Thread by @DrBinoyVShah

Post-acute Covid Syndrome. (Thread)
1.
Persistence of symptoms and/or development of complications beyond 4 weeks from the onset of acute symptoms.

@HaryaxPathak @ProfSomashekhar @neoarchana @neoarchana @pankti4299 @AlishaAkhani @hard_dil @shreya__kataria

2.
It has 2 categories
A) Subacute or ongoing (4-12 weeks)
B) Chronic or post-Covid (beyond 12 weeks).

Why does it occur?
Cellular damage, cytokine storm and pro-coagulant state.

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3.
Some reports suggest that the residual effects might include fatigue, dyspnea, chest pain, cognitive disturbances, arthralgia, anxiety, depression.

Investigations that can be done - ECG, Echocardiography, D-Dimer, Pulmonary function test, CT, EEG, Psych elav.

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4.
Cardiovascular effects also include increased cardiometabolic demand and fibrosis.

Hematologic effect according to certain retrospectives studies is a hyper-coagulable state, but there is varied duration of hyperinflammation.

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5.
Neuropsychiatric - may include headache, anxiety, depression, PTSD, dysautonomia, brain fog.

Renal - reduced eGFR has been reported
at 6months follow-up.

@DevPalkar @pankti4299 @HaryaxPathak

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6.
Endocrine - new or worsening of diabetes. Patients with newly diagnosed DM without any risk factor, HPA axis supression or hyperthyroidism should undergo proper clinical investigation under an endocrinologist.

Dermatologic - Hair loss has been reported in 20% Covid-19 pts.

7.
Gastrointestinal - Prolonged viral fecal shedding can occur in COVID-19 even after negative nasopharyngeal swab testing. May even alter gut microbiome.

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Here is in infographic summarising everything.

8.
This is a summary thread of an excellent review article published in nature medicine.
nature.com/articles/s4159…

@HaryaxPathak @ProfSomashekhar @neoarchana @pankti4299

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