post covid

The pathogen SARS-CoV-2 causes the dangerous disease Covid-19 (Corona Virus Disease 2019).

In the case of a mild course, a coronavirus infection lasts two to three weeks on average. If the course is severe, however, the acute duration of the disease can double. But even then, the dangerous virus infection is unfortunately not completely over in many cases.

Many Covid-19 patients continue to suffer from various physical or mental impairments long after the acute treatment. It affects people of all ages, children and young people as well as adults and the elderly.

The patients are clinically considered to have recovered from the SARS-CoV-2 infection. This means that no corona viruses can be detected in your body. Nevertheless, many of them still suffer from sometimes severe symptoms, so they are definitely not healthy. In such a case, experts speak of long-Covid or post-Covid syndrome.

According to current studies and figures, around 10% of all Covid patients suffer from the long-term effects of Corona.

Doctors are already familiar with such long-term health consequences from other viral infections, such as the Spanish flu or the MERS coronavirus (Middle East Respiratory Syndrome). However, current research studies suggest that the long-term consequences of a Covid-19 infection occur more frequently and last longer than, for example, after an influenza illness. The highly contagious corona virus is considered a so-called multi-organ virus that not only affects the lungs, but also occurs in numerous other body organs, such as the kidneys, heart, liver and even the brain.

In the ICD-10, the international index of diseases, Post Covid can be found in the chapter "Preliminary classifications for diseases with unclear etiology" under the numbers U09.9-!.

Long-Covid and Post-Covid - what is the difference?

Corona long-term consequences are summarized under the term Long-Covid as well as under the term Post-Covid, but the two terms cannot be equated with each other. The symptoms are the same, but the main difference is the duration of the disease.

The guideline recommendation of the British "National Institute for Health & Care Excellence (NICE)" defines the terms according to the Robert Koch Institute (RKI) as follows:

• If the health problems persist beyond the acute phase of the disease (usually after a severe or even critical course) for a period of four weeks or if they recur, this is referred to as a long covid .

• Health problems that are still present more than 12 weeks after the onset of a SARS-CoV-2 infection and cannot be medically explained otherwise are classified as Post Covid

A long Covid disease can therefore turn into a post Covid syndrome.

In English-speaking countries, this clinical picture is known as "long haulers": These are patients who have survived a Covid 19 infection but are still "lugging around" certain symptoms three months after the acute phase.

There are other alternative names for the Post Covid Syndrome in medical terminology, such as the acronym PASC (English: “post acute sequelae of SARS-CoV-2”): Translated into German, the abbreviation means “post-acute consequences of Covid -19".

The abbreviation CCS – “chronic Covid syndrome” or PCS (post Covid syndrome) is also common.

Symptoms: How diverse are the post-Covid symptoms?

The post-Covid clinical picture is very diverse.

The symptoms that fall under this term can be physical complaints of the lungs, the muscles and the circulatory system, but also concentration problems, headaches, depression, anxiety or exhaustion such as fatigue syndrome.

Basically, all organs, cells and tissues of the human body can be affected - as well as the psyche!

The post-Covid symptoms that patients report are also very different: They can occur as individual symptoms or in connection with other complaints. In addition, they can also last for different lengths of time.

There is currently no uniform definition of the “post-Covid” clinical picture.

The most common long-term consequences of corona that have been observed in studies to date include:

• anosmia (loss of smell)
• Ageusia (complete loss of taste).
• Tiredness, lack of energy and pronounced exhaustion (fatigue)
• Headache
• Disorders of the cardiovascular system
• difficulty concentrating
• memory problems
• word-finding disorders
• Depressed moods and depression
• Difficulty breathing such as shortness of breath, difficulty breathing or coughing problems
• sleep disorders
• anxiety states
• Heart problems such as heart palpitations, heart palpitations, chest pain or even heart damage.
• lung damage
• hair loss
• Decreased performance
• Other body organ impairments or organ damage
• limb and muscle pain
• eczema
• Inflammatory reactions
• Neurological disorders such as numbness.

