If you have recovered from COVD-19, But are still experiencing
certain symptoms , you could have post COVID-19 conditions or
“LONG COVID”.
What are these symptoms? How long do they last and are any
treatment options ?
Most people who had COVID-19, recover completely within a few
weeks. But some people, even those who had milder versions of the
disease-continue to experience symptoms after their initial recovery.
These health issues are called post-COVID-19 syndromes. They're
generally considered to be effects of COVID-19 and persist for more
than four weeks after been diagnosed with the COVID-19 virus.
Older people, patients with many comorbidities, patients who had
prolonged hospitalisation and have been on oxygen therapy and on
ventilator, are the most likely to experience lingering COVID-
19 symptoms.
Common signs and symptoms that linger over time
include:
Although COVID-19 is seen as a disease that primarily affects the
lungs, it can damage many other organs as well. This organ
damage may increase the risk of long-term health problems.
Organs that may be affected by COVID-19 include, brain, heart
and increase in clotting and blockage of blood vessels. These
patients are also prone to various secondary bacterial or fungal
Infections.
The most common complication is lung fibrosis. This type of
pneumonia which is often associated with COVID-19 can cause long-
standing damage to the tiny air sacs (alveoli) in the lungs. The
resulting scar tissue can lead to long-term breathing problems. Lung
fibrosis post-SARS-CoV-2 infection has been observed in people with
an older age, history of smoking, severe illness with CT scan severity
score 17/25 and above, prolonged ICU stay and mechanical
ventilation. The respiratory fibrosis caused due to infections is
unlikely to recover after 21 days of duration. It takes a long time to
reverse, till then patients require supportive care and aggressive
pulmonary rehabilitation efforts to recover. These patients have
progressive and exertional dyspnoea and reduction in walking
efficiency (6MWT is reduced). The patients may need to do lung
function test and a repeat CT scan chest after three weeks of covid
infection to rule out lung fibrosis.
Mild or severe signs of lung impairment post initial infection might
go as long as four months. These patients end up with permanent lung
damage of varying degrees and might require home oxygen
supplementation for a prolonged duration, even after recovering from
COVID 19 infection.
The role of available anti-fibrotic therapies like Nintedanib and
Pirfenidone, which are used for the treatment of idiopathic pulmonary
fibrosis, is still being evaluated for the prevention or reduction of
post-COVID fibrosis. Some of these patients may need low doses of
corticosteroids.
Also, one should be put on a small dose of blood thinners for at least a
month in order to reduce the chances of patient getting a heart attack
or a brain stroke.
Some post COVID care such as drinking plenty of fluids, breathing
exercises, meditation, nutritious diet, adequate sleep, avoid smoking
and drinking should be considered as precautionary measures. It is
also important to brisk walk in the first week post recovery, followed
by doubling the time in the second week. Post covid, it is ideal to get
vaccinated after 90 days.
Secondary bacterial infections with pneumococcus commonly follow
influenza disease and use of influenza vaccine and PCV13 may
reduce this burden in the elderly and those with underlying illnesses.
Lowering the risk of acquiring a respiratory infection will allow for
less visits to clinics and less hospital admissions, thus decreasing the
burden on the health infrastructure at this time and lowering ones’
exposure to acquiring COVID-19 in the hospitals/clinics.
It has been seen that older adults who received pneumococcal
conjugate vaccine (PCV13), which prevents acquisition of certain
pneumococcal strains, experienced 35% lower incidence of COVID-
19 diagnosis, 32% lower incidence of covid hospitalisation, 33%
lower incidence of COVID-19 deaths as compared to the adults who
did not receive the vaccine. In contrast, an alternative pneumococcal
vaccine (PPSV23), which prevents severe pneumococcal disease but
does not block acquisition of the bacterium, was not associated with
Protection.
Pneumococcal vaccination protects against pneumococci after one has had
COVID-19. Also, it is safe to get the pneumococcal vaccination; no unexpected
side-effects will occur.
Other adult vaccination to prevent Flu is influenza vaccine, also commonly
known as Flujab. Flu jab is the best protection against serious complications
from flu. After the flu jab, one will have a lower risk of getting flu. And even if
one gets the flu, the chances of becoming seriously ill is less, with reduced rate
of hospitalisation.
So, if you or a loved one has lung disease or any other co-morbidity, ask a
healthcare professional about pneumococcal and influenza vaccination.
These, in addition to Covid vaccines, will give you added protection from
developing serious complications arising due to Covid-19 too.
Dr Anil Mehndiratta (MBBS , MD, AFIH, FCCP)
Senior Pulmonologist,
DG Shipping India& OEUK/OGUK Approved Medical Examiner,
Past IMA Goa President
Vasco da gama, Goa
@DrAMehndiratta