Long Covid: An Overview

Introduction

People who get infected with the COVID-19 (coronavirus) virus develop long COVID or long-term effects of COVID. These long-term effects may stay for a few days to months, leading to various health problems. These long-term symptoms usually present in people with severe illness due to COVID. However, people with mild effects can also experience long-term effects of this viral disease. These symptoms are less severe in people who get fully vaccinated for COVID-19, while others are at a high risk of developing long-term effects. Therefore, these long COVID or post-COVID symptoms are an ongoing or a new range of health conditions that occur in a person after getting infected by the COVID-19 virus.

What Are the Symptoms Caused by Long COVID?

The symptoms caused by long COVID include:

Common Symptoms:

• Fever.

• Fatigue.

• Post-exertional malaise.

• Sore throat.

Heart and Respiratory Symptoms:

• Chest pain.

• Shortness of breath (SOB).

• Cough.

• Heart palpitations.

Digestive Symptoms:

• Pain in the stomach.

• Diarrhea.

Neurological Symptoms:

• Anxiety.

• Depression.

• Headaches.

• Change in taste and smell.

• Dizziness.

• Brain fog or difficulty in concentrating.

• Disturbed sleep.

Other Symptoms:

• Rashes.

• Joint pain.

• Muscle pain.

• Irregular menstrual cycles.

• Deep vein thrombosis.

• Pulmonary embolism.

• Hearing problems.

• Erectile dysfunction.

• Diabetes.

• Hypertension.

• Kidney disorders.

What Are the Causes of Long COVID?

The actual causes of long COVID are yet to be explained clearly, but researchers have suggested many mechanisms that may lead to long-term COVID effects. These include:

1. During the initial phase of COVID, the National Institute of Health Research, United Kingdom, suggested that four syndromes may cause long COVID effects.

• Permanent damage to the heart and lungs of a person.

• Chronic fatigue syndrome or post-viral fatigue.

• Existing COVID symptoms.

• Post-intensive care syndrome.

2. An article published in 2021 suggested the pathophysiological processes that can cause long COVID, and these are as follows:

• Post-Ischemia and vascular injury are caused by internal blood clots (thromboses) and a tendency to form blood clots (hypercoagulability)

• Post-infection immune system dysregulation is caused by inflammation.

• Renin-angiotensin dysregulation.

• Severe toxicity in tissues infected by a virus, especially lungs.

3. Other causes of long-term COVID effects or long COVID:

• Post-infection auto-antibodies develop in the body.

• Poor immune system function can cause the virus to stay in the body longer than usual.

• Recurrence of COVID-19 or reinfection.

• Strong immune system response or damage caused by the inflammation in the body.

• Oxygen exchange inhibition due to the formation of blood plasma micro clots.

• Mental health problems include anxiety, insomnia, depression, and post-traumatic stress.

What Are the Risk Factors Associated With Long COVID?

The risk factors associated with long COVID include:

• Asthma.

• Age above 50 years.

• Obesity.

• Women are more likely to develop long COVID effects than men with severe acute COVID.

• Presence of more than five COVID symptoms, such as headache, cough, loss of taste and smell, fatigue, and diarrhea.

How To Diagnose Long COVID?

Long COVID effects cannot be diagnosed with any specific test but can be evaluated with existing laboratory tools and tests. Doctors usually use xenon MRI to examine long COVID cases as it can reveal any previous condition. This radiology test helps diagnose lung function by evaluating gas exchange, ventilation, and barrier tissue. In addition, xenon MRI determines the air uptake by the lungs, air absorption by the lungs, and the blood taken up by the blood. Apart from this, the doctor can advise various diagnostic tests depending on the symptoms presented by the person. These tests include:

• Kidney function test.

• D-dimer.

• Liver function test.

• Electrolytes.

• Muscle damage.

• Iron levels.

• Heart health test.

• Full blood count.

• Urine culture test.

• Chest X-rays.

• Electrocardiogram or ECG.

How Are Long COVID Effects Treated?

Treatment for long covid is not specific. However, symptoms are treated individually with conventional methods. For example, a person suffering from neurological symptoms such as brain fog is advised cognitive rehabilitation therapy to improve memory, thinking abilities, and concentration.

Symptoms related to the lungs, heart, and gastrointestinal tract are treated with standard treatment protocols. These symptoms can be treated by a general physician or a specialist of a particular condition, such as a pulmonologist for the lungs and a cardiologist for the heart.

Specific remedies may help to manage the long COVID effects; these include:

• The prescribed medications by the doctor to treat symptoms post-COVID infection.

• Healthy diet.

• No smoking.

• Avoiding alcohol.

• Avoiding caffeine.

• Good quality of sleep or rest.

Symptoms that may need medical attention post-COVID infection:

• Weakness.

• Pain in the chest.

• Worsening breathing problems or breathlessness.

• Memory problems or confusion.

• Change in speech, hearing, and vision.

What Are the Preventive Measures for Long COVID Effects?

Long effects of COVID-19 can be prevented in the following ways:

• First, a person should get vaccinated for COVID-19 and complete all booster doses according to age and medical condition.

• Vaccination may help reduce the risk of long-term COVID effects and severe illness.

• A person should always wear high-protection respiratory masks in poorly ventilated and overcrowded areas.

• A person should regularly wash hands to get rid of the infection and get them periodically self-tested to avoid spreading the virus to people in contact.

• A person suffering from any underlying medical condition must follow preventive measures strictly to reduce the risk of disease and virus contact.

What Are the Complications Associated With Long COVID?

The complications of long COVID are:

• Myocarditis (inflammation of heart muscles).

• Diabetes.

• Severe kidney injury.

• Abnormal lung function.

• Concentration and memory problems.

• Hair loss.

• Difficulty sleeping.

• Body rashes.

• Anxiety.

Conclusion

Long-term COVID effects usually occur after a few weeks post-infection from the virus. The symptoms cannot be diagnosed with any particular method or tool because they can also be present in person due to any underlying medical condition. The doctor, therefore, manages long COVID effects by treating various health problems and the symptoms presented by the person. Also, medical treatment is based on complications, and secondary infections caused post-COVID in a person. Therefore, people should get vaccinated for COVID-19 to minimize the risk of severe long-term COVID effects.