KOCHI: Long-Covid syndrome comprises myriad multisystem symptoms manifested for a variable period after a Covid infection.
Ever since the pandemic outbreak, its psychosocial effects have fascinated medical society.
The severity of the illness varies from person to person, so does the rate of recovery and the amount of sequela.
Like any other viral infection, Covid also affects many organ systems including the lungs, heart, brain, kidneys, liver, vascular and immune systems.
In most people, the symptoms subside after a few days or weeks. Many people experience mild to moderate symptoms, like a running nose, body ache, fatigue, fever to moderate pneumonia without a dip in oxygen levels which is usually treated in an OPD or clinics.
A fraction of people develop severe debilitating pneumonia with ARDS, sepsis, Multi-organ Dysfunction Syndrome (heart, kidneys, liver, brain) and lung failure, requiring ICU admission, invasive ventilation and perhaps ECMO.
Despite treatment, some succumb to death after staying in ICUs for some time.
The time for recovery from such an illness is expected to be a few weeks to months, while time for complete curing of symptoms may vary from person to person.
Critical illness polyneuropathy
This comprises details of a patient prior to illness like age, comorbidities, a reserve of each organ system, BMI, functional status, and physical activities before the illness.
Classification (Weeks post-infection)
An early description of long Covid includes many symptoms different from that of patients who suffered severe Covid that required hospitalisation.
According to what has been observed over the last two years, these symptoms are classified as long-Covid or post-acute Covid (symptoms beyond 3 weeks) and chronic post‐Covid(beyond 12 weeks).
Studies report one in 10 people who experience mild to moderate Covid are unwell for 3 weeks or more. Two-fifths of people report a worsened quality of life. Studies claim only 13 per cent of people were completely free of symptoms after 60 days of discharge from hospitals.
Even asymptomatic patients have been seen to develop nonspecific symptoms after a few weeks of illness.
Though the symptoms are mostly nonspecific, the most common symptoms are fatigue, exertional breathlessness, chest discomfort, joint and muscle pain, palpitation and decreased sleep.
Some studies show that two-thirds of patients report at least one symptom on both 30th and 60th days of symptom onset.
Even those who had mild to moderate infections and were managed as out-patients experienced long Covid symptoms with ongoing morbidity and disability following a non-critical illness.
Rare syndromes like Guillen Barrie Syndrome, Myasthenia Gravis, Positional Orthostatic Tachycardia Syndrome are other rare conditions associated with post-Covid illness.
The exact reasons for prolonged symptoms are not clearly understood and it is thought to be an ongoing inflammatory process in recovering patients.
These factors affect the severity of Covid:
CT Severity Score.
Need for ICU admission.
Ventilatory requirements.
No damage to organ systems.
Time required for recovery.
Amount of residual fibrosis.