Long COVID | August 2023 | Clinical Corner

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August 15, 2023

 

Long COVID

 

It has been over 3 years since the pandemic started. As we get more experience with this situation, we are able to improve our diagnoses, treatments and recommendations. Unfortunately, there still is much to be learned. Approximately 10% of individuals infected with COVID-19 developed symptoms that may be defined as “Long COVID.” Many of these symptoms are also present in other chronic conditions and typically routine imaging and blood tests come back as normal. There is no clear algorithm to diagnose Long COVID as it is a complicated disease that can impact every organ system of the body. A paper published in Nature Medicine (Dec 2022) divided symptoms into four groups:

  1. Cardiac and renal issues such as palpitations, chest pain and kidney damage.
  2. Insomnia and anxiety problems
  3. Musculoskeletal pain, osteoarthritis and problems with mental skills.
  4. Digestive and respiratory issues resulting in trouble breathing, asthma, stomach pain, nausea and vomiting.

 

There also appears to be specific patterns in these distinct groups, with older males more likely in the first group, and higher incidence of females in the other 3 groups. It is important to note that not everyone will neatly fall into one of these categories. Other clinical presentations may include a chief complaint of post exertional malaise, dysautonomia (dysfunction of the autonomic nervous system) and exercise intolerance.

Vaccinations can lower the risk of long COVID by 35%. Vaccination also was beneficial for those who receive the vaccine after they recovered from COVID infection. A healthy lifestyle also was beneficial for those who do become infected, but this is not necessarily the case for everyone. It is known that despite all the treatments and information we presently have, anyone can get long COVID regardless of age, health status or disease severity.

Resources:

  1. Family Practice News Vol.53 No. 5 May 2023 MDedge.com/FamilyMedicine
  2. Nature Medicine (2022 Dec 1. doi: 10.1038/s41591-022-02116-3)
  3. JAMA Network Open (2022 Oct 12. doi: 10.1001/jamanetworkopen.2022.36057)

 

A special thanks  to Dr. Henry Szelag, Family Physician at McLaren Central Michigan, for submitting this clinical corner.