The long term health problems from Covid-19

There are people who continue to experience poor health after being diagnosed with Covid-19, a phenomenon that’s being referred to as “post-Covid syndrome”.

Covid-19 symptoms can sometimes persist for months. The virus can damage the lungs, heart and brain most people who Covid-19 re-cover completely within a few weeks. But some – even those who had mild versions of the disease – continue to experience symptoms after their initial recovery. Older people and people with serious medical conditions are the most likely to experience lingering Covid-19 symptoms.

The most common signs and symptoms that linger over time include:

• Fatigue
• Cough
• Shortness of breath
• Headaches
• Joint pain

Although Covid-19 is seen as a disease that primarily affects the lungs, it can damage many other organs as well. This organ dam-age may increase the risk of long-term health problems. It is known that after a bad case of influenza, people often don’t feel well for six or eight weeks.

They’re tired and fatigued and can have a lingering cough. With flu, significant amounts of the virus are present in respiratory fluids up to 24 hours before symptoms appear, and the levels start to fall a few days later. In adults, the virus is usually gone within five or six days. At six weeks, you won’t find any viral particles at all, but people can still be experiencing this post-viral condition. This kind of persistent fatigue occurs after other illnesses too, but influenza has been the classic one where it’s described.

The prolonged fatigue isn’t explicable by any apparent structural damage. It could be related to a dysfunction in the central nervous system because there seem to be a lot of nervous system effects associated with this disease. Many people feel like they have problems with memory and concentration. This is different from what we’re used to seeing after viral illnesses.

You don’t generally see these sorts of cognitive problems persist after people have had influenza, for instance. What we are seeing currently with the coronavirus is that up to 60% of people who have recovered from the acute phase of Cov-id-19 still have persistent fatigue, even three or four months later.

In this case, it may be that the post-viral syndrome is affecting a much higher proportion of people and lasting a lot longer than we’re used to seeing with influenza and other illnesses. We also know that loss of smell has become a characteristic presentation for Covid-19, and in some people, that symptom is persisting after the acute phase of the illness. It’s not clear why. There is some evidence that the virus directly attacks the olfactory nerves (nerves involved in smell), although that hasn’t been shown consistently.

There are some hints that the virus could be using the olfactory nerves as a conduit to the brain. The coronavirus that causes Covid-19 is also different from the influenza virus, therefore its long-term consequences are likely going to reflect that. Before Covid-19, we had no model of a viral respiratory dis-ease so frequently causing an overwhelming inflammatory response that can lead to extensive scarring of the lungs.

And this virus can also attack many other organs. While influenza typically infects solely the respiratory organs, the coronavirus has the ability to infect cells in, for example, the gastrointestinal tract, the cardiovascular system, skin, kidneys and nervous system. And it triggers not only an inflammatory cascade but also an out-of-control cascade of blood clotting in some people.

It looks like some of the long-term impacts of this virus might be irreversible. For example, the shortness of breath is often due to lung scarring, and we think that could be permanent. The virus leads to more blood clots, and that could lead to a stroke that permanently damages the brain or, if the clot goes to the lungs, a pulmonary embolism that destroys lung tissue.

Much is still unknown about how Covid-19 will affect people over time. However, researchers recommend that doctors closely monitor people who have had Covid-19 to see how their organs are functioning after recovery. The potentially long-lasting problems make it even more important to reduce the spread of the disease by following precautions such as wearing masks, avoiding crowds and keeping hands clean

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