10 Long term effects of COVID-19 (Long COVID)

10 Long term effects of COVID-19 (Long COVID)

What is Long COVID?

Post-COVID syndrome which is known as Long COVID is persistence of symptoms following COVID-19. Due to the prevalence of symptoms for over 4 weeks post initial infection, this results in long-term impairment of health and quality of life.

Two major Types of Long COVID

Long COVID which is a sequel of COVID-19 can be categorized into two major types. This is based on the duration that the symptoms would continue after the clearance of the acute infection.

  1. Ongoing symptomatic COVID-19 : occurs from four to twelve weeks post-infection.
  2. Post-COVID-19 syndrome: when symptoms last for over 12 weeks post-infection. 

10 Major effects of Long COVID

The long term persistence of COVID-19 which is known as Long COVID has devastating effects. They can cause harm to many system of the Human body. They are the Respiratory system, Nervous system, Cardiovascular system and Digestive system of the Human Body.

Effect of Long Covid on the Respiratory system

COVID-19 primarily affects the respiratory tract,  particularly the lungs. Therefore, the Long Term effects of the disease include respiratory symptoms such as Shortness of breath and persistent cough. This is likely due to a combination of the body’s exaggerated immune system reaction to the virus, and the lung inflammation that it triggers.

#1 Shortness of Breath

Shortness of breath or Breathless is a common symptom of Long COVID. There are often abnormalities in lung capacity. For instance, the ability of gas to transfer between the lungs and blood and vice-versa, and small airway function. This could arise at the time of discharge  and even months later in individuals  that have had COVID-19 pneumonitis. In conclusion, sequelae of COVID-19 pneumonitis include 3 types. They are pulmonary fibrosis, bronchiectasis and pulmonary emboli. 

Many individuals that recover their lung function may  be breathless due to  a  dysfunctional breathing pattern. This can often be overcome through re-assurance that  other pathology has  been excluded. Also, breathing pattern re-education and exercises that can restore normal nasal and diaphragmatic breathing. 

#2 Cough

Cough is a commonly a predominant symptom of Long COVID. The viral infection that irritates the lungs results in the dry cough. Certainly, even after the virus is long gone the airways are hypersensitive  to external stimuli. Additionally, there are two other possibilities t cough. They are. the lung inflammation may persist or fibrosis (scarring) of the lung  may have developed which also causes a protracted cough.  Coughs that persist after the common cold or flu, is different from this scenario. It is because, chronic cough in Long COVID is usually accompanied by other multisystem manifestations.

An expert assessment is in need to identify the cause of the cough. However, this will allow treatments to be specifically targeted. Sometimes the involvement  of a speech and language therapist or chest physiotherapist with a special interest in cough management is needed. This is because, it is found to  be very beneficial in order to find the exact reason for the cough.

Staying well  hydrated and  avoiding forceful throat clearing, are effortless mechanisms that can be tried at home to overcome cough. 

Effect of Long Covid on the Nervous system

A  wide spectrum of symptoms related to nervous system involvement occurs in Long COVID. This could probably  be due to inflammation of the brainstem as a result of the virus. Fatigue, anxiety, depression, and difficulty in sleeping are often profound symptoms of long COVID that affect quality of life.

#3 Fatigue

Fatigue is the unrelenting tiredness and constant state of weariness that does not recover through rest. This can affect a person in many ways. Negatively, affecting mental health, physical health or both diminishing the sense of energy that is in-built to live an active lifestyle.

There are multiple symptoms that are commonly associated with  fatigue. They are sleepiness, headache, dizziness, aching muscles, muscle weakness, slowed reflexes and responses, impaired decision-making, irritability, impaired hand-to-eye coordination, appetite loss, reduced function of the immune system. 

Since fatigue is not a disease but a symptom, an expert assessment will aid in identifying possible causes contributing to it. For example, people with fatigue may be feeling this way because of anaemia, underactive thyroid, heart disease, obstructive sleep apnoea and more. Lifestyle changes may be needed to manage the fatigue if a reversible cause is not identified. 

#4 Anxiety

The experience of excessive worry without the appearance of logical reasons that become ongoing and distressing is called Anxiety. Anxiety affects and interferes with the  daily lives of the person and makes the situation worse. Many sufferers of Long COVID experience Anxiety when they did not have these feelings before being infected with the virus.

Panic attacks are a common feature of Anxiety disorder. This is the  feeling of intense terror that occurs for no apparent reason. Physical anxiety reactions such as trembling, sweating, rapid heartbeat, nausea are other symptoms of anxiety. Moreover, the Avoidance behaviour in which avoiding social situations that could bring anxiety or panic at an extreme level too reflects anxiety.

To achieve recovery from this Long Term effect of COVID-19, both therapeutic measures and medication can be endeavoured. Medications for Anxiety include the usage of anxiolytics and antidepressants. Therapeutic measures include aiming to change thinking patterns that trigger anxiety is a great way to overcome anxiety. Also, gradual exposure to situations that trigger anxiety, meditation and breathing exercises too are methods to follow in order to gradually overcome anxiety.

#5 Depression

Depression is a mood disorder. This involves feelings of persistent sadness and loss of interest in usual pleasurable activities. This is distinct from mood fluctuations a person may encounter within the course of a day. Even-though depression involves a constant feeling of sadness, depression is not merely feeling sad. It is vital to distinguish between sadness and depression.

