Post-acute COVID-19 syndrome

Abstract

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19) pandemic that has resulted in millions of deaths and a major strain on health systems worldwide. Medical treatments for COVID-19 (anticoagulants, corticosteroids, anti-inflammatory drugs, oxygenation therapy and ventilation) and vaccination have improved patient outcomes. The majority of patients will recover spontaneously or after acute-phase management, but clinicians are now faced with long-term complications of COVID-19 including a large variety of symptoms, defined as “post-acute COVID-19 syndrome”. Most studies have focused on patients hospitalised for severe COVID-19, but acute COVID-19 syndrome is not restricted to these patients and exists in outpatients. Given the diversity of symptoms and the high prevalence of persistent symptoms, the management of these patients requires a multidisciplinary team approach, which will result in the consumption of large amounts of health resources in the coming months. In this review, we discuss the presentation, prevalence, pathophysiology and evolution of respiratory complications and other organ-related injuries associated with post-acute COVID-19 syndrome.

SARS-CoV-2 Causes Lung Inflammation through Metabolic Reprogramming and RAGE

“…Seventy different systemic organ-specific disorders were identified to be associated with post-COVID-19 symptoms [ 51 ]. The mechanisms involved are not fully understood; however, most clinicians and researchers agree that inflammation is the number one reason for these long-term sequelae followed by the induction of hypoxia [ 52 , 53 , 54 , 55 ]. Both inflammation and hypoxia are the results of metabolic reprogramming (MR) caused by the virus and persist in patients, especially those with underlying diseases.…”

Pulmonale Manifestationen bei Long-COVID

“…Aktuell wird geschätzt, dass ungefähr 15 %der COVID-19-Patientenüber Wochen bis Monate fortbestehende Symptome nach einer akuten SARS-CoV-2-Infektion aufweisen, wobei die Häufigkeiten in Untersuchungen mit Patienten nach COVID-19-bedingter Hospitalisierung deutlich höher und in bevölkerungsbasierten Umfragen deutlich niedriger liegen können [20,23]. Risikofaktoren für die Entwicklung eines Long-COVID-Syndroms sind unter anderem höheres Alter und weibliches Geschlecht sowie eine Hospitalisierung und vermehrte Symptome während der COVID-19-Erkrankung, wobei ein direkter Zusammenhang der Häufigkeit des Auftretens mit der Schwere der initialen Erkrankung nicht vollständig gesichert ist und die Erkrankung auch bei milden COVID-19-Verläufen vorkommt [6,8,23].…”

The Impact of Charlson Comorbidity Index on the Functional Capacity of COVID-19 Survivors: A Prospective Cohort Study with One-Year Follow-Up

“…Although complete vaccination against COVID-19 has covered nearly 60% of the world’s population, the pandemic continues to grow, and cumulative cases have exceeded 520 million worldwide, with more than 6 million deaths reported [ 1 ]. In those who survive, a wide variety of sequelae have been described [ 2 ]. Among others, survivors may experience fatigue, persistent respiratory symptoms, decreased physical function, and decreased quality of life for up to 6 months post-infection [ 3 ].…”