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COVID-19 Sequelae, You should Know about Long COVID

by Amélie Poulain
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A recent study in the UK found that only 30 percent of people who contracted COVID-19 fully recovered after a year. The WHO also estimates that about 10-20% of patients will develop symptoms of long COVID. Common symptoms include tiredness, trouble breathing, poor sleep quality, muscle and chest pain, reduced concentration and memory, and emotional problems. Studies in the United States also found an increased risk of developing cardiovascular disease within a year of infection.


WHO estimates that about 10-20 percent of people who contracted COVID-19 will develop symptoms of long COVID. (Photo via unsplash.com)

Taipei, TAIWAN (Merxwire) – A recent British study published in the medical journal “Lancet Respiratory Medicine” showed that less than 30% of people diagnosed with COVID-19 fully recovered within one year of infection, and it also suggested that post-infection Important warning. The survey found that “long COVID” will become a common disease in the world, which can be said to be a major sequela after the spread of the COVID-19 virus. Christopher Brightling, a Professor of the University of Leicester also said the follow-up will continue for 25 years to understand the long-term effects of the virus on humans.

In an official statement released by the WHO in October 2021, “long COVID” is defined as people who have been diagnosed or may have been infected with the virus. The onset of symptoms is within 3 months after infection and the symptoms have persisted for more than 2 months. The causes of the symptoms cannot be explained from the perspective of other diseases. WHO estimates that about 10 to 20 percent of patients will experience long COVID. Common symptoms include fatigue, poor breathing, poor sleep quality, muscle and chest pain, reduced concentration and memory, and emotional problems. Therefore, COVID-19-related research has shifted from vaccine prevention, clinical drugs, and treatment to clinical research on “long COVID”.

The study looked at the health of people infected with COVID-19 in 39 UK hospitals between March 2020 to April 2021. The percentage of people who participated in the study fully recovered after 5 months was 26%, and 28.9% fully recovered after 1 year. Among them, women’s resilience is 33% lower than men’s, only half of the obese people fully recover, and 42% of infected people who have been put on a respirator during treatments fully recover. Rachel Evans working at National Institute for Medical Research led the study and mentioned that during the recovery period of the subjects within one year after discharge, their disease, mental health, quality of life, exercise capacity, organ damage, and other aspects of recovery didn’t have much improvement.

Women have a 33% lower resilience than men after being infected with the COVID-19 virus, so women are higher than men in the main group of long COVID. (Photo via pexels.com)

Symptoms of long COVID

According to the UK medical staff guidelines, symptoms that cannot be explained by other causes for more than 12 weeks after the isolation of infection can be regarded as long COVID. Long COVID affects the lungs and brain more obviously. The main symptoms include extreme fatigue, the pain of muscle and joint pain, poor sleep quality, shortness of breath, chest pain, poor memory and concentration, and decreased mobility. The type, severity, and duration of symptoms vary from different persons, and some people also experience mental health problems such as anxiety and depression, changes in taste and smell, and gastrointestinal disturbances. Even mild patients may develop long COVID. Professor Christopher Brightling believes that if there is no active and effective treatment, the long COVID will become a long-term disease, accompanied by people infected with COVID-19.

Possible Causes of long COVID

At present, the main reasons for the occurrence of long COVID cannot be fully confirmed, but it is determined that the symptoms of long COVID are not necessarily caused by the COVID-19 virus, but may also be caused by other accidental reasons, psychological stress or chronic diseases of the body. The researchers are currently mainly in-depth research in four directions:

  • Immune system inflamed disorder: When the body is infected or damaged, it will produce a natural inflammatory response to fight the foreign attack. Studies have confirmed that the new coronavirus attaches to cells for a long time, which may cause autoantibodies to produce false attack behaviors on organs or tissues.
  • The COVID-19 virus continues latent: The lungs and respiratory tract are initially infected by the virus, but the virus can also infect other parts of the body. Some experts believe the virus still lurks in other parts of our bodies, such as the microbe-laden gut.
  • Blood clots and small blood vessel damage: Viral infections cause micro clots in the body, which block the capillaries in the body that supply cells with oxygen and nutrients and remove waste products from metabolism. As a result, the damage to cells is accelerated, and people become extremely fatigued.
  • Damaged mitochondria: The mitochondria in human cells convert the energy provided by food into a form that the body can use. When damaged, it can lead to abnormal conditions in the production and consumption of energy in the body. The COVID-19 virus puts mitochondria in a dormant state, like a shutdown, and the metabolism of the body goes wrong.

