Indian Journal of Respiratory Care

IJRC Email      Register      Login

VOLUME 10 , ISSUE S1 ( April, 2021 ) > List of Articles

REVIEW ARTICLE

Post-COVID-19 Sequelae

Uthara Vijai Kumar

Keywords : COVID-19-associated pulmonary aspergillosis, post-COVID-19 sequelae, pulmonary fibrosis, thromboembolic disease

Citation Information :

DOI: 10.4103/ijrc.ijrc_30_21

License: CC BY-NC-SA 4.0

Published Online: 06-12-2022

Copyright Statement:  Copyright © 2021; Indian Journal of Respiratory Care.


Abstract

COVID-19 is a new disease and the acute clinical presentation is mostly clear now. It is also known now that the disease may have sequelae affecting various systems. The respiratory sequelae include pulmonary fibrosis due to the immune-mediated mechanisms that follow a cytokine storm, diffuse alveolar damage, and microvascular thrombosis. A decline in lung function may be seen in patients who still have residual symptoms and hypoxia. COVID-19-associated pulmonary aspergillosis, a well-recognized complication, especially in patients with acute respiratory distress syndrome, has emerged as a significant risk factor for increased mortality. Fatigue is a common symptom that patients come back with, in the post-COVID period. Dyspnea without hypoxia has been attributed to respiratory muscle dysfunction and deconditioning resulting in decreased exercise tolerance. Palpitation is another common persisting symptom. Thromboembolic disease, a common association during the acute phase of illness, is not an uncommon entity that is seen even after “recovery” from COVID-19. Thromboembolic events causing stroke have been identified as an immediate complication of COVID-19, but can occur during the recovery phase as well, in high-risk patients. The return of smell and taste sensations could take a few weeks to months even after complete recovery from the illness. Mood swings, anxiety, and sleep deprivation have all been reported by patients recovering from this viral illness. The last 14 months have been feverishly spent in trying to understand this particular disease, but the long-term complications of COVID-19 are still elusive.


HTML PDF Share
  1. WHO. Coronavirus Disease 2019(COVID-19) Situation Report. Available from: https://www. who.int/emergencies/diseases/novelcoronavirus-2019/events-as-they-happen. [Last accessed on 2021 Feb 28].
  2. Fraser E. Long term respiratory complications of covid-19 BMJ 2020; 370:m3001.
  3. National Institute of Allergy and Infectious Diseases. COVID-19, MERS & SARS; 2020. Available from: https://www.niaid.nih.gov/diseases-conditions/COVID-19. [Last accessed on 2021 Feb 28].
  4. Ooi GC, Khong PL, Müller NL, Yiu WC, Zhou LJ, Ho JC, et al. Severe acute respiratory syndrome: Temporal lung changes at thin-section CT in 30 patients. Radiology 2004;230:836-44.
  5. Zhang P, Li J, Liu H, Han N, Ju J, Kou Y, et al. Long-term bone and lung consequences associated with hospital-acquired severe acute respiratory syndrome: A 15-year follow-up from a prospective cohort study. Bone Res 2020;8:8.
  6. Wu C, Chen X, Cai Y, Xia J, Zhou X, Xu S, et al. Risk factors associated with acute respiratory distress syndrome and death in patients with coronavirus disease 2019 pneumonia in Wuhan, China. JAMA Intern Med 2020;180:934-43.
  7. George PM, Wells AU, Jenkins RG. Pulmonary fibrosis and COVID-19: The potential role for antifibrotic therapy. Lancet Respir Med 2020;8:807-15.
  8. Zhang T, Sun LX, Feng RE. Comparison of clinical and pathological features between severe acute respiratory syndrome and coronavirus disease 2019. Zhonghua Jie He He Hu Xi Za Zhi 2020;43:496-502.
  9. Wang Y, Dong C, Hu Y, Li C, Ren Q, Zhang X, et al. Temporal changes of CT findings in 90 patients with COVID-19 pneumonia: A longitudinal study. Radiology 2020;296:E55-64.
  10. Chen R, Gao Y, Chen M, Jian W, Lei C, Zheng J, et al. Impaired pulmonary function in discharged patients with COVID-19: More work ahead. Eur Respir J 2020;56:2002194.
  11. Koehler P, Bassetti M, Chakrabarti A, Chen SCA, Colombo AL, Hoenigl M, et al. Defining and managing COVID-19-associated pulmonary aspergillosis: The 2020 ECMM/ISHAM consensus criteria for research and clinical guidance. Lancet Infect Dis 2020;S1473-3099(20)30847-1.
  12. Chowdhary A, Tarai B, Singh A, Sharma A. Multidrug-resistant candida auris infections in critically Ill coronavirus disease patients, India, April-July 2020. Emerg Infect Dis 2020;26:2694-6.
  13. Carfì A, Bernabei R, Landi F; Gemelli Against COVID-19 Post-Acute Care Study Group. Persistent symptoms in patients after acute COVID-19. JAMA 2020;324:603-5.
  14. Ackermann M, Verleden SE, Kuehnel M, Haverich A, Welte T, Laenger F, et al. Pulmonary vascular endothelialitis, thrombosis, and angiogenesis in Covid-19. N Engl J Med 2020;383:120-8.
  15. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020;5:1265-73.
  16. Holmes EA, O'Connor RC, Perry VH, Tracey I, Wessely S, Arseneault L, et al. Multidisciplinary research priorities for the COVID-19 pandemic: A call for action for mental health science. Lancet Psychiatry 2020;7:547-60.
  17. Garner P. COVID-19 at 14 Weeks-Phantom Speed Cameras, Unknown Limits, and Harsh Penalties; 2020. Available from: https://blogs.bmj. com/bmj/2020/06/23/paul-garner-COVID-19-at-14-weeks-phantomspeed-cameras-unknownlimits-and-harsh-penalties/. [Last accessed on 2020 Sep 29].
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.