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What are the signs of post-acute infection syndrome?




The long-term health effects of COVID-19 refocus on post-acute infection syndrome (PAIS) and refocus on the need to fully understand the pathophysiology, clinical indicators, and epidemiology of these syndromes. The discussion has started. Important blind spot In the field of medicine. A better understanding of these persistent symptom profiles not only for the acute sequelae of SARS-CoV-2 infection (PASC), well known as long COVID, but also for other diseases with unexplained acute sequelae. This will impose a fine on the doctor. Adjust diagnostic criteria.Have a clear definition and a better understanding Symptoms after acute infection These are the steps needed to develop an evidence-based, interdisciplinary management approach.


Observations of unexplained chronic sequelae after SARS-CoV-2 are known as PASC or long COVID.

Long COVID has been reported as a syndrome of survivors of serious and serious illness, but its effects are Mild infection It did not require hospitalization. This means that PASCs share many of the same characteristics as chronic diseases caused by other pathogenic organisms, especially if they occur after mild or moderate COVID-19 infection, but many are sufficient. It has not been clarified.

PAIS is characterized by a series of major symptoms centered on:

In many cases, non-specific symptoms appear to varying degrees.

These similarities suggest a unified pathophysiology that needs to be elucidated in order to properly understand and manage post-infection chronic disorders.

Overview of PAIS

Detailed revisions to what is currently known about PAIS Nature medicine.. It provides a variety of useful information to support the poor perception of these conditions in clinical practice, and as a result, patients may experience delays or complete lack of clinical care.

The following integrated sequelae of infection are mentioned:

  • Q fever syndrome following intracellular bacterial infection Coxiella Bernetti

  • Dengue Fatigue Syndrome That Can Follow Infection by Mosquito-borne Infection Dengue fever virus

  • Fatigue and rheumatic symptoms in a subset of individuals infected with Chikungunya virusA mosquito-borne virus that causes fever and joint pain in the acute phase

  • Post-polio syndromeMay appear 15-40 years after the first polio attack (as well as some other neurotrophic microorganisms, West nile virusMay lead to lasting effects)

  • Long-term, debilitating chronic symptoms have long been reported in a subset of patients after a common and typically less severe infection.For example, after mononucleosis, generally Epstein-Barr virus (EBV), and after the outbreak Giardia duodenal, Usually an intestinal parasite that causes an acute intestinal parasite. In fact, some studies have confirmed an association between the development of this giardiasis and chronic fatigue. Irritable bowel syndrome (IBS), and Fibromyalgia It lasts for years.

  • Views expressed in the literature on the frequency and validity of post-treatment Lyme disease Syndrome (PTLDS) is divided. Substantial evidence shows persistent arthralgia, malaise, and subjective neurocognitive impairment in a minority of Lyme disease patients after recommended antibiotic treatment, but some early studies are sufficient. The rigor could not characterize the first episode of Lyme disease.

Symptoms and signs

Based on the available evidence, the symptoms and symptoms that are more often seen on healthcare checks can be characterized as follows:

  • Exercise intolerance, fatigue

  • Symptoms of “illness behavior” like flu: fever, fever, muscle aches, feeling sick, malaise, sweating, irritation

  • Neurological / neurocognitive symptoms: brain fog, poor concentration or memory, difficulty searching for words

  • Rheumatoid symptoms: Chronic or recurrent joint pain

  • Trigger-specific symptoms: For example, posting eye problems EbolaIBS Post GiardiaAnosmia and ageusia after COVID-19, movement disorders after polio and West Nile virus

Myalgic encephalomyelitis / chronic fatigue syndrome

Patients with this disorder experience exacerbations of symptoms after physical, cognitive, or emotional exercise that exceeds (very low) tolerance limits.Other prominent features frequently observed in Myalgic encephalomyelitis/ Chronic fatigue syndrome (ME / CFS) is neurocognitive dysfunction (commonly known as brain fog), refreshing sleep, pain, sensory deficits, gastrointestinal problems, and various forms of autonomic dysfunction. Up to 75% of ME / CFS cases report infectious-like episodes that precede the onset of the disease. Post-infection and post-viral fatigue syndrome was originally envisioned as a subset of chronic fatigue syndrome. However, at this time, there seems to be no clear consensus on whether to consider these terms synonymous with either the ME / CFS label or a subset thereof, or to include more broadly post-infection fatigue conditions.

Practical diagnostic criteria

Due to the revision of the available criteria, the PAIS diagnostic criteria should include not only the presence of symptoms, but ideally the intensity, course, and constellations of the individual’s symptoms and the trajectory of the symptoms. It became clear that there is. PAIS changes over time and is merely a comparison of the presence of symptoms at a single point of time that is misleading. In addition, when a diagnosis of ME / CFS is made, attention should be paid to the choice of diagnostic criteria, prioritizing more conservative criteria so as not to risk overestimating the syndrome.

Asthenia is the underlying symptom of most epidemiological studies on PAIS, but with other characteristic symptoms and signs that may allow better identification, rather than other features such as worsening of post-exercise symptoms. Focusing solely on this is reductive in the overall observable clinical picture of these post-infection syndromes that have a significant impact on the patient.Quality of life.

This article was translated from Italy Univadis ..

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