An Overview of Post COVID-19 Syndrome
Purvit Patel, BASIS Chandler, Chandler, Arizona, USA
After contracting COVID-19, most individuals battle the disease for a couple of weeks before making full recovery and being able to continue with their lives as before. Others, however, face a more difficult reality, where they could have to wait months or even years before full recovery. This is known as long COVID, or post COVID-19 Syndrome, an area that is still being researched as the pandemic continues. This article aims to provide an overview of this condition, whose understanding is constantly changing.
Post COVID-19 Syndrome is an umbrella term characterized by patients having COVID-19 symptoms more than four weeks after they are first diagnosed with the disease (CDC, 2022). These symptoms can last for years, even after the acute COVID-19 disease has passed (Mayo Clinic, 2022).
Fatigue is one of the most common symptoms, appearing in 30%-90% of those with post COVID-19 syndrome (Diem et al., 2022). Fatigue presents itself as the feeling that one gets from long periods of high concentration. However, instead of just a few hours, patients can experience fatigue for months. In many cases, patients develop chronic fatigue syndrome, characterized by a perpetual lack of motivation and an increased risk of depression (ScienceDaily, 2022; Healthline, 2017). Furthermore, those with post COVID-19 syndrome show higher levels of neuroticism, a personality trait characterized by mood instability, making one more prone to depression (Delgado-Alonso et al., 2022). This is likely associated with the massive 25% increase in the incidence of depression as a result of the pandemic (WHO, 2022). Brain fog is another common symptom of long covid in which a person is cognitively impaired and has trouble concentrating. Researchers believe it is similar to the impairment caused by chemotherapy. COVID-19 sometimes causes inflammation in the brain, leading to this cognitive impairment (Stanford Medicine, 2022). Reduced microvascular perfusion, which is the passage of blood and gas exchange to a capillary bed in tissues, could explain symptoms like fatigue, exercise intolerance and shortness of breath in patients post COVID-19 compared to healthy counterparts (Doeblin et al., 2019). Reduced blood flow lowers the amount of oxygen delivered to tissues, causing a patient to feel out of breath easier than before, and feel fatigued after a period of high concentration. Other than these, sleep problems, muscle pain, and shortness of breath are common post COVID-19 symptoms (CDC, 2022).
Because of the long-term nature of the symptoms, scientists are researching the predisposing factors to post COVID-19 syndrome to identify any groups at higher risk. They have found that post COVID conditions are more likely in those who have had a severe COVID-19 illness than those with a milder form of the disease. Unvaccinated people are also more susceptible to long-term symptoms compared to those that are vaccinated and have a breakthrough infection (CDC, 2022). An observational study with around 4,500 patients from Iran found that the difference between women and men contracting these symptoms was statistically significant and that women were more likely to experience post COVID-19 syndrome than men. It also found that the presence of respiratory problems at the beginning of the acute disease was positively associated with post COVID-19 syndrome (Asadi-Pooya et al., 2021).
Because a relatively short amount of time has passed since the start of the COVID-19 pandemic, there is still not enough information to answer some of the key questions that have emerged from this condition, such as how long symptoms are expected to last, who is at risk to have the condition, and what affects the severity of symptoms. Researchers are currently trying to gather more information about the risk factors and preconditions that make a person more susceptible to long-term symptoms after COVID-19 to potentially alert those that are at risk. As of now, however, because of this lack of information, people should weigh the risks of potentially having COVID-19 symptoms for months when considering vaccination and protective measures.
Anaya, J.-M., et. al. (2021, September 10). Post-covid syndrome. A case series and Comprehensive Review. Autoimmunity Reviews. https://doi.org/10.1016/j.autrev.2021.102947
Asadi-Pooya, A. A., et. al. (2021, November). Risk factors associated with long COVID syndrome: A retrospective study. Iranian journal of medical sciences. doi.org/10.30476/ijms.2021.92080.2326
Centers for Disease Control and Prevention. (n.d.). Long Covid or post-covid conditions. Centers for Disease Control and Prevention. Retrieved September 7th, 2022 from https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
Delgado-Alonso, C., et. al. (2022, February 14). Examining association of personality characteristics and neuropsychiatric symptoms in post-covid syndrome. MDPI. https://doi.org/10.3390/brainsci12020265
Diem, L., et. al. (2022). Fatigue in Post-COVID-19 Syndrome: Clinical Phenomenology, Comorbidities and Association With Initial Course of COVID-19. In Journal of Central Nervous System Disease (Vol. 14, p. 117957352211027). SAGE Publications. https://doi.org/10.1177/11795735221102727
Doeblin, P., et. al. (1970, January 1). Brief research report: Quantitative analysis of potential coronary microvascular disease in suspected long-COVID syndrome. Front Cardiovasc Med. https://doi.org/10.3389/fcvm.2022.877416
Mayo Foundation for Medical Education and Research. (2022, June 28). Covid-19: Long-term effects. Mayo Clinic. Retrieved September 7th, 2022 from https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351
Nall, R. (2020, March 29). Depression and fatigue: An unfortunate connection. Healthline. Retrieved September 11, 2022, from https://www.healthline.com/health/depression/fatigue#an-unfortunate-connection
News Center. (2022, June 13). Brain fog after covid-19 has similarities to 'chemo brain,' Stanford-led study finds. News Center. Retrieved September 7th, 2022 from https://med.stanford.edu/news/all-news/2022/06/brain-fog-covid-chemo-brain.html
ScienceDaily. (2022, August 31). SARS-COV-2 can trigger chronic fatigue syndrome, study finds. ScienceDaily. Retrieved September 7, 2022, from https://www.sciencedaily.com/releases/2022/08/220831095019.htm
World Health Organization. (n.d.). Covid-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. World Health Organization. Retrieved September 7th, 2022 from https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide