Long COVID: Difference between revisions

Jump to navigation Jump to search
Line 236: Line 236:


===Secondary Prevention===
===Secondary Prevention===
There are no established measures for the secondary prevention of [long COVID].
There are no established measures for the secondary prevention of [[long COVID]].


==See also==
==See also==

Revision as of 16:34, 10 March 2022

WikiDoc Resources for Long COVID

Articles

Most recent articles on Long COVID

Most cited articles on Long COVID

Review articles on Long COVID

Articles on Long COVID in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on Long COVID

Images of Long COVID

Photos of Long COVID

Podcasts & MP3s on Long COVID

Videos on Long COVID

Evidence Based Medicine

Cochrane Collaboration on Long COVID

Bandolier on Long COVID

TRIP on Long COVID

Clinical Trials

Ongoing Trials on Long COVID at Clinical Trials.gov

Trial results on Long COVID

Clinical Trials on Long COVID at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Long COVID

NICE Guidance on Long COVID

NHS PRODIGY Guidance

FDA on Long COVID

CDC on Long COVID

Books

Books on Long COVID

News

Long COVID in the news

Be alerted to news on Long COVID

News trends on Long COVID

Commentary

Blogs on Long COVID

Definitions

Definitions of Long COVID

Patient Resources / Community

Patient resources on Long COVID

Discussion groups on Long COVID

Patient Handouts on Long COVID

Directions to Hospitals Treating Long COVID

Risk calculators and risk factors for Long COVID

Healthcare Provider Resources

Symptoms of Long COVID

Causes & Risk Factors for Long COVID

Diagnostic studies for Long COVID

Treatment of Long COVID

Continuing Medical Education (CME)

CME Programs on Long COVID

International

Long COVID en Espanol

Long COVID en Francais

Business

Long COVID in the Marketplace

Patents on Long COVID

Experimental / Informatics

List of terms related to Long COVID

For COVID-19 main page, click here

For COVID-19 frequently asked inpatient questions, click here

For COVID-19 frequently asked outpatient questions, click here

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];

Synonyms and keywords: Long COVID Syndrome, long COVID, long-haul COVID, post-COVID-19 condition, post-COVID-19 syndrome, post-acute sequelae of COVID-19 (PASC), chronic COVID syndrome (CCS).

Overview

  • Shortly after the COVID-19 pandemic onset, emerging studies showed that a considerable proportion of patients with COVID-19 might exhibit sustained postinfection sequelae.

Historical Perspective

Definition

  • On October 6, 2021, World Health Organization (WHO) released a clinical case definition of the post-COVID-19 condition through a robust, protocol-based methodology (Delphi consensus), which engaged a diverse group of representative patients, patient-researchers, external experts, WHO staff, and other stakeholders from multiple geographies. It was acknowledged that this definition may change with emerging new evidence and continuously evolving our understanding of the consequences of COVID-19.
  • According to WHO clinical case definition, the post-COVID-19 condition is defined as:

There are concerns about the difficulty in defining cases[1].

Classification

There is no established system for the classification of long COVID.

Pathophysiology

The exact pathogenesis of long COVID is not fully understood.

Epidemiology and Demographics

  • The reported incidence/prevalence of long COVID-19 varies in different studies mainly due to the absence of single terminology and definition.
  • One study found that up to 70% of individuals at low risk of mortality from COVID-19 experience impairment in one or more organs (including heart, lungs, kidneys, liver, pancreas, or spleen) 4 months after acute COVID-19 episode.
  • A meta-analysis, including 47,910 patients (age 17-87 years), estimated that 80% of the patients with SARS-CoV-2 infections developed one or more long-term (ranging from 14 to 110 days) symptoms.
  • Women seem to be more commonly affected by long COVID than men.

Risk Factors

Screening

There is insufficient evidence to recommend routine screening for long COVID.

Natural History, Complications, and Prognosis

  • The natural history, clinical course, long-term complications, and prognosis of long COVID-19 are still not completely understood.
  • Manifestations of the post-COVID-19 condition vary considerably in terms of organ involvement and severity of symptoms; however, they generally impact the everyday functioning of affected patients.
  • Symptoms might newly develop following initial recovery from an acute COVID-19 illness or occur as a persist from the initial episode.
  • Symptoms might also fluctuate or relapse over time.

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Long COVID can involve almost every organ. The most common symptoms of long COVID include:

Physical Examination

Laboratory Findings

There are no diagnostic laboratory findings associated with long COVID. Symptoms do not correlate with the serology of SARS-CoV-2.

Electrocardiography

In patients with cardiopulmonary symptoms, an ECG may be needed.

X-ray

A chest x-ray may be helpful in the diagnosis of pulmonary complications of COVID such as lung damage (ie, ground glass opacities, consolidation, interlobular septal thickening), pleural effusion.

Echocardiography or Ultrasound

In selected patients with cardiopulmonary symptoms, echocardiography may be necessary.

CT scan

In patients with cardiopulmonary symptoms, a chest CT scan may be needed.

MRI

There are no MRI findings associated with long COVID. However, a cardiac MRI may be helpful in the diagnosis of myocarditis in COVID-19 patients.

Other Imaging Findings

There are no other imaging findings associated with long COVID.

Other Diagnostic Studies

In selected patients with cardiopulmonary symptoms, Holter monitoring, cardiopulmonary exercise testing (CPET), and pulmonary function tests may be necessary.

Treatment

Due to the diversity of symptoms and their severity, the mainstay of long COVID treatment is multidisciplinary and supportive. The management should focus on supporting self-management and individualized rehabilitation.

Medical Therapy

  • Olfactory/gustatory symptoms
    • In most patients with a loss or decrease in sense of smell or taste, symptoms improve slowly over several weeks and do not require medical intervention. Patients may need education on food and home safety.
    • In patients with persistent symptoms, olfactory training may be appropriate. If conservative management fails, referral to an otolaryngologist and specialized taste and smell clinic may also be considered.
  • Alopecia
    • There is no specific therapy for alopecia in COVID-19 patients, and it should be managed similarly to non-COVID-19 patients.
    • In patients with concomitant malnutrition, nutritional deficiencies should be corrected.

Primary Prevention

The most effective measure to prevent the post-COVID-19 condition is to prevent COVID-19. These primary prevention strategies include:

Secondary Prevention

There are no established measures for the secondary prevention of long COVID.

See also

References

  1. Wisk LE, Nichol G, Elmore JG (2022). "Toward Unbiased Evaluation of Postacute Sequelae of SARS-CoV-2 Infection: Challenges and Solutions for the Long Haul Ahead". Ann Intern Med. doi:10.7326/M21-4664. PMID 35254883 Check |pmid= value (help).