Long Covid • Symptoms of the long-term corona consequences

In March 2020, a global pandemic caused by the novel coronavirus SARS-CoV-2 was declared by the World Health Organization (WHO). But not only the acute infection plays a role, infected people are increasingly suffering from the long-term consequences of Corona, although they have recovered. Not only severe courses can lead to long Covid – people with a symptom-free or only mild course also complain of long-lasting symptoms.

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Corona: long-term and long-term consequences of COVID-19

What is Long Covid?

COVID-19 is now recognized as a multi-organ disease that can trigger numerous symptoms. In addition to the acute infection, there are two other conditions related to COVID-19:

• Long Covid: Symptoms that persist for at least four weeks after a corona infection

• Post Covid: Symptoms that persist for at least 12 weeks after infection

This means that those affected continue to struggle with symptoms even months after an infection. Depending on the severity of the symptoms and the severity of the Long Covid Syndrome, those affected cannot go about their everyday activities and, in severe cases, are temporarily unable to work.

Long Covid: symptoms of the syndrome

Those affected suffer from numerous complaints with Long Covid and Post Covid: So far, over 200 different symptoms are known in ten organs. Very often those affected mention extreme tiredness (fatigue), disturbed breathing up to difficulty breathing (dyspnea), headaches, disturbances up to loss of taste and smell, sleep disorders, pain and psychological complaints.

In addition to fatigue, other symptoms point to the coronavirus

Long Covid also possible with children

Children and adolescents can also contract Long Covid, albeit much less often than adults. Common symptoms for them are headache, fatigue, difficulty breathing, insomnia and olfactory disorders. However, previous study results on Long Covid in children and adolescents are mainly based on the alpha variant of the coronavirus – it remains to be seen whether the more contagious delta variant will change the situation. (As of: 08/09/2021)

In addition, there is a very rare form of long covid among young people, the Pediatric Inflammatory Multi-Organ Syndrome (PIMS). In most cases, they develop the syndrome a few weeks after a symptom-free corona infection. Affected people suffer from a high fever, skin rashes and organ inflammation. The syndrome is classified as an emergency that requires immediate hospital treatment.

Causes of Long Covid and Post Covid

Since COVID-19 is a novel disease, research is still being carried out on the long-term effects to find out what causes are behind Long Covid. So far, various mechanisms have been identified which can cause long covid. However, they are very individual, so they can differ greatly between those affected.

Possible causes for Long Covid:

• Persistent infestation by the virus and persistence of virus components in the body

• Side effects of treatment for COVID-19

• Chronic inflammation

• Autoimmune reactions

• Immunodeficiency

• Ongoing tissue damage from the infection, including damage to blood vessels

• Disturbed microvascularization, i.e. deviations in the formation of new blood vessels and the supply of blood vessels to tissue

• Disturbances in the renin-angiotensin-aldosterone system (RAAS), which regulates blood pressure and electrolyte balance

Diagnosis: when is long covid present?

The medical diagnosis of Long Covid is not easy due to the novel nature of the disease and its complex appearance. Although there are currently no specific parameters for diagnosing Long Covid, laboratory testing is important if the disease is suspected. In addition, a detailed anamnesis, physical examination and assessment of the neurological and psychological state of those affected play a major role.

According to the current guideline on Long Covid Syndrome, it occurs when one of the following four criteria is met:

1. Symptoms of an acute corona infection or its treatment persist

2. Symptoms that affect the state of health again

3. New symptoms that emerged as a result of COVID-19 after the acute phase of infection

4. Pre-existing underlying diseases such as diabetes mellitus, high blood pressure or heart disease worsen

In particular, people with previous illnesses should seek medical help immediately if their state of health worsens or new symptoms occur. In these cases, the treatment of the underlying disease can be reviewed and adjusted if necessary.

Corona vaccination: who can be vaccinated and who is not?

Treatment of Long Covid and Post Covid

So far there is no special treatment for COVID-19 or Long Covid. Rather, the present symptoms are treated in both cases – to alleviate the symptoms and to prevent persistent occurrence (chronification). The question of whether COVID-19 and Long Covid lead to lasting organ damage is also still open.

Rehabilitation is also important as part of the treatment of Long Covid. The range of rehabilitation measures is very large and depends on the severity of the illness: From outpatient remedies such as physiotherapy to early rehabilitation measures in the hospital to aftercare in special facilities. This is intended to restore restricted body functions and help those affected to find their way back to everyday life.

A first, small observational study showed that vaccination of those affected with Long Covid can improve symptoms. However, these results first have to be verified in larger, controlled studies. Until then, the recommendation that recovered people should receive a single corona vaccination after six months will continue to apply.

A table on the global vaccination status can be found here.