Post-Covid symptoms: studies and knowledge

Original article: Sintomi post-Covid: studi e conoscenze, by Silvia De Giorgi

Patients who have developed Sars-Cov-2 infection experienced a wide range of symptoms: from the mildest to complications that brought them to the hospital. The most common mild symptoms are fatigue, headache, rhinitis, muscle pain, loss of sense of smell, and altered taste. The organs most affected are the lungs and all components of the respiratory system. Nevertheless, some diagnosis concerns the gastro-intestinal, cardiocirculatory and ocular system. Often, in the face of infection, even in the asymptomatic patients was observed a low oxygen saturation. What do we know about post-Covid symptoms?

Worldwide researchers are conducting studies about “post-Covid syndrome“. Deep monitoring of patients who got a more or less acute Sars-Cov-2 infection is in progress; since people have shown symptoms of the disease even months after a negative test. They suffer from lung and neurological damages, but patients continue to complain about a variety of symptoms. Long-term effects cannot be overlooked.

The Sars-Cov-1 studies

Between November 2002 and August 2003, there were 8096 cases of SARS (Severe Acute Respiratory Syndrome) worldwide, with 900 deaths. In Hong Kong, 40% of the 233 survivors of SARS got chronic weariness after 3-4 years. In a study conducted in Toronto, many patients showed chronic post-SARS syndrome characterized by persistent fatigue, widespread myalgia, weakness, depression, and disturbed sleep.

Another study conducted in over two years on patients who had developed SARS at the Prince of Wales Hospital in Hong Kong showed significant pulmonary function impairment, negatively impacting healthcare workers.

Building on the study conducted on the Sars-Cov-1 virus (Fig.1), the virus that caused the epidemic, it was inevitable to explore the persistence of symptoms even after several years for this new coronavirus.

The virus Sars-Cov-1 visualized at the electric or transmission microscope — *Figure 1 –*The virus Sars-Cov-1 visualized at the transmission electron microscope* [Bibliography:* wikipedia.org]

An Italian study about post-Covid symptoms

In an Italian study conducted by Fondazione Policlinico Universitario Agostino Gemelli IRCCS (Rome), persistent symptoms were evaluated in patients discharged from the hospital after recovery from Covid-19. What emerged was that after 60 days after the onset of the first symptom Covid-19 related, more than 75% of patients reported one or more symptoms, especially fatigue, dyspnea, joint, and chest pain.

In the same Polyclinic – to perform a complete post-Covid19 check-up – a multidisciplinary service involving several specialists has been established. Psychiatrists, otolaryngologists, pulmonologists, infectivologists, and gastroenterologists keep collecting data on the aftermaths of the disease, which should not be underestimated. Nutrition is evaluated since the European Society for Clinical Nutrition and Metabolism (ESPEN) recommends nutritional screening in post-Covid patients. In fact, following SARS-CoV-2 infection, overactive inflammation may increase catabolic processes and anorexia.

Symptoms COVID-19 correlated durng the acute phase during the disease and later — *Figure 2 – Symptoms COVID-19 related during the disease and later [Bibliography: pubmed.ncbi.nlm.nih.gov*]

Consortium PHOSP- COVID

In the United Kingdom, a team of physicians and researchers are evaluating the long-term effects of Covid-19. The study aims to assess the short-term (0-6 months), medium-term (6-12 months), and long-term (more than 12 months) effects on 10,000 patients hospitalized with Covid-19. The goal is to create new strategies for clinical assistance and personalized therapies for the patients. For this reason, the data collected during the study will be incorporated into an international collaborative network, working with the European Respiratory Society and Canadian Thoracic Society.

It will be needed a worldwide collective effort to deeply understand this virus’s potential and for anyone who gets infected to be adequately cared for and understood in time to avoid physical and psychological complications.

Bibliography:

Ngai JC, Ko FW, Ng SS, To KW, Tong M, Hui DS. The long-term impact of severe acute respiratory syndrome on pulmonary function, exercise capacity and health status. Respirology. 2010
Moldofsky H, Patcai J. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC Neurol. 2011
Carfì A, Bernabei R, Landi F, for the Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent Symptoms in Patients After Acute COVID-19. JAMA. 2020
Gemelli Against COVID-19 Post-Acute Care Study Group., Landi, F., Gremese, E. et al. Strategie sanitarie globali post-COVID-19: la necessità di un approccio interdisciplinare. Aging Clin Exp Res 32, 1613-1620 (2020)
https://phosp.org/