Long covid as a long-term consequence of coronavirus together vs. Corona

Long-COVID and post-COVID: long-term consequences of COVID-19 diseaseA corona infection can have longer-term health consequences after both severe and mild COVID-19 disease or unnoticed infection. Learn more about possible long-term effects of SARS-CoV-2 infection, which distinguishes between long-COVID and post-COVID, here.

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Viral diseases can be treacherous. Sometimes affected individuals continue to suffer from symptoms long after they have recovered from an infection. Long-term consequences are also known from other infectious diseases (Spanish flu, MERS, SARS), but recent studies suggest that long-term consequences after an infection with the coronavirus occur more frequently and for longer than after an influenza infection, for example. Coronavirus is considered a multi-organ virus, occurring in numerous organs in addition to the lungs, such as the kidney, heart, liver or brain. It may fit that the health impairments observed after SARS-CoV-2 infection, even after the acute illness phase of four weeks, include very different symptoms.

From shortness of breath to dizziness: Possible Long-COVID symptoms

SARS-CoV-2, the COVID-19 disease triggered by it, and the prolonged health impairments observed in connection with infection or disease are currently being intensively researched.

In October 2021, the World Health Organization (WHO) published the first case report

of long-term consequences of a COVID-19 disease (post-COVID-19) published. In addition, 16 medical societies under the leadership of the German Society of Pneumology and Respiratory Medicine e.V. (DGP) has drawn up a guideline on long and post-COVID for healthcare professionals. Based on this, a patient guideline has been developed that describes common symptoms of long- and post-COVID and explains how those affected can behave – although, according to the authors, much is still unknown in this context.

Long covid as a long-term consequence of coronavirus together against corona

Patient guideline of the DGP

Some infected people feel little to nothing from their corona infection. In a mild disease course, COVID-19 disease can last for about two to three weeks. The duration of the disease varies greatly from person to person and is z. B. Also influenced by whether a COVID-19 vaccine has already been administered. A maximum of four weeks is expected for the acute phase of the disease. In severe courses, the acute phase of the disease can last twice as long. Organ-specific long-term sequelae can often be observed after intensive treatments. Even less severely ill patients can have health symptoms beyond the acute phase of the disease or develop new ones. According to current guidelines, depending on the period during which the complaints exist, from

– "Long-COVID": symptoms persisting more than four weeks after infection or illness – or from "post-COVID-19 syndrome": symptoms or health disturbances persisting beyond 12 weeks or new symptoms or health disturbances that cannot otherwise be explained,

spoken. Often the causes are non-specific complaints such as fatigue, shortness of breath, concentration problems ("brain fog") or dizziness. Reliable, representative data on the proportion of patients with long-term effects are not yet available. Female patients suffer particularly frequently from late effects. Patients with a severe course of COVID-19. Data from England indicate that around 40 percent of those with severe disease require long-term medical support, for example to improve impaired lung function or other affected organs. In many patients, changes in the lungs can still be seen months after the onset of symptoms. You will find a report from Germany about a protracted recovery in this article.

Study: Corona vaccination may also protect against long-term effects

"suggests that those who have been fully vaccinated are not only protected against severe courses of the disease, but also against long-term consequences of COVID-19 infection in the case of infection after vaccination.

Study: Subsequent vaccination can also alleviate long-term consequences

Vaccinated individuals are less likely than unvaccinated individuals to develop long-COVID after coronavirus infection. This is still true six months after vaccination. In addition, there was evidence that unvaccinated individuals who suffered from long-COVID as a result of infection and were subsequently vaccinated also benefited from vaccination: On average, they had fewer and less severe long-COVID symptoms than those who remained unvaccinated.