Symptoms similar to post-traumatic stress disorder can also occur as part of a post-Covid illness.

Some patients also developed kidney or metabolic diseases such as diabetes mellitus after the acute SARS-CoV-2 infection phase. So-called thromboembolism, i.e. the blockage of a blood vessel by a blood clot, has also occurred after the actual phase of the disease.

All of the symptoms mentioned do not have to occur with every post-Covid syndrome.

History: How much is known about Post Covid?

It is still unclear to what extent persistent or recurring health problems after recovering from a Covid-19 infection subside, persist or can be treated using various treatment methods.

The disease and the associated long-term consequences are currently too new to be able to make an accurate prognosis. The medical expertise on how patients with their various health problems can be treated in the most effective way is also developing step by step.

However, doctors can already draw on their many years of specialist experience in the therapy of states of exhaustion, neurological and cardiological diseases, chronic pain syndromes or mental illnesses and derive appropriate therapy approaches for the affected post-Covid patients.

Specialists assume that the majority of symptoms in most patients will subside over time.

However, it is important to seek medical help as early as possible: the earlier those affected become active themselves, the better the chances of a full recovery.

Causes and Risk Factors: Who Gets Post Covid Most Often?

With regard to the specific causes of the Post Covid Syndrome, there are still some uncertainties at the moment.

Numerous scientific investigations and research studies on the syndrome are currently ongoing in order to better understand the underlying processes and thus be able to treat them more adequately. Strictly speaking, the post-Covid syndrome is to be regarded as a chronic form of a corona virus infection. Such a reaction also occurs as a result of many other viral diseases, so they are not new or unique as a result of a Covid-19 infection.

However, experts associate the following risk factors with Post Covid Syndrome:

Course of a Covid-19 infection

People who have had a moderate or even critical course of infection are considered to be particularly at risk.

Around 50% of the patients who had to be treated as inpatients in the hospital or even intensive care due to a Covid-19 disease are not fit again after the acute phase of the disease. Even if they have survived the actual virus infection, they still struggle with persistent and sometimes intense symptoms for some time.

But even people with a mild course of infection are not automatically protected from the post-Covid syndrome. About five to 30 percent of them also suffer from long-term corona effects.

age

Corona long-term effects can affect people of all ages, even children. However, a scientific research study from Great Britain has shown that long-Covid and post-Covid symptoms are most common in people between the ages of 35 and 49 (approx. 27% of patients).

They are closely followed by the 50 to 69 year olds (approx. 26% of the patients) and the over 70 year olds (approx. 18% of the patients).

Gender

Women seem to be more frequently affected by long or post-Covid syndrome.

Several scientific studies have now shown that female patients between the ages of 40 and 60 have an increased risk of long-term corona effects compared to men of the same age.

Scientific researchers suspect the causes of this to be in the immune system of the female body, because this tends to work against its own organism more than the immune system of men.

autoantibodies in the blood

Antibodies are directed against the body's own healthy structures.

Apparently, numerous Covid-19 patients form many such autoantibodies, which can be detected in the blood for up to six months after the acute phase of the disease and can possibly promote the development of long or post-Covid syndrome. Scientists are currently investigating whether inhibiting these autoantibodies can be a promising treatment approach in post-Covid.

Elevated viral load at onset of disease

Infected people who carry a particularly high viral load at the beginning of the coronavirus infection also have an increased risk of chronic disease progression.

Either the affected patients got infected with a very large amount of virus or their body's immune system was not able to control the contagious virus to a sufficient extent. There are now drugs that can be used to lower viral loads.

Many symptoms of illness

British researchers were able to find that Covid-19 patients who suffered from more than five symptoms of the disease in the first week of the infection were about three times more likely to be affected by long and post-Covid than people who struggled with fewer symptoms. Many symptoms at the beginning of the disease therefore harbor an increased post-Covid risk.

