Long COVID-19 Syndrome: A Comprehensive Review of Its Effect on Various Organ Systems and Recommendation on Rehabilitation Plans

Abstract

The majority of people infected with SARS-CoV-2 fully recovered within a few weeks. However, a considerable number of patients of different ages still suffer from long-lasting problems similar to the multi-organ damage in its acute phase of infection, or experience symptoms continuously for a longer term after the recovery. The severity of the primary infection seems not to be associated with the possibility and severity of long-term symptoms. Various unresolved symptoms have been reported in COVID-19 survivors months after hospital discharge. Long COVID-19 Syndrome refers to survivors 4 months after initial symptoms onset. It is important to understand the systemic effects of Long COVID-19 Syndrome, its presentations, and the need for rehabilitations to restore functional recovery in survivors. Government, healthcare workers, and survivor groups should collaborate to establish a self-sustaining system to facilitate follow-up and rehabilitations, with prioritization of resources to more severely Long COVID-19 Syndrome survivors. This review looks into the systemic effects of Long COVID-19 Syndrome in various aspects: respiratory, cardiovascular, hematological, renal, gastrointestinal, neurological, and metabolic effects of Long COVID-19 Syndromes. Recommendations for follow-up and rehabilitations details have been explored to cope with the tremendous Long COVID-19 Syndrome patients.

Keywords: Long COVID-19 Syndrome; Post COVID-19 Syndrome; recovery; rehabilitations.

Figure 1

The timeline of Post-acute COVID-19 syndrome is defined as 4 to 12 weeks between initial confirmation of SARS-CoV-2 infection, while Post-COVID-19 syndrome is defined as 12 weeks after initial infection. The underlying progression/persistence of symptoms is associated with initial virus elimination recovery and angiotensin-converting enzyme 2 (ACE2)-associated system damage.

Figure 2

Summary of multi-system clinical presentations of Long COVID-19 Syndrome. (Parts of the figure were drawn and adapted by using pictures from Servier Medical Art (http://smart.servier.com/) (accessed on 20 June 2021), licensed under a Creative Commons Attribution 3.0 Unported License (https://creativecommons.org/licenses/by/3.0/) (accessed on 20 June 2021).

Figure 3

(A,B) Recommended rehabilitation model for patients with Long COVID-19 Syndrome.