Yes, covid-19 has been spreading around the world for more than a year and claiming millions of lives, but there are still many aspects that we do not fully know about this new coronavirus, including the long-term effects on our body and all the symptoms that they may persist. It is a deceptive and new virus in many ways.

But research published February 19 in the medical journal JAMA Network Open sheds some light on this enigma that has been dubbed “long covid,” “ongoing covid,” “post-covid syndrome,” or “acute post-covid syndrome.”

In a simple way, people infected with covid-19 can suffer symptoms or long-term effects, regardless of the severity of the disease they went through when they were infected.

“In some people, some symptoms can persist or reappear for weeks or months after initial recovery. This can also happen to people with a mild disease”, indicated the World Health Organization (WHO) in a document published in September 2020.

In addition, the WHO detailed that the persistence of symptoms can occur regardless of whether it has been needed or no hospital care.

So, what signs or symptoms indicate that you have already had COVID-19 and how long can they last? This is what we know so far.

Fatigue and trouble sleeping

Fatigue is one of the most common symptoms of COVID-19 infection and also one of the longest-lasting, according to the US Centers for Disease Control and Prevention (CDC).

Research published February 19 in the Jama Network Open magazine found that more than 30% of the 177 participants that it followed for 9 months reported persistent symptoms. Fatigue was the most common, along with loss of smell or taste.

All the people who participated in this study, conducted by researchers at the University of Washington, had COVID-19 confirmed by laboratory tests. 30% also reported a poorer quality of life, compared to the time before contracting the new coronavirus.

And 8% of the participants indicated that they had trouble doing at least one daily activity, such as daily chores around the house.

Similarly, a study that followed more than 1,700 COVID-19 patients in Wuhan, the original epicenter of the pandemic in China, recorded that 76% suffered at least one symptom months after being discharged from the hospital.

The most common? Fatigue and sleeping difficulties, with 63% and 26%, respectively, of patients reporting them half a year after their initial covid-19 diagnosis.

“When we look at long-term symptoms, the big things we see are fatigue, lethargy and sleep disturbances. And that’s probably more than half of what we see,” Dr. Christian Sandrock previously told Citizen Free Press.

Sandrock is Professor of Lung Intensive Care Medicine and Infectious Diseases at the University of California School of Medicine in Davis, California. He also cautioned that many patients experience multiple symptoms, and these can be intermittent.

Mental confusion or “fog”

Patients suffering from the long-term effects of COVID-19 largely face a condition known as mental confusion or “fog,” said Dr. Alfonso Hernandez-Romieu, a member of the CDC, in conversation with Citizen Free Press. in january.

This mental confusion “is defined as mild subjective cognitive impairment, approximately four weeks after acute illness,” he explained.

Along the same lines, Dr. Allison Navis, an assistant professor at the Icahn School of Medicine at Mount Sinai Hospital in New York, noted that mental confusion “is a symptom, not a diagnosis. And it means many different things to different people. It’s often a combination of short-term memory problems, concentration, or trouble expressing yourself.”

And there is another relevant issue, according to Navis. This mental confusion does not appear to have a clear relationship to the severity of the COVID-19 infection, age, or other risk factors.

As he explained, doctors have observed these symptoms in young patients, both children and adolescents, who had mild COVID-19 and were healthy.

Difficulty breathing, coughing, and loss of smell or taste

These symptoms are also one of the most indicative of a covid-19 infection and usually persist in patients long after the initial diagnosis.

In the study published in JAMA Network Open, shortness of breath was one of the most common. While coughing and loss of smell or taste appear high on the WHO and CDC lists of symptoms that can persist.

“Our analysis indicates that most patients continue to live with at least some of the effects of the virus after leaving the hospital. So the need for post-discharge care is highlighted, especially for those experiencing serious infections. Our work also underscores the importance of conducting longer follow-up studies in larger populations,” says the statement from the study that followed 1,700 covid-19 patients in Wuhan.

Signs on the skin

An analysis from Massachusetts General Hospital, published in October 2020, found that some people infected with COVID-19 had skin-related symptoms long after their initial infection. Those signs on the skin could last for up to 60 days or more.