Pre-existing illness

People with certain previous illnesses are particularly at risk in the event of a coronavirus infection. This applies not only to the acute phase of the disease, but also to post-Covid. These pre-existing conditions include, for example, obesity (obesity), overweight, type 2 diabetes mellitus, bronchial asthma or mental illnesses.

A possible reason for the increased risk potential could be that these pre-existing conditions promote inflammatory processes in the body.

gut microbiome

The composition of the microbiome, i.e. the intestinal flora, also plays an important role. Patients who have lost the fullness and diversity of the microbiome as a result of an acute coronavirus disease are probably at increased risk of corona complications. This was the finding of scientific researchers at the University of Hong Kong.

Therapy: What is recommended for Post Covid?

As multifaceted as the symptoms are, the treatment options are just as varied.

Since the specific causes of the long-term effects of Corona have not yet been finally researched and therefore cannot be treated in a targeted manner, only the post-Covid symptoms can be treated so far. According to previous observations, the symptoms of the disease improve in a large number of affected patients after around two to three months. In some patients, however, the symptoms last longer and may even persist permanently. Depending on the type and severity of the symptoms of the disease, special treatment approaches and training are effective.

Various disciplines such as pulmonary medicine, neurology or cardiology deal with the care of post-Covid sufferers in order to achieve a significant improvement in their state of health.

• For example, methods of physiotherapy can be used together with physiotherapy, breathing therapy and manual therapy to specifically promote the coordination and endurance of the patient.

• Hand and arm movements as well as perception can be significantly improved through occupational therapy.

• Memory performance and the ability to concentrate can also be significantly improved through targeted neurological training.

• Emotional disorders such as anxiety or depression can be treated with psychotherapy.

• If the patients suffer from swallowing or speech disorders, logopedic therapy can also be very effective.

If the post-Covid symptoms are very pronounced, those affected can benefit from a rehabilitation stay in a special rehabilitation clinic.

Patients who had to be treated in a clinic due to a severe course in the acute infection phase generally automatically receive such follow-up rehabilitation treatment.

There is currently no targeted drug post-Covid therapy. However, intensive research is currently being carried out into which drugs that have already been approved could be effective, for example to inhibit internal inflammatory processes or to optimize blood circulation.

You can do that yourself with Post Covid

The most effective measure to prevent long or post-Covid syndrome is to avoid a corona virus infection.

This can be achieved, for example, through preventive measures such as careful compliance with infection control measures and corona vaccination. Nevertheless, the vaccination does not offer 100% protection against Covid disease and therefore also not against Post Covid. A so-called breakthrough infection can also occur in people who have been fully vaccinated. However, there is scientific evidence that despite a breakthrough infection, the risk of contracting post-Covid is lower for vaccinated people.

In the case of an existing post-Covid illness, those affected should consult the doctor treating them as to whether preventive vaccination against further corona infection makes sense and when is the ideal time for this. So far, however, there are no reliable facts as to which post-Covid patients will benefit from vaccination.

The return to normal

After recovering from corona disease, it is important for those affected to find their way back to normal everyday life. The exact time from which this is possible depends, among other things, on the existing post-Covid symptoms and the severity of the symptoms. The individual physical condition and the everyday stresses that occur also play a decisive role in this context.

Together with the doctor treating them, those affected can draw up an individual plan with clear targets.

In any case, it is important that those affected allow themselves sufficient rest in order to optimally support the organism during recovery. Excessive demands and overload can lead to a deterioration in the state of health.

accept offers of help

Hospitals in Germany now offer special outpatient clinics for corona patients with long-term effects of Covid 19.

In addition, there are a wide variety of self-help groups nationwide in which patients can exchange ideas with other sufferers. This can be very valuable, especially for coping with everyday life.

Sources

https://www.kbv.de/html/themen_55220.php
https://www.zusammengegencorona.de/covid-19/long-covid-langzeitseiten-einer-covid-19-chloride/
https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus/covid-long-haulers-long-term-effects-of-covid19
https://www.stmgp.bayern.de/coronavirus/post-covid/
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