Other related reasons include the virus directly affecting the functioning of organs and tissues, the destruction of the brain and other organs when the blood is deprived of oxygen, and the formation of scar tissue when damaged lungs or other organs are not fully repaired. Another reason is the side effects on the body when receiving active treatment such as respirators, sedatives, corticosteroids, and pain relievers.

Which ethnic groups are more likely to develop long COVID? It is impossible to classify a unified statement. Data show that the most common age group for “long COVID” is 35 to 49 years old, women, people with chronic diseases and overweight people are more likely to get the disease. People who work in health care, as social workers or educators also have higher rates of this symptom. Three-quarters of long COVID patients experience symptoms of fatigue or muscle weakness. Although not life-threatening, extreme fatigue or shortness of breath can still interfere with daily life, and after a period of incubation, it may cause more serious conditions such as stroke, heart failure, pulmonary embolism, myocarditis, diabetes, and chronic kidney disease. Do children experience long COVID? Younger children usually have milder illnesses and fewer sequelae. In adolescents, it is more likely to have long-term effects, with an incidence of about 10%, and may affect the heart, pancreas, or other respiratory-related complications. Research from University College London found that between 2% and 14% of teens also experienced fatigue, headaches, and shortness of breath 15 weeks after a positive nucleic acid test. Research by the Israeli Ministry of Health shows that 11.2% of children will develop long COVID.

Study shows the risk of cardiovascular disease increase within a year of contracting COVID-19. (Photo via unsplash.com)

Increased Risk of Cardiovascular Disease after COVID-19

In addition to long COVID-19 side effects, a study recently published in ScienceDaily by the school of medicine of the University of Washington found that one month to one year after contracting the COVID-19 virus, the risk of cardiovascular disease will increase. It may lead to serious cardiovascular-related complications and even death. There have been at least 15 million cases of cardiovascular disease in the world, which appeared or became severe after infection. Therefore, we must pay attention to cardiovascular health after the epidemic.

The study was led by MD Ziyad Al-Aly, an assistant professor of Medicine school. Dr. Ziyad Al-Aly said that the heart damage caused by the COVID-19 virus infection cannot be easily recovered, and there is a certain chance that there will be lifelong sequelae. The study mainly conducted a one-year health observation and statistical analysis of infected people. It was found that the probability of developing heart disease was 4% higher than that of uninfected people, which is equivalent to 3 million people in the United States who developed heart diseases or complications of vascular diseases after contracting the COVID-19 virus. When compared with the uninfected control group, the risk of coronary artery disease was increased by 72%, the risk of heart attack was increased by 63%, and the risk of stroke was increased by 52%. Overall, the rate of major cardiovascular disease adverse events in the diagnosed patients was 55% higher than that in the uninfected patients.

Why is the incidence of cardiovascular disease increased after infection? Doctors believe that it may be because the virus invades organ cells through the cell surface receptor “ACE2” during infection, causing damage to various parts of the body such as the respiratory tract, cardiovascular, and gastrointestinal tract. It is difficult to fully recover, and the virus will hide in the cells and activates the body’s immune mechanism. The immune system will start to attack the infected cells, which will set off an immune storm in the body and cause inflammation of the organs. The most common disease is myocarditis.

The scars left by the heart attack can cause abnormal discharge symptoms, which may lead to irregular heartbeats or heart failure. When the cardiovascular epidermis and endothelium are inflamed, the repaired plaque deposits will be destroyed and causing cardiovascular disease. Abnormal blood clotting factors can lead to blood clots. Whether the patients are mild or severe, it will cause damage to the organs in the body, leaving cardiovascular-related sequelae or complications, so we have to be careful of the follow-up.

The impact of the COVID-19 virus may have lifelong effects on the human body. (Photo via pexels.com)

Is it impossible to fully recover after being infected with COVID-19? The answer varies depending on different persons. 70% of the people certainly need a recovery period of more than one year and 10% to 20% of the people will enter the longer COVID-19, especially those with more severe symptoms when they are infected. At present, apart from symptomatic medication for obvious symptoms, there is no set of time-proven treatment methods, so most of the symptoms have been controlled and daily activities have been gradually increased to help the body recover. WHO also reminded young people after the infection to pay attention to possible heart problems in the future.

Doctors recommend that after being infected by the COVID-19 virus, even if you have recovered, you should continue to observe and track your physical condition for at least one year to ensure that there are no obvious or serious sequelae. Regular work and rest with appropriate exercise to improve resilience and reduce the chance of virus damage to the body. If you are concerned about your physical condition after the infection, you can also go to the “Integrated Medical Clinic for the Recovered from COVID-19” in major hospitals, and let the professional medical staff guide and accompany you through the recovery stage after the virus infection, and return to normal life as soon as possible.

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