The Conundrum of ‘Long-COVID-19ʹ: A Narrative Review

Abstract

COVID-19 is an ongoing pandemic with many challenges that are now extending to its intriguing long-term sequel. ‘Long-COVID-19ʹ is a term given to the lingering or protracted illness that patients of COVID-19 continue to experience even in their post-recovery phase. It is also being called ‘post-acute COVID-19ʹ, ‘ongoing symptomatic COVID-19ʹ, ‘chronic COVID-19ʹ, ‘post COVID-19 syndrome’, and ‘long-haul COVID-19ʹ. Fatigue, dyspnea, cough, headache, brain fog, anosmia, and dysgeusia are common symptoms seen in Long-COVID-19, but more varied and debilitating injuries involving pulmonary, cardiovascular, cutaneous, musculoskeletal and neuropsychiatric systems are also being reported. With the data on Long-COVID-19 still emerging, the present review aims to highlight its epidemiology, protean clinical manifestations, risk predictors, and management strategies. With the re-emergence of new waves of SARS-CoV-2 infection, Long-COVID-19 is expected to produce another public health crisis on the heels of current pandemic. Thus, it becomes imperative to emphasize this condition and disseminate its awareness to medical professionals, patients, the public, and policymakers alike to prepare and augment health care facilities for continued surveillance of these patients. Further research comprising cataloging of symptoms, longer-ranging observational studies, and clinical trials are necessary to evaluate long-term consequences of COVID-19, and it warrants setting-up of dedicated, post-COVID care, multi-disciplinary clinics, and rehabilitation centers.

Persistent Post-COVID-19 Syndrome in Hemodialyzed Patients—A Longitudinal Cohort Study from the North of Poland

“…In our study, fatigue or muscle weakness and sleep difficulties were very common at six months after discharge. This is consistent with data from the general population both after SARS and SARS-CoV-2 [7,18]. Although our cohort reported feeling more breathless as compared to the period before infection, it was not the dominant persistent symptom as in other studies [19].…”

“…It is a well-recognized fact that COVID-19 may affect the cardiovascular system, and post-recovery can lead to myocarditis, arrhythmias, and thromboembolic events in subjects from the general population with and without preexisting cardiovascular disease [ 20 ]. Sudden cardiac arrest has also been reported in a few patients recovered from COVID-19 [ 18 , 21 , 22 ]. It cannot be ruled out that a similar situation occurs in HD patients who are very burdened with cardiovascular diseases.…”

FAIR, ethical, and coordinated data sharing for COVID-19 response: a review of COVID-19 data sharing platforms and registries

“…Long COVID affects approximately 30-87% of adults 15,16 and 5-8% of children 17,18 who are infected with SARS-CoV-2 and harmonized, longitudinal datasets with linked clinical, human and pathogen OMICs, and imaging data may facilitate long COVID-related prognosis and treatment and help identify participant-level factors correlated with the emergence of variants of concern (VOC) and VOC-related differences in etiology and vaccine efficacy. Supplementary Figure 1 shows registry-and platform-specific participant-level linkages between data types.…”

Cognitive symptoms after COVID-19

“…This term is not exclusive to SARS-CoV-2 infection, and has previously been used in the context of other post-infectious processes and/or such other conditions as chronic fatigue syndrome. During the COVID-19 pandemic, this term has been used to describe difficulty concentrating, memory problems, and sometimes confusion, ( 15 , 16 ) hypersensitivity to light and sound, and tinnitus. ( 17 ) Together with fatigue, cognitive symptoms frequently persist beyond 4 weeks after SARS-CoV-2 infection.…”