently show that a substantial number of hospitalized COVID-19 patients continue to battle health issues months after discharge [4,5].

Defining Long COVID: WHO's Clinical Case Definition

To standardize understanding and facilitate research, a WHO working group has proposed a preliminary clinical case definition for "Post-COVID-19 condition." This definition hinges on the presence of symptoms three months from the onset of SARS-CoV-2 infection, lasting for at least two months, and not explained by an alternative diagnosis [6,7].

Global studies highlight the widespread nature of Long COVID: between 50% and 87% of hospitalized patients reported at least one post-COVID-19 symptom weeks after recovery or discharge. Alarmingly, 20% of COVID-19 patients continued to experience symptoms for over three months, even if the initial severity had lessened [8]. These persistent and incapacitating symptoms underscore that the pandemic's negative effects extend far beyond the acute phase, continuing to impact individuals, families, and social structures [9].

While less than 20% of COVID-19 patients require hospital admission, over 80% of those admitted need some form of respiratory support, from oxygen to ventilator assistance [10,11]. Certain demographics face a higher risk of developing long-term COVID-19 symptoms, including individuals over 65 and those with pre-existing co-morbidities such as diabetes, hypertension (HTN), chronic obstructive pulmonary disease (COPD), heart disease, and renal illness.

Common Symptoms of Post-COVID-19 Syndrome:

Worldwide studies suggest that approximately 10-15% of patients develop a range of persistent symptoms, including:

  • Profound Weakness & Tiredness: Persistent fatigue that isn't relieved by rest.
  • Respiratory Issues: Breathlessness and chronic cough.
  • Cognitive Impairment: Often referred to as "brain fog," manifesting as memory loss and difficulty concentrating.
  • Gastrointestinal Problems: Anorexia and constipation.
  • Autonomic Dysfunction: Excessive sweating.
  • Circulatory & Pain Issues: Swelling of legs and chest pain.
  • Dermatological & Allergic Reactions: Alopecia (hair loss) and various allergic manifestations.

Despite COVID-19 being an acute viral illness from which most patients recover within weeks, a significant number of patients continue to experience these new, recurring, or persistent symptoms for extended periods, leading to potential long-term impairment across various aspects of their lives.

References

  1. WHO, Coronavirus disease 2019 (COVID-19) situation report, 7 May 2021, WHO Bull, 2021.
  2. Wit E, van Doremalen N, Falzarano D, Munster VJ. SARS and MERS: recent insights into emerging coronaviruses. Nat Rev Microbiol. 2016;14(8):523–34.
  3. WHO (COVID-19) Homepage: Bangladesh: situation. Available from: https://covid19.who.int/region/searo/country/bd (Accessed October 15, 2022).
  4. Chippa V, Aleem A, Anjum F. Post Acute Coronavirus (COVID-19) Syndrome. Available from: https://www.ncbi.nlm.nih.gov/books/NBK570608/ (Accessed October 15, 2022).
  5. Roessler M, Tesch F, Batram M, Jacob J, Loser F, Weidinger O, et al. Post COVID-19 in children, adolescents, and adults: Results of a matched cohort study including more than 150,000 individuals with COVID-19. Berlin, Germany: Cold Spring Harbor Laboratory (2021). doi: 10.1101/2021.10.21.21265133
  6. Perego E, Callard F, Stras L, Melville-Johannesson B, Pope R, Alwan NA. Why the patient-made term “long COVID” is needed. Wellcome Open Res. (2020) 5:224. doi: 10.12688/wellcomeopenres.16307.1
  7. WHO. A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021. (2021) [cited 2022 May 9]. Available from: https://www.who.int/publications/i/item/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1 (Accessed April 18, 2022).
  8. Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS, et al. Post-acute COVID-19 syndrome. Nat Med. (2021) 27:601–15. doi: 10.1038/s41591-021-01283-z
  9. Senjam SS, Balhara YPS, Kumar P, Nichal N, Manna S, Madan K, et al. Assessment of post COVID-19 health problems and its determinants in north India: A descriptive cross sectional study. Delhi, India: Cold Spring Harbor Laboratory (2021). doi: 10.1101/2021.10.03.21264490
  10. WHO: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected Interim guidance 13 March (2020) P. 1. Available from: https://www.who.int/docs/default-source/coronaviruse/clinicalmanagement-of-novel-cov.pdf (Access November 7, 2022).
  11. Bhuiyan AKMI, Sakib N, Pakpour AH, Griffiths MD, Mamun MA. COVID-19-related suicides in Bangladesh due to lockdown and economic factors: case study evidence from media reports. Int J Ment Health Addict. (2021) 19 (6):2110–5. doi: 10.1007/s11469-020-00307-y

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