Residual Symptoms in Patients After Acute COVID-19, Literature review

Abstract

Gabija Pajedienė1, Gintarė Jonuškytė1, Monika Martusevičienė2 1Lithuanian University of Health Sciences, Medical Academy, Faculty of Medicine 2Lithuanian University of Health Sciences, Kaunas Hospital Abstract Background. COVID-19 pandemic caused by the SARS-CoV-2 virus has already affected at least 163 million people worldwide. The most common symptoms are cough, fever, dyspnea, musculoskeletal symptoms (myalgia, joint pain, fatigue), gastrointestinal symptoms, and smell and taste disturbances [1,2,3]. As the part of the population suffering from COVID-19 infection increases, we see more people with residual symptoms of COVID-19 infection. Aim: to find out the most common residual conditions after COVID-19 and the frequency of occurrence. Methods: the priority of studies chosen included systematic reviews, then moved on to literature reviews, prospective studies and the last choice – case reports. Literature analysis was performed using Pub Med database, and MeSH terms, such as „COVID-19 sequelae“, „COVID-19 outcomes“, additional terms were chosen based on organ system damaged, for example: (COVID-19) AND (cardiovascular) AND (long-term outcomes). Due to the fact, that all studies on this topic are not older than 2 years, we did not need to apply date filter for the articles. Using MeSH terms more than 1500 studies were found. When more detailed filters were applied, and relevant articles were chosen, studies were filtered to the ones used in this study. Inclusion criteria: All of the patient analyzed were tested positive for SARS-CoV-2 infection using PCR or serological testing. Studies only included humans. Exclusion criteria: Patients not confirmed SARS-CoV-2 with objective tests. Patients younger than 18 years old. Results: residual changes in respiratory system – restrictive changes and isolated decrease of DLCO found in pulmonary function tests. Changes in radiologic pulmonary tests were still seen 90 days after COVID-19 disease. Most common cardiovascular outcomes – pericarditis, perimyocarditis, or myocarditis, which causes heart failure, malignant arrhythmias and acute coronary syndromes. Nervous system damage includes the most common symptoms – olfactory and gustatory dysfunction. For 3% to 14% of patients’ olfactory dysfunction persists up to 30 to 40 days after onset of symptoms. Systemic neurologic symptoms include headache, myalgia, dizziness, confusion. These symptoms can persist for 55% of the patients up to 3 months after the disease. Severe neurologic complications are less common, they occur up to 18% of COVID-19 patients, the most common of them – acute cerebrovascular complications. Keywords: COVID-19, SARS-CoV-2, sequelae, complications.