November 29, 2023

Decoding the Long-Term Effects of COVID-19: Understanding the Pathophysiology, Epidemiology, Diagnosis, and Management

A recent review published in Signal Transduction and Targeted Therapy provides a comprehensive analysis of the post-acute sequelae of COVID-19, commonly known as long COVID. The review examines the pathophysiology, epidemiology, diagnosis, and management of this chronic condition.

Long COVID refers to the persistent symptoms experienced by individuals recovering from COVID-19, lasting for a period of four to twelve weeks or more than twelve weeks following the acute phase. These symptoms can affect various systems in the body, including cardiovascular, pulmonary, neuropsychiatric, gastrointestinal, reproductive, and musculoskeletal systems.

Understanding the symptoms and underlying mechanisms of long COVID is crucial for effectively managing the condition and preventing the transmission of the SARS-CoV-2 virus.

The researchers conducted an extensive review of data published in various scientific databases, including the Cochrane Library, Web of Science, EMBASE, and PubMed, from January 2020 to June 2023. The data was screened by two researchers, with any discrepancies resolved by a third researcher.

The review reveals that long COVID can lead to serious health consequences and even fatalities. A study conducted across 56 countries found that 65% of COVID-19 patients experienced at least one symptom within six months, including fatigue, post-exercise weakness, and cognitive impairment. In China, physical weakness or exhaustion was reported by 63% of patients, while sleep difficulties and depression/anxiety affected 23% of patients. Although the morbidity of long COVID reduced from 68% after six months to 55% after two years, the frequency of long-term sequelae remains high, with 66% of patients in European research reporting at least one sequela after 60 days of symptom onset.

Long COVID appears to be more prevalent in individuals above the age of 65, with 45% of this age group experiencing the condition compared to 35% in individuals between the ages of 18 and 64. Therefore, prioritizing preventive measures for long COVID in older COVID-19 patients is crucial.

Early diagnosis of long COVID involves medical imaging and laboratory investigations. Various tests, including immunoglobulin G (IgG)/IgM, antigen, and polymerase chain reaction (PCR) testing, have demonstrated high sensitivity for COVID-19 diagnosis. Additional tests, such as echocardiography, cardiac biomarkers, magnetic resonance imaging (MRI), chest imaging, pulmonary function tests, and positron emission tomography (PET), aid in the diagnosis of specific complications and damage to the heart, lungs, and neuropsychiatric system. The composition of the gut microbiota can also predict the incidence of long COVID and its symptoms.

In terms of management, avoiding pollutants, smoking cessation, regular exercise, and umbilical cord-derived mesenchymal stem cell (UC-MSC) therapy are recommended for long-term COVID management. Cardiovascular issues can be treated with beta-adrenergic blockers and exercise training. Non-pharmacological and pharmacological therapies are available for specific conditions associated with long COVID, such as postural orthostatic tachycardia syndrome (POTS) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Other treatments include anticoagulant therapy, specific supplements, nasal irrigation, and viral persistence inhibitors.

However, there is still a need for further research to better understand the biological mechanisms of long COVID and develop targeted therapies. Early detection is crucial for timely intervention and improving the quality of life for individuals affected by long COVID.

1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it