Postacute Coronavirus (COVID-19) Syndrome

Excerpt

Coronavirus disease 2019 (COVID-19), the viral illness caused by the novel coronavirus SARS-CoV-2, has resulted in significant morbidity and mortality worldwide following the identification of the first cases in Wuhan, China, in December 2019. Since the evolution of the COVID-19 pandemic, significant progress has been made that has led to a better understanding of this viral illness and resulted in the development of novel therapeutics and vaccines that have changed the course of this highly transmissible viral illness.

A substantial proportion of patients who recover from SARS-CoV-2-induced viral illness often report various clinical symptoms of physical, psychological, and cognitive natures despite biochemical evidence indicating the cessation of replication of SARS-CoV-2 four weeks after the initial infection. These symptoms were initially described by many different terms (eg, post-acute COVID-19, long-haul COVID-19, chronic COVID-19 syndrome, post-acute sequelae of COVID-19). However, with emerging data frequently describing these symptoms in patients recovering from COVID-19 across different countries, the term "long COVID" has been internationally recognized and is widely accepted to describe these symptoms.

Long COVID has been reported in at least 10% of patients recovering from SARS-CoV-2 infections and possibly up to 50% to 70% of hospitalized cases. This condition is seen in all levels of disease severity, from asymptomatic to critically ill, but the likelihood of this condition is highly correlated with the severity of symptoms. More than 200 symptoms have been associated with this illness, with the most commonly reported clinical symptoms being malaise, dyspnea, fatigue, brain fogginess, autonomic dysfunction, headache, persistent loss of smell or taste, cough, depression, low-grade fevers, palpitations, dizziness, muscle pain, and joint pains. This article describes the prevalence, system-based manifestations, relevant clinical investigations, treatment, and importance of an interprofessional team approach in managing long COVID-19.