Late sequelae after mild COVID-19 courses

Long-COVID can also affect patients with a mild course of the disease – and can manifest itself in a wide variety of symptoms. Among the most common symptoms of long-COVID is fatigue – a rapid and severe exhaustibility that many recovered patients suffer from even months after their acute COVID-19 illness. Shortness of breath is also common, as are concentration and memory problems. Loss of the sense of taste and smell – a typical symptom of COVID-19 disease – can also persist long after recovery, as this article shows. Fatigue is the term used to describe a rapid. Severe fatigue. Fatigue often accompanies chronic illnesses such as cancer or rheumatism. Fatigue can also occur after viral infections such as COVID-19. The causes are not yet thoroughly researched. Often it is not the virus itself, but the immune system, which has not yet regained its composure after the infection, that is responsible, according to the website of the Charite Fatigue Center

on post-COVID fatigue from the Berlin Charite hospital.

Children and Long-COVID – first results

Long-COVID can also occur in children and adolescents. However, it is still unclear how often and how severely they are affected. The study results are partly contradictory.

According to the Professional Association of Pediatricians and Adolescent Physicians, initial study results suggest

suggests that children with a severe course may suffer from persistent symptoms such as fatigue, concentration problems or muscle pain. In an article published in the scientific journal "Nature"

for example, statistics from England show that around ten percent of all children and adolescents up to the age of 16 still had at least one symptom of the disease five weeks after COVID-19 diagnosis; data from Russia showed that one in four children treated in hospital still had symptoms five months after discharge.

, comparing various complaints in children with and without SARS-CoV-2 infection, however, suggest that there are no significant differences between these two groups of children. One conclusion could be that, in addition to the virus itself, measures to combat the pandemic (such as closed schools and contact restrictions) among children play a role as a cause and are linked to health impairments.

Specific risk factors for Long-COVID

In terms of risk factors, there are indications that chronic and psychological pre-existing conditions and a severe COVID-19 disease course favor the development of Long-COVID. Long-COVID also appears to occur particularly in middle age. For socially disadvantaged people. Overall, women appear to be more likely to contract long-COVID than men. Those working in health professions also appear to be at occupationally increased risk for SARS-CoV-2 infection and thus also for long-COVID disease.

Long-COVID care: from family practice to self-help group

The late symptoms of COVID-19 are very unspecific, also with regard to permanent damage. At the same time, arrangements are made to help those affected and to gain further insights. Primary contact persons for patients with Long-COVID are usually family physicians, who often form good networks together with specialists in private practice and can thus ensure interdisciplinary, outpatient care. In some regions, there are already primary care and specialist COVID practices that can also be used as points of contact for patients.

In addition, clinics have already established Long-COVID outpatient clinics to care for patients with long-term sequelae.

There is not yet a causative therapy for long or post-COVID, so currently treatment is symptom-based. Therefore, rehabilitation has a special role to play in Long-COVID. Since several organ systems are usually affected, several medical disciplines are often involved in the treatment, especially general medicine, pediatrics and pulmonary medicine, neurology, psychosomatics, psychiatry, and psychotherapy. An overview of rehabilitation clinics that offer long-term or post-COVID care is provided by the Federal Working Group for Rehabilitation (Bundesarbeitsgemeinschaft fur Rehabilitation)

There are also support groups. An initial overview of initiatives is listed on the website of the National Contact and Information Center for the Initiation and Support of Self-Help Groups

Inter-ministerial Working Group (IMA) Long-COVID: Researching long-term effects – helping affected persons

Under the chairmanship of the German Federal Ministry of Health (BMG), an Interministerial Working Group (IMA) on "Long-COVID" was established to take stock of the situation and formulate recommendations for action on this basis. In the future, with the involvement of numerous experts, it is planned to. Experts are driving forward research into long-COVID with the aim of improving care. Recommended u. a. A significantly expanded data and information base, a review and, where appropriate. Complement the care situation and increase awareness of care options. Of the tools available for reintegration into the workforce. Affected persons with a severe or. complex Long-COVID patients can be severely limited in their ability to participate in social and professional life, concludes the IMA. Since little is known about protective factors at this time, the best protection against long COVID is certainly still to avoid infection with SARS-CoV-2, i.e., infection control measures as well as vaccination would help reduce the risk for long COVID as well.

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