The team evaluated nearly 1,000 cases of patients with various manifestations of COVID-19 on the skin, including hives, papulosquamous rashes, and swollen hands and feet. The persistence of these conditions lasted from 12 to 130 days, depending on the case.

“Our findings reveal a previously unreported subset of patients with long-standing COVID-19 skin symptoms, particularly those with COVID feet,” the hospital said in a statement. And they added: “The skin is a potential visible window to inflammation that could be occurring in the body.”

In April 2020, a study published in the British Journal of Dermatology by Spanish researchers described the skin lesions of 375 patients with covid-19.

The most frequent in the series studied, with 47% of the cases, was that of welts of highly variable shape and extension, some similar to those that appear when mosquitoes or fleas bite us, others as multiple scattered red spots, as explained by Dr. Elmer Huerta, a public health specialist and Citizen Free Press contributor.

Lasting psychological effects

The study that followed 1,700 covid-19 patients in China for six months also found that the virus could have long-lasting psychological complications, with anxiety or depression in 23% of the participants.

In that sense, the findings of this research on fatigue, sleeping difficulties and anxiety or depression dovetail with previous studies on patients who had a related coronavirus that caused severe acute respiratory syndrome (SARS) in 2003 and 2004, according to the Chinese researchers.

In addition, depression was one of the long-term symptoms that the CDC recorded about covid-19.

Other symptoms that may persist after having covid-19

As covid-19 still represents an enigma for science, there are long-term symptoms that have not been investigated in depth such as those already mentioned. According to the WHO, the CDC and the Mayo Clinic add to the list:

  • Headaches and body aches
  • Joint pain
  • Diarrhea, nausea
  • Chest or abdominal pain
  • Fast or pounding heartbeat
  • Rashes or hair loss

The first thing, of course, is to seek medical help and confirm the covid-19 diagnosis, in case you haven’t already. On the other hand, Dr. Sandrock, from the University of California Davis School of Medicine, talks about a treatment that is consistent: supportive care.

This, he says, involves living better and a higher quality of life. It means you really need to sleep. Sleep is going to matter a lot, he said. And he added that stress reduction, meditation and yoga can also help.

Sandrock said patients need to adjust their life to a less stressful and calmer pace to allow the body to heal. “We want people to be really patient with themselves, to know that it is going to take a long time to work on that,” he recommended.

Along the same lines, Dr. Allison Navis, from Mount Sinai, explained that patients should get enough sleep and take care of their mental health. He also cautioned that those who experience fatigue should take exercise in stride. Don’t do anything that will make you feel worse afterward.

Long-term problems you should pay attention to

The CDC notes that “more serious long-term complications appear to be less common, but some cases have been reported.” Precisely because covid-19 not only affects the lungs, but also targets various organs of the body. Here are the conditions the CDC lists:

  • Cardiovascular: inflammation of the heart muscle
  • Respiratory: abnormalities in lung function
  • Kidney: acute kidney injury
  • Dermatological: rash, hair loss
  • Psychiatric: depression, anxiety, mood swings
  • Neurological: taste, smell, problems sleeping, concentrating and memory

However, the agency noted that “what these long-term effects entail is still unknown” and further research is needed.

“There are ongoing studies that will take several years to investigate further,” he said. A point that the WHO also insisted on, as it explained that “very little is known about the evolution over time of people affected by covid-19.”

To the long-term conditions that COVID-19 can cause in the organs, the Mayo Clinic adds effects in the brain such as “cardiovascular accidents, seizures, and Guillain-Barré syndrome, a condition that causes temporary paralysis.”

In addition, the institution noted, covid-19 can increase “the risk of developing Parkinson’s and Alzheimer’s disease.” Likewise, the virus can make it more likely for blood clots to form and cause blood vessel problems.

“While large clots can cause heart attacks and strokes, much of the damage to the heart caused by COVID-19 is thought to come from very small clots that block the tiny blood vessels (capillaries) in the heart muscle,” explained the Mayo Clinic. And he added that clots can affect other parts of the body such as the lungs, liver, kidneys and legs.

“Not much is known yet about how Covid-19 is going to affect people over time. But researchers recommend that doctors closely monitor people who have had COVID-19 to see how their organs are working after they recover,” said the Mayo Clinic.

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