Long Covid

Many people who become infected with the SARS-CoV-2 pathogen still suffer from various health problems months after their illness.

In the course of the pandemic, it has been shown that even with a mild course of the corona disease or even an unnoticed infection, long-term late effects on one’s own health can persist. The technical term for these long-term effects is "Long Covid".

Viral diseases are generally considered a treacherous affair. It is not uncommon for the affected persons to continue to suffer from various symptoms and complaints for a long time after the infection has been overcome. Longer recovery times are observed, particularly in the case of inflammation and viral infections affecting the lungs.

Physicians are also familiar with long-term health consequences from other infectious diseases such as the Spanish flu. However, research studies suggest that after a SARS-CoV-2 infection, the long-term consequences occur more frequently and can last longer than, for example, with influenza.

This is what happens with Long Covid

Long Covid patients have clinically recovered from a SARS-CoV-2 infection. This means that no corona viruses can be detected in your body. Nevertheless, these patients still suffer from some severe symptoms. So they are not completely healthy.
If the course of the disease is mild, it takes about two to three weeks until the corona infection is over. If the course is moderate or severe, the acute phase of the disease doubles.

Even after the acute stage of the disease, however, a large proportion of those affected develop various symptoms of the disease. According to experts, around 80% of patients who had to be hospitalized due to their corona virus infection suffer from long-term health consequences.

However, Long Covid also affects people who have had a mild or even asymptomatic course of the disease. About a third of all Covid patients who were able to cure their viral disease at home also suffer from the long-term effects of Corona.

The corona virus can affect various body organs. In addition to the lungs, the brain, kidneys, heart, pancreas, nervous and vascular systems, and liver can also be affected. Accordingly, the possible long-term consequences are very diverse.

Long Covid or Post Covid? Where is the difference?

The two terms Long Covid and Post Covid must be distinguished from one another in terms of content:

Post Covid includes all symptoms, health disorders and limitations that exist after the acute phase of the disease, in the convalescence phase. The health problems usually occur after a severe to critical course of the disease and usually persist for at least 12 weeks after the start of the corona virus infection. Depending on how severe the acute corona disease was, the symptoms and complaints can last longer than 12 weeks, sometimes even for months.

In contrast, the long Covid syndrome describes a wide range of health disorders and symptoms that exist at least four weeks after the corona virus infection.

In short:

• Long Covid: The symptoms persist at least four weeks after the SARS-CoV-2 infection.
• Post Covid: The symptoms persist for at least 12 weeks after the SARS-CoV-2 infection.

Symptoms: what does Long Covid look like?

Long Covid has a very wide range of symptoms. The leading long-Covid key symptom is the so-called "chronic fatigue": This means a gradual, pronounced exhaustion. In quite a few cases, fatigue is a side effect of chronic illnesses, and even after a corona virus infection, this severe exhaustion can make itself felt. It is characterized above all by severe tiredness and exercise intolerance, but various neurological symptoms such as taste and smell disorders, memory disorders, poor performance, difficulty finding words or headaches can also be observed.

However, the exact causes have not yet been conclusively clarified among scientists and physicians. It is suspected that it is not the virus itself that causes this symptom, but rather the body's own immune system, which has not yet been able to calm down after the acute infectious disease.

So far, it is not possible to say specifically how long the individual affected patients will suffer from the long-term consequences of the COVID-19 infection or whether there will be permanent damage to their health.

respiratory

• gentle breathing
• strong and persistent urge to cough/cough
• Difficulty breathing/shortness of breath (e.g. during moderate physical exertion such as climbing stairs or walking)
• Lung fibrosis: Here the tissue of the lungs is changed in such a way that the gas exchange (diffusion capacity) between air and blood in the lungs is significantly more difficult. This leads to a reduction in lung function.

Cardiovascular

• Chest tightness and pressure (angina pectoris)
• Pain complaints in the chest
• palpitations
• Heart muscle inflammation (myocarditis)
• Heart failure (heart failure)
• Heart rhythm disturbances (arrhythmia)
• Damage to the blood vessels/inflammation in the bloodstream
• Formation of blood clots, which can lead to so-called microthrombosis. As a result, heart attacks, strokes or even kidney failure (kidney insufficiency) can occur.
• Impairment of the white and red blood cells (sometimes over a period of several months)

Generalized Symptoms

• Exhaustion, exhaustion and pronounced tiredness
• Chronic Fatigue
• powerlessness
• Fever
• Pain complaints, for example muscle pain, joint pain or headaches.

neurology

• concentration problems
• Word-finding disorders and speech difficulties
• Memory problems/forgetfulness
• Sleep disorders (especially after severe illness)
• dizziness
• Headache
• Perception disorders and sensitivity disorders up to paralysis
• unsteady gait
• Peripheral neuropathy symptoms such as numbness or pins and needles
• Psychological/psychiatric symptoms such as signs of anxiety or depression may also occur.

Psychology & Psychiatry

• signs of anxiety disorders
• signs of depression
• Signs of Post Traumatic Stress Disorder (PTSD)

gastrointestinal tract

• nausea complaints
• Diarrhea
• Loss of appetite (especially in elderly patients)
• abdominal and abdominal pain

ear, nose and throat area

• Loss of taste and smell: Loss of smell (anosmia) is rare. On the other hand, a reduced sense of smell (hyposmia) can be observed more frequently.
• Altered smell perception (parosmia)
• Odor perceptions in the absence of the respective odor source (phantosmia)
• earache
• inflammation in the throat
• earache

Special case – symptoms in children

Long-term health consequences can also occur in children as a result of corona virus disease. Similar to adult sufferers, the most common complaints are:

• derating
• concentration problems
• joint pain
• Muscle aches
• Exhaustion and pronounced tiredness
• sleep disorders
• difficulty breathing

It has not yet been conclusively clarified how often Long Covid occurs in childhood and what specific risk factors there are. According to the current state of knowledge, however, older children and teenagers seem to suffer more frequently from long-term health problems.

Some Long Covid symptoms are very non-specific. They could also be the consequence of the psychosocial stress that children and young people are constantly confronted with during the corona pandemic. The symptoms do not have to be directly related to an acute infection.

History: How is Long Covid evolving?

In principle, it is not possible to predict exactly how quickly a person will recover from an acute SARS-CoV-2 infection.

For most people, symptoms resolve within four weeks of the onset of the viral infection. Whether or not symptoms and symptoms persist afterwards does not depend solely on the severity of the disease. Nevertheless, according to current knowledge, people with a severe course of coronavirus disease are more likely to develop Long Covid symptoms.

In addition, new complaints or symptoms can also become noticeable. How often this is the case, however, cannot yet be said in concrete terms. Important long-term data on the long-Covid course are still missing at this point in time.

Likewise, it is currently not possible to say to what extent the symptoms will persist or will recede after a while. The extent to which organ complications can occur is also still unclear.

Causes and Risk Factors: Who is Most Likely to Have Long Covid?

There are some factors that significantly increase the risk of Long Covid. These include:

• Overweight and obesity (severely overweight)
• Age & Gender: Women are affected slightly more often than men, older people suffer from Long Covid more often than younger people.
• Chronic and psychological pre-existing conditions
• nicotine consumption
• Severe course of COVID-19 disease
• bronchial asthma
• More than five symptoms of illness in the first acute week of illness

Therapy: How to treat Long Covid?

Currently, only the symptoms of the long-term effects of the corona virus can be treated. In general, these improve after two to three months at the latest, at least that is what previous observations have shown. In some rare cases, however, Long Covid can also last longer, in the worst case even persist permanently.

For a targeted drug therapy, the causes of the corona long-term consequences must first be determined. Therefore, specific treatments have so far only been used for functional or cognitive impairments. The specific therapy method is based primarily on the symptoms that occur: For example, swallowing or speech disorders are treated with speech therapy. Occupational therapy, on the other hand, can produce good results for movement and perception disorders.

Physiotherapy can also promote coordination, endurance and strength with the help of targeted physiotherapy or breathing therapy. Even if a short rehab cannot guarantee lasting healing success, this time can still contribute to improving the symptoms in particularly difficult cases.
In the case of emotional and psychological stress such as anxiety disorders or depression, psychotherapy can help to improve the symptoms and complaints. Exchanging ideas with others in a self-help group can also be very helpful.

What you can do yourself with Long Covid

In all likelihood, most corona patients will recover completely.
Anyone who has survived a SARS-CoV-2 infection but still suffers from consequential damage should definitely consult a doctor or a psychologist. As a first step, a good place to go is your own family doctor’s practice, in order to at least alleviate the physical symptoms and complaints. In order to avoid long-term physical or psychological consequences, a specialist should then be consulted.

Give your body enough time to fully recover and process the viral disease. Take it easy and do something good for yourself in order to regain new strength in this way.
After surviving a corona virus infection, you should also start exercising gradually and slowly. Don't overstrain yourself and slowly train your endurance again.

Sources

https://www.zusammengegencorona.de/informieren/koerperliche-gesundheit/long-covid-langzeitseiten- sequences-of-a-covid-19-disease/
https://www.rki.de/SharedDocs/FAQ/NCOV2019/FAQ_Liste_Gesundheitliche_Langzeitseiten.html
https://www.aerzteblatt.de/nachrichten/131696/Long-COVID-Jeder-3-aeltere-Erwachsene-developed-after-the-recovery-further-diseases
https://www.helmholtz.de/newsroom/artikel/was-wir-ueber-long-covid-wissen/
https://www.neurologe-und-psychiater-im-netz.org/neurologie/news-archiv/artikel/long-covid-ist-ein-illness-image-with-many-faces
https://www.awmf.org/leitlinien/detail/ll/020-027.html
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