SadnessDepression
Awareness that this feeling will pastFeeling of permanence
Comes in waves Constant and unremitting
Feeling to connect with othersFeels outcast and alone
Looks forward to thingsNo hope about future
Able to smile about past memoriesLoss of self-esteem, feeling worthless 
Feel guilty around specific issuesGeneralized guilty about everything
Will to live existsSuicidal thoughts

In addition to feeling constant sadness, other symptoms such as constant headaches, memory loss and pains in joints can be exacerbated by  depression.

Untreated depression can have severe effects on the individual, the family and other relationships, occupation and more . Professional Medical advice and guidance of a psychologist is in need to treat Depression.

If you need someone to talk to, call the Samaritans on 116 123.

#6 Insomnia

Insomnia is a sleep disorder in which difficulty falling and/or staying asleep arises. However, Insomnia is not a disease, but a symptom that can be managed. COVID-19 induced insomnia, which is also referred to as “coronasomnia,” can be caused in many ways. They are total disruption of daily routines, sleepless nights, monotony in the day or complete lack of a daily routine that took place during the course of infection.

Things  that can help manage Insomnia include regular exercise and improving sleep hygiene measures. These include turning off devices that emit blue light at least an hour before sleep, sticking to a sleep schedule, ensuring comfortable temperature of the room, blocking out light and  lowering  noise. Furthermore, seeking professional advice is recommended if the condition is persistent for a few weeks irrespective of the above lifestyle changes. Cognitive behavioural therapy is also a helpful and successful online therapy with apps such as sleepio.

Effect of Long Covid on the Cardiovascular system

The viral infection causes damage to the Cardiovascular system by damaging the heart muscle and affects heart function. Coronavirus infection also affects the inner surfaces of veins and arteries, which can compromise blood flow to heart or other parts of the body.

#7 Chest pain

Chest pain is a widely reported Long COVID symptom. Complaints of persistent chest pain at exertion post-recovery from COVID-19 demonstrates that COVID-19 microvascular dysfunction remains unresolved and should be investigated. Although, not often thought of, chest pain may also be a manifestation of dysfunctional breathing. Severe chest pain , sudden chest pain, especially accompanied by shortness of breath lasting more than five minutes are critical conditions of chest pain and immediate medical consultation is recommended.

#8 Palpitations and Irregular Heart rhythm

Palpitations can be noticed when the heart  is beating too fast or irregularly. This is a common symptom that arises after recovery from COVID-19.  This could be accompanied with chest discomfort and feeling lightheaded or dizzy, especially upon standing.

An ECG (electrocardiogram) can assess the heart rate and rhythm . Depending on the symptoms, blood tests, an exercise stress test, and other investigations, such as a coronary angiogram or longer term heart rate monitoring are other methods to track irregular heart rhythm.

In addition to medicinal treatments, relaxation techniques, vagal maneuvers, hydrating, restoring electric balance of the human body are possible techniques to overcome Irregular Heart Rhythm. 

Effect of Long Covid on the Digestive system

Gastrointestinal sequelae of Long COVID effects are not uncommon.

#9 Acid reflux

Acid reflux is a common feature of Long COVID. Burning pain in the centre of the chest, known as heartburn is a common symptom of acid refulx. This happens as a result of stomach acid flowing back up into the food pipe. It could sometimes flow back in to the throat, leaving an unpleasant sour taste in your mouth.

It is also a very common cause of  cough or hiccups that keep coming back, bloating and feeling sick. In order to lessen Acid Reflux there are various home remedies to follow. They are intaking smaller but frequent meals, weight loss, avoiding fast food, and sleeping with the head of the bed raised are a few of them. However, for persistent or debilitating acid reflux, medication is in need. Thereby, it will suppress acid production and allow the lining of the stomach and food pipe to heal. When large hernias are evident, surgical procedures will help get-rid of acid reflux.

Effect of Long Covid on the Musculoskeletal system

COVID-19 being a respiratory illness, however negatively affects the Musculoskeletal system as well.

#10 Joint Pains

COVID patients often reveal experience of joint pains. In fact, joint pains in some patients do not fade away even after recovery. 

Inflammatory joint disease can occur from a viral infection that sparks an exaggerates immune response that can lead to both muscle aches and joint pains. Therefore, pain in arms, legs, or back that develops spontaneously without any injury occurs due to COVID. If the person already has a history of arthritis, the infection with the coronavirus  may exaggerate the symptoms.

Analgesic medication are possible treatments for joint pains induced by Long COVID. Applying ice, heat and resting, losing weight, physical therapy, staying active, and over-the-counter anti-inflammatory and over-the-counter anti-inflammatory and analgesic medication are possible treatments for the joint pains induced by Long COVID.


Can Long COVID be treated?

Fortunately for people with Long COVID, the symptoms resolve over time. However, it is important that a doctor evaluates in order to exclude pathology that needs specific medical treatment. For example, for individuals with shortness of breath may need a pulmonary embolism excluded. Moreover, inhaler treatment for hypersensitive airways, or breathing pattern re-education for dysfunctional breathing pattern are other ways of treatment. Therefore, keeping a specialist with constant updates may dismantle the devastating effects of possible significant pathology. 

References

https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/anxiety-disorders

https://www.medicalnewstoday.com/articles/8933#symptoms

https://twitter.com/drkirstykennedy/status/1070298118149804032/photo/1

https://www.bmj.com/content/374/bmj.n1648

https://academic.oup.com/ehjcr/article/5/3/ytab105/6184571

https://www.news18.com/news/india/decoding-long-covid-gastroenterologist-explains-why-acidity-loss-of-appetite-shouldnt-be-ignored-3822338.html

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