The first year of the COVID-19 pandemic claimed the lives of millions of people