When is it considered to have prolonged Covid-19 syndrome?

Long-lasting Covid syndrome or post-Covid-19 is abnormal health symptoms with no known cause, occurring after 4-12 weeks of recovery, as defined by WHO.

Mr. Loc, 62, in Ho Chi Minh City, contracted Covid-19 in January, symptoms of cough with sputum, shortness of breath, chest pain, SpO2 (capillary blood oxygen concentration) measurement sometimes decreased to 92%. The doctor instructed to treat at home, take medicine, support oxygen, lie on the stomach, pat the back, the shortness of breath gradually improved. A week later, he tested negative, no symptoms.

Nearly two months after recovering from the disease, Mr. Loc coughed again, had green phlegm, had a fever of 39-40 degrees, was tired, had difficulty breathing, his left leg was swollen, painful, hot, and difficult to move. The doctor diagnosed a blood clot in his left leg causing venous thrombosis and severe pneumonia, with nodular fibrosis – long-lasting Covid sequelae. The patient was admitted to the hospital, treated with antibiotics, anticoagulants, oxygen support, physical therapy…, the blood clot in the leg veins dissolved, the blood vessels were re-opened, and the inflammation in the lungs was gone. At home, Mr. Loc continued to take anticoagulants, practice breathing, supplement nutrition and follow up with the doctor’s appointment.

Ms. Huynh Thu Ngan, 27 years old, an office worker in Ho Chi Minh City, after recovering from Covid-19 suffered a lot of hair loss, headaches, shortness of breath when climbing stairs, prolonged fatigue… but did not go to the doctor. She said that a few years ago she had dengue fever, pneumonia, and had a similar situation, and soon after. Therefore, this time, Ngan increased her yoga practice, supplemented vitamins and minerals, slept early, and the unpleasant symptoms gradually decreased.

However, Ngan’s parents in Quang Nam do not think so. “My parents are more afraid of sequelae than they are of contracting Covid,” Ngan said. Her parents had relatively mild Covid-19 infection, were negative, had no underlying disease, and still had a cough and headache. Grandparents and 5 relatives decided to rent a car to Ho Chi Minh City to examine the sequelae.

Over the past time, the country has recorded a number of cases of severe post-Covid-19 sequelae, such as ischemic stroke, pulmonary embolism leading to cardiac arrest, lung damage, fibrosis, dependence on ventilators, etc. In mid-March, Thanh Nhan General Hospital, Hanoi, a 62-year-old female patient died due to severe lung damage. Doctors believe that many people are subjective with prolonged, severe Covid symptoms, late hospitalization, and difficulty in treatment, like the two patients above. Many others worry too much, go to the doctor after recovering from the disease even if there are no unusual symptoms.

Doctor Nguyen Nhu Vinh, Head of the Department of Respiratory Function Investigation, Ho Chi Minh City University of Medicine and Pharmacy Hospital, said that in the past few months, the post-Covid-19 clinic has received hundreds of patients every day. Some cases have mild sequelae, some have no symptoms but do not understand correctly about the post-Covid-19 situation, too worried and afraid to go to the doctor. Out of about 7,000 patients examined at the hospital recently, only 10 need to be hospitalized for post-Covid-19 treatment. Most of them are elderly, have diabetes, heart disease, cancer, had to breathe oxygen during the acute Covid phase, a few young people had mild disease.

Doctor Vo Ngoc Anh Tho, Deputy Head of the Department of Tropical Diseases, Cho Ray Hospital, said studies around the world showed that 80% of F0 had at least one abnormal symptom in the first 4 weeks of Covid, such as fatigue. , cough, chest tightness, hair loss, insomnia, difficulty concentrating, headache… They are not life-threatening, are self-regulating and heal by the body within three months. The best chance of recovery is within the first month after recovery.

“People with severe post-Covid-19 sequelae account for a low percentage,” said Doctor Tho. Serious and potentially life-threatening post-Covid-19 sequelae include: Lung damage (pulmonary fibrosis, atelectasis); cardiovascular (increased blood clotting that causes blood clots to lead to stroke, myocardial infarction, pulmonary embolism); kidney damage; neuropsychiatric sequelae (insomnia, headache, anxiety, depression). Particularly in children, MIS-C syndrome may appear.

Health problems that occur after Covid-19 Up to now, it is still considered by the World Health Organization (WHO) as a scientific phenomenon that cannot be explained. Usually, people recover from Covid-19 after two to six weeks. In some people, the virus causes symptoms that last for weeks or months after testing negative. People who are not hospitalized or have mild illness can also experience persistent symptoms, some developing complications with long-term health effects. WHO calls health problems after Covid-19 Post-Covid Symptoms or Prolonged Covid syndrome (Long Covid).

From February 2021, WHO organizes many international consultations with experts to come up with a general concept of this condition and its subtypes. WHO’s definition of persistent Covid-19 is: “Post-Covid condition occurring in a person with a history of nCoV infection, usually three months from the onset of Covid-19 infection, symptoms persisting for at least two months , cannot be explained by diagnosis”.

WHO records more than 200 post-Covid symptoms have been reported. In which, three common symptoms include fatigue, shortness of breath, and cognitive dysfunction. Symptoms that interfere with daily living, may begin after recovery or persist from an acute infection, may change and recur over time.

The progression of Covid-19 disease is divided into three phases. The acute phase is when the rapid test is positive, usually about 4 weeks long. From 4 weeks to 12 weeks is the stage where Covid-19 is still progressing, the test is negative but the disease is not completely cured. After 12 weeks is considered the post-Covid-19 period. Thus, Long-lasting Covid Syndrome includes both the advanced and post-Covid-19 phases, ie from 4 weeks to 12 weeks or more.

The US Centers for Disease Control (CDC) calls the Persistent Covid-19 Syndrome the “Post-Covid-19 Condition”. In Vietnam, the term post-Covid-19 or Covid-19 is used equivalently, from 4 weeks to 12 weeks or more, according to Dr. Vinh.

Doctor Vinh listens to the heart and lungs of a patient who comes for a post-Covid-19 examination. Photo: English Letters

According to WHO’s definition, the number of people who actually have prolonged Covid-19 syndrome in Vietnam is not much,” said Dr. Vinh. However, many patients still recommend “testing for peace of mind.” “In these cases testing is unnecessary, a waste of money and time as well as putting psychological pressure on the patient,” said Dr. Vinh.

Doctor Tho also said that many people have the mentality of “blaming” health abnormalities due to Covid-19 but ignore the real cause of other diseases. For example, they have a background of hypertension, diabetes, cardiovascular disease, after Covid unfortunately suffered a stroke and attributed the “culprit” as sequelae. Therefore, instead of post-Covid-19 check-ups, people with underlying medical conditions should have regular health screenings to diagnose and have an appropriate treatment plan.

Experts recommend that people who have no symptoms, still work and live normally, do not need to go to the doctor after Covid-19. If the symptoms of fatigue, cough, sore throat, hair loss, trouble sleeping, heavy breathing, palpitations… persist after 4 weeks, you should see a doctor. In case of having one of the following symptoms: Difficulty breathing, coughing up blood, SpO2 drops below 94%; left chest pain with increasing pain; severe headache, accompanied by vomiting, weakness in limbs, facial paralysis; severe abdominal pain; or the child has a high fever that does not go down, lethargy, difficult to wake up, red rash on the body… need to go to the hospital right away.

“Absolutely not self-medicate, buy drugs of unknown origin or quality for self-healing after Covid,” said Doctor Tho.

Thu Anh – Thuc Linh


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