Thread by @HaryaxPathak

#LongCOVID is real and bad.

Here is one of the most extensive and comprehensive long term follow-up of COVID patients (3762 respondents) with long lasting symptoms/complaints.

medrxiv.org/content/10.110… via @ahandvanish @GinaAssaf et al. 🙌🏻🙌🏻

A thread on LONG COVID.

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Points covered:

➡️ What is Long COVID?
➡️ Who can get Long COVID?
➡️ Why does Long COVID occur?
➡️ Symptoms of Long COVID
➡️ Some literature on Long COVID
➡️ Concerns about Long COVID
➡️ Instructions for the Common Man

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➡️ What is Long COVID?

> A large number of COVID19 patients suffer from long lasting effects of the infection

> Characterized by a constellation of symptoms involving multiple systems in the body for >28 days

> Leading to increased morbidity even after "apparent recovery"

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➡️ Who can get Long COVID?

> Any patient who suffered from #COVID19 infection - mild, moderate or severe - can suffer from Long COVID.

> Even those with a mild infection can have symptoms lasting for more than 28 days and develop Long COVID.

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➡️ Why does Long COVID occur?

> The pathophysiology behind Long COVID is yet unknown.

> Theories:

* ACE-2 receptor mediated multi-organ damage
* Viral persistence in body long after recovery
* Relapse or reinfection
* Immune mediated reactions
* Mental factors like PTSD

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➡️ Symptoms of #LongCovid

Here's a summary of the symptoms of Long COVID from @TheKenWeb.

A very helpful article on Long COVID from @TheKenWeb by @maitriporecha1.

the-ken.com/story/the-hidd…

We'll look at the symptoms in detail.

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➡️ Symptoms of #LongCovid

> @ahandvanish et al studied a total of 205 symptoms in their study.

>Non-Neuropsychiatric - Includes all symptoms of individual organ systems.

> Neuropsychiatric - Symptoms associated with neurological and cognitive functions.

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➡️ Non-Neuropsychiatric Symptoms:

> These symptoms are further divided according to the organ systems affected -

ENT
Gastrointestinal
Reproductive, Genitourinary and Endocrine
Cardiovascular
Musculoskeletal
Dermatological
Immunological/Auto-immune
Pulmonary

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A look at the prevalence of Non Neuropsychiatric Symptoms:

The graphs show prevalence of individual symptoms in percentage.

1. HEENT
2. Reproductive, Genitourinary, Endocrine
3. Cardiovascular
4. Musculoskeletal

Source: medrxiv.org/content/10.110…

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5. Immunological and Autoimmune
6. Dermatological
7. Gastrointestinal
8. Pulmonary

Source: medrxiv.org/content/10.110…

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Apart from these, there are certain generalized, systemic symptoms as well.

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➡️ Neuropsychiatric Symptoms:

> These are further divided into sub-categories:

Emotion and Mood
Sleep
Memory
Headaches
Speech and Language
Hallucinations
Taste and Smell
Sensorimotor symptoms
Cognitive Functions

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A look at the Neuropsychiatric Symptoms:

1. Emotion and Mood
2. Sensorimotor Symptoms
3. Taste and Smell
4. Speech and Language

Source: medrxiv.org/content/10.110…

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5. Memory and Headaches
6. Hallucinations
7. Cognitive Functions
8. Sleep

Source: medrxiv.org/content/10.110…

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➡️ Some Literature on Long COVID

Here is one excellent article on Long COVID and its management in @bmj_latest via @trishgreenhalgh et al.

bmj.com/content/370/bm…

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A comprehensive infographic about Long COVID from the article by @trishgreenhalgh et al.

A basic, preliminary guide on how to approach suspected cases of Long COVID.

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The National Institute for Health and Care Excellence @NICEComms has released a comprehensive set of guidelines on management of COVID and Post-COVID syndrome aka Long COVID.

nice.org.uk/guidance/ng188…

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➡️ Concerns about Long COVID

> Mechanisms are not fully known. More studies are needed to establish pathophysiology of Long COVID.

> Duration is undetermined. We don't yet know if some of the organ damage is short-term, long-term or permanent.

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> Increased post-infection morbidity and secondary mortality due to long term organ/systemic damage.

> Increased healthcare costs and burden.

> Aggravation of chronic disorders like Diabetes, Hypertension, COPD etc.

> Reduction in Quality of Life post-infection.

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➡️ Instructions for the Common Man

Here are some basic instructions to follow to manage Long COVID:

1. Prevent COVID infection:

>Masks and Distancing are mandatory.
> Vaccination when available.

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2. Post-infection:

> Daily self-assessment of well-being.

> Rehabilitation to pre-infection status.

> Manage chronic diseases adequately.

> Note down:

* New symptoms
* Persistence and/or Aggravation of new/old symptoms.

> Consult a doctor asap for the above points.

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