Abstract

The majority of people infected with SARS-CoV-2 fully recovered within a few weeks. However, a considerable number of patients of different ages still suffer from long-lasting problems similar to the multi-organ damage in its acute phase of infection, or experience symptoms continuously for a longer term after the recovery. The severity of the primary infection seems not to be associated with the possibility and severity of long-term symptoms. Various unresolved symptoms have been reported in COVID-19 survivors months after hospital discharge. Long COVID-19 Syndrome refers to survivors 4 months after initial symptoms onset. It is important to understand the systemic effects of Long COVID-19 Syndrome, its presentations, and the need for rehabilitations to restore functional recovery in survivors. Government, healthcare workers, and survivor groups should collaborate to establish a self-sustaining system to facilitate follow-up and rehabilitations, with prioritization of resources to more severely Long COVID-19 Syndrome survivors. This review looks into the systemic effects of Long COVID-19 Syndrome in various aspects: respiratory, cardiovascular, hematological, renal, gastrointestinal, neurological, and metabolic effects of Long COVID-19 Syndromes. Recommendations for follow-up and rehabilitations details have been explored to cope with the tremendous Long COVID-19 Syndrome patients.

Highlights

  • Ever since the first case of COVID-19 reported in early December 2019 in China, the incidence has been rising drastically

  • Postacute-COVID-19 is defined as ongoing symptomatic COVID-19 for people who still have symptoms 4 and 12 weeks after the onset of acute symptoms, while postCOVID-19-syndrome is for people who still have symptoms for more than 12 weeks after onset of acute symptoms according to the UK NICE guidelines [7]

  • This review aims to look into the long-term effects of COVID-19 infection on respiratory, cardiovascular, neurological, and metabolic system of recovered COVID-19 patients (Table 1 and Figure 2), and to make recommendations on the management of Long COVID-19 patients

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Summary

Introduction

Ever since the first case of COVID-19 reported in early December 2019 in China, the incidence has been rising drastically. Though a majority of patients recovered from COVID-19 infections, over 70%-of-survivors were reported to have impairments in one or more organs 4 months after initial symptoms [3]. They are termed “long haulers” [4], or patients living with “Chronic COVID syndrome”, “post-COVID-19 syndrome”, or “postacute-COVID19 [5,6]. Despite the commencement of global COVID-19 vaccination programs [10], the infection rate remains high at the time of writing. This may imply we will have to live with. Recovered COVID-19 patients are defined as previously infected patients with SARSCOV-2 negative testing by polymerase-chain-reaction (PCR) on 2 consecutive occasions separated by at least 24 h and without clinical symptoms at the time of discharge [14]

The Effects of Long COVID-19 Syndrome on Various Systems
Respiratory System
Cardiovascular System
Haematological System
Renal System
Digestive System
Neurological System
Metabolic System
Recommendation of Follow-Up
Findings
Conclusions

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