If you have recovered from COVD-19, But are still experiencing

certain symptoms , you could have post COVID-19 conditions or

“LONG COVID”.

What are these symptoms? How long do they last and are any

treatment options ?

Most people who had COVID-19, recover completely within a few

weeks. But some people, even those who had milder versions of the

disease-continue to experience symptoms after their initial recovery.

These health issues are called post-COVID-19 syndromes. They're

generally considered to be effects of COVID-19 and persist for more

than four weeks after been diagnosed with the COVID-19 virus.

Older people, patients with many comorbidities, patients who had

prolonged hospitalisation and have been on oxygen therapy and on

ventilator, are the most likely to experience lingering COVID-

19 symptoms. 

Common signs and symptoms that linger over time

include:

• Fatigue

• Shortness of breath or difficulty breathing

• Cough

• Joint pain

• Chest pain

• Memory, concentration or sleep problems

• Muscle pain or headache

• Fast heartbeat

• Loss of smell or taste

• Depression or anxiety

• Fever

• Dizziness

Although COVID-19 is seen as a disease that primarily affects the

lungs, it can damage many other organs as well. This organ

damage may increase the risk of long-term health problems.

Organs that may be affected by COVID-19 include, brain, heart

and increase in clotting and blockage of blood vessels. These

patients are also prone to various secondary bacterial or fungal

Infections.

The most common complication is lung fibrosis. This type of

pneumonia which is often associated with COVID-19 can cause long-

standing damage to the tiny air sacs (alveoli) in the lungs. The

resulting scar tissue can lead to long-term breathing problems. Lung

fibrosis post-SARS-CoV-2 infection has been observed in people with

an older age, history of smoking, severe illness with CT scan severity

score 17/25 and above, prolonged ICU stay and mechanical

ventilation. The respiratory fibrosis caused due to infections is

unlikely to recover after 21 days of duration. It takes a long time to

reverse, till then patients require supportive care and aggressive

pulmonary rehabilitation efforts to recover. These patients have

progressive and exertional dyspnoea and reduction in walking

efficiency (6MWT is reduced). The patients may need to do lung

function test and a repeat CT scan chest after three weeks of covid

infection to rule out lung fibrosis.

Mild or severe signs of lung impairment post initial infection might

go as long as four months. These patients end up with permanent lung

damage of varying degrees and might require home oxygen

supplementation for a prolonged duration, even after recovering from

COVID 19 infection.

The role of available anti-fibrotic therapies like Nintedanib and

Pirfenidone, which are used for the treatment of idiopathic pulmonary

fibrosis, is still being evaluated for the prevention or reduction of

post-COVID fibrosis. Some of these patients may need low doses of

corticosteroids.

Also, one should be put on a small dose of blood thinners for at least a

month in order to reduce the chances of patient getting a heart attack

or a brain stroke.

Some post COVID care such as drinking plenty of fluids, breathing

exercises, meditation, nutritious diet, adequate sleep, avoid smoking

and drinking should be considered as precautionary measures. It is

also important to brisk walk in the first week post recovery, followed

by doubling the time in the second week. Post covid, it is ideal to get

vaccinated after 90 days.

Secondary bacterial infections with pneumococcus commonly follow

influenza disease and use of influenza vaccine and PCV13 may

reduce this burden in the elderly and those with underlying illnesses.

Lowering the risk of acquiring a respiratory infection will allow for

less visits to clinics and less hospital admissions, thus decreasing the

burden on the health infrastructure at this time and lowering ones’

exposure to acquiring COVID-19 in the hospitals/clinics.

It has been seen that older adults who received pneumococcal

conjugate vaccine (PCV13), which prevents acquisition of certain

pneumococcal strains, experienced 35% lower incidence of COVID-

19 diagnosis, 32% lower incidence of covid hospitalisation, 33%

lower incidence of COVID-19 deaths as compared to the adults who

did not receive the vaccine. In contrast, an alternative pneumococcal

vaccine (PPSV23), which prevents severe pneumococcal disease but

does not block acquisition of the bacterium, was not associated with

Protection.

Pneumococcal vaccination protects against pneumococci after one has had

COVID-19. Also, it is safe to get the pneumococcal vaccination; no unexpected

side-effects will occur.

Other adult vaccination to prevent Flu is influenza vaccine, also commonly

known as Flujab. Flu jab is the best protection against serious complications

from flu. After the flu jab, one will have a lower risk of getting flu. And even if

one gets the flu, the chances of becoming seriously ill is less, with reduced rate

of hospitalisation.

So, if you or a loved one has lung disease or any other co-morbidity, ask a

healthcare professional about pneumococcal and influenza vaccination.

These, in addition to Covid vaccines, will give you added protection from

developing serious complications arising due to Covid-19 too.

Dr Anil Mehndiratta (MBBS , MD, AFIH, FCCP)

Senior Pulmonologist,

DG Shipping India& OEUK/OGUK Approved Medical Examiner,

Past IMA Goa President

Vasco da gama, Goa

@DrAMehndiratta