INTRODUCTION:

Most people infected with COVID -19 infection get better within 10 days of illness.
People when continue to experience mild symptoms post recovery called as Post covid
syndrome or Long covid , these people may experience post COVID conditions and also
develop long – term complications that affect the organs.
Post COVID complications are a broad range of new, ongoing or returning health
conditions , people can experience more than 28 days/4 weeks after first being infected
with the corona virus.
Even asymptomatic people who did not have symptoms when they were infected can
have post COVID complications. These complications can have different types and
combinations of health problems for different lengths of time.
As per recent data, people infected with COVID-19 (corona virus) may experience mild
symptoms or completely Asymptomatic. How long the corona virus lasts in the body
depends upon person to person, exposure to the virus and severity of infection.
COVID-19 symptoms can remain for more than 20 days upto 45 days. Due to long term
effect of corona virus, patients can develop post COVID complications.

RISK GROUP:
Elderly old age group people and people having serious medical conditions such as
diabetes, immuno deficiency disorders, cancers or chronic diseases are at the risk of
developing post COVID complications.
As per recent data even young person recovered from COVID-19 feeling healthy, post
recovery can also have long term effects of corona virus may experience symptoms for
weeks to months after infection.

CAUSES OF POST COVID SYNDROME/ LONG COVID:

Currently, researchers are not able to define the causes related to long term effects of
corona virus, as per recent report possible long covid causes identified in recovered from COVID-19
patients may include:
  Reduced or lack of response from the immune system
 Re infection of the virus
 Multisystem Inflammatory Syndrome(MIS)
 Prolonged hospitalization due to severity
 Post-traumatic stress

As per recent data of SARS- coV-2 survivors of acute COVID-19 infection may be at
increased risk of infections with bacterial, fungal infections or other complications.

POST COVID LONG-TERM SYMPTOMS:

Long COVID or post COVID syndrome having range of symptoms that can last 7 days to 28
days after first being infected with the corona virus or can appear weeks after recovery. It can
happen to anyone who recovered from COVID-19, completely Asymptomatic or having mild,
moderate, severe or critical symptoms.

Some common signs and symptoms of post covid complications observed after recovery that
include:

 Body pain, joints pain or headache

 High blood sugar (Hyperglycemia)
 Fever
 Fatigue, feeling of Tiredness or lack of energy
 Loss of taste or smell
 Shortness of breath or difficulty breathing
 Coughing or chest pain
 New onset diabetes
 Myalgia (muscle pain) for long period
 Inability to focus or difficulty thinking or a lack of mental clarity (brain fag)
 Rapid or fast heartbeat (heart palpitation)
 Insomnia, anxiety disorder or depression
 Dizziness or light headed when you stand up from sitting or lying down (orthostatic
hypotension)
 Red bumps or rash on a flat, red patch of skin (maculopapular rash)
 Symptoms that get worse after mental or physical activities
 Post acute COVID-19 syndrome defined if people affected with COVID-19 infection and after
recovery they may experience these severe complications apart from other post COVID symptoms,
may include;

 Myocardial infarction(MI) - chest discomfort with a without dyspnoea, nausea and

diaphoresis
 Chronic fatigue syndrome
 Deep vein thrombosis (DVT) -a blood clot in a deep vein
  Neurological symptoms - seizures, stroke, muscle weakness, tingling or numbness in the
hands and feet
 Gastrointestinal (GI) symptoms – loss of appetite, nausea, vomiting, diarrhea and
abdominal pain or discomfort
 Pancreatitis
 Hemothorax – collection of blood in the space between the chest wall and the lung
 Pneumothorax – air leaks into the space between the lungs and chest wall
 Pulmonary fibrosis – progressive lung fibrosis due to respiratory infections
 Arthritis – swelling and tenderness of one or more of joints
 Fungal infections like Mycormycosis, aspergillosis, yellow fungus, etc.,

SARS-coV-2 can cause severe inflammation, which can trigger immune system that reacts to an
injury is by making blood clotting system more active due to this other parts of the body affected by
blood clots include the lungs, kidneys, liver, heart and legs. COVID-19 can also weaken blood vessels
and cause them to leak, which contributes to potentially long-lasting problems with the liver and
kidneys.

LONG-TERM ORGAN DAMAGE IN COVID-19(MULTIORGAN DYSFUNCTION):

Severe acute respiratory syndrome coronavirus 2 (SARS-coV-2) infection triggers long-

lasting changes in the immune system, it primarily affects the lungs. Conditions associated with long
COVID-19 infection may be the result of injury to multiple organs, including the lungs, brain, blood
vessels, skin, nerves, kidney and heart. This can be seen as metabolic, musculoskeletal,
cardiovascular and neurological complications secondary to the disease. Organ damage may
increase the risk of long-term health issues. As per recent data COVID-19 mainly affect these organs
and body parts:

LUNGS: Pneumonia associated with COVID-19 can cause long-term damage to the tiny branches of
air tubes in the lungs,(alveoli) where the lungs and the blood exchange O2 and CO2 during the
process of breathing in and breathing out. Scar tissue in the lungs can lead to long- term breathing
problems.
HEART: Patients post COVID-19 recovery have shown irreversible tissue death of the heart muscle,
even in people who experienced only mild COVID-19 symptoms. This may increase the risk of
myocardial infarction (MI) resulting heart failure or other heart related life-threatening
complications in the future.

BRAIN: There are many reports where young people with COVID-19 also experienced neurological
symptoms include muscle weakness, tingling or numbness in the hands and feet, and can eventually
cause paralysis (Guillain- barre syndrome), dizziness, sudden black out, confusion, delirium, seizures,
stroke. COVID-19 may also increase the risk of developing Alzheimer’s disease and Parkinson’s
disease.

KIDNEY: Patients affected with COVID-19 can develop sudden loss of kidney function, known as
acute kidney injury. Dialysis may be necessary in severe cases, but this type of kidney damage can
sometimes be reversed. People with CKD are at higher risk of developing a severe symptoms post
COVID-19 recovery. So, it’s important to take all the necessary precautions to prevent infection.
WARNING SIGNS POST COVID RECOVERY:

Some of the people may experience symptoms post recovery and persisting from 7 days to
28 days. Suggest all to watch out warning signs of post covid conditions such as reappearance of
fever, chest pain, continuous shortness of breath, trouble breathing, tiredness, muscles or joint pain
and dizziness or blackout on standing.

Coronavirus can cause long-lasting damage to the immune system, which can affect organs
and changes, particularly in the lungs may last for long, in this conditions post COVID care is very
important to avoid further reinfection or complications.
MULTISYSTEM INFLAMMATORYSYNDROME IN CHILDREN (MIS-C) AND COVID-19:

MIS-C is a serious condition that appears to be linked to coronavirus disease 2019 (COVID-19).
Most children who become infected with the COVID-19 virus have only a mild illness. But in children
who go on to develop MIS-C, some organs and tissues such as the heart, lungs, blood vessels,
kidneys, digestive system, brain, skin or eyes become severely inflamed. Signs and symptoms
depend on which areas of the body are affected.

MIS-C is considered a syndrome – a group of signs and symptoms, not a disease because much
is unknown about it, including its cause and risk factors. Identifying and studying more children who
have MIS-C may help to eventually find a cause. The U.S. centers for disease control and prevention
(CDC) and the National Institutes of Health are working with doctors and researchers across the
country to learn more about risk factors for MIS-C, share data and improve diagnosis and treatment
of MIS-C.

Rarely, some adults develop signs and symptoms similar to MIS-C. This new and serious
syndrome, called MIS-A, occurs in adults who were previously infected with COVID-19. Virus and
many didn’t even know it MIS-A seems to occur weeks after COVID-19 infection, though some
people have a current infection. If MIS-A is suspected , a diagnostic or antibody test for COVID-19
can help confirm current or past infection with the virus, which aids in diagnosing MIS-A.

MIS-C is rare and most children who have it eventually get better with medical care. But some
kids rapidly get worse, to the point where their lives are at risk.

Much remains to be learned about this emerging inflammatory syndrome. If child shows any signs
or symptoms, get help fast.

SYMPTOMS:

Signs and symptoms of MIS-C include those below, though not all children have the same
symptoms:

 Fever that lasts 24 hours/ longer

 Vomiting
 Diarrhea
 Pain in the stomach
 Skin rash
 Feeling unusually tired
 Fast heartbeat
 Rapid breathing
 Red eyes
 Redness/swelling of the lips and tongue
 Redness/swelling of the hands/feet
 Headache, Dizziness or lightheadedness
 Enlarged lymphnodes

WARNING SIGNS OF MIS-C:

 Severe stomach pain

 Difficulty breathing
  Pale, gray or blue colored skin, lips or nail beds – depending on skin tone
 New confusion
 Inability to wake up or stay awake

COMPLICATIONS:

Many specialists consider MIS-C to be a complication of COVID-19, without early diagnosis and
appropriate management and treatment. MIS-C can lead to severe problems with vital organs, such
as the heart, lungs or kidneys. In rare cases, MIS-C could result in permanent damage or even death.

PROBLEM STATEMENT:

In India, from 3 January 2020 to 6.03 pm CET, 14 January 2022, these have been 36,582,129
confirmed cases of COVID-19 with 4,85,350 deaths, reported to WHO. As of 3 January 2022, a total
of 1,476,253,454 vaccine doses have been administered.

Globally, as of 6.03 pm CET, 14 January 2022, there have been 318,648,834 confirmed cases of
COVID-19, including 5,518,343 deaths, reported to WHO. As of 13 January 2022, a total of
9,283,076,642 vaccine doses have been administered.
DIAGNOSIS OF POST COVID SYNDROME/ LONG COVID:

If someone experiencing any symptoms post-COVID, not necessarily required to check again
the positive results. To diagnose, the physician may require the complete medical history and
previous covid treatment. Apart from checking temperature, blood pressure, pulse rate, SpO2 level
and breathing function, physician may require these tests to check the severity of symptoms:

 Complete blood picture

 Serum electrolytes
 Kidney function test
 Liver function test
 C- Reactive Protein for inflammation level
 Troponin test for heart condition
 D-dimer, to check that no blood clots are present
 Serum ferritin to check iron levels
 ECG, Chest X-Ray or CT scan
 Complete Urine examination

REFERENCES :

1.https://convert.ampify.io/builders/d?s=69c0b277&u=http://www.pacehospital.com/post-covid-
complications-long-term-effects-of-coronavirus-after-recovery

2. https://www.mayoclinic.org/diseases-conditions/mis-c-in-kids-covid-19/symptoms-causes/syc-
20502550

3. https://covid19.who.int/region/searo/country/in

4. https://covid19.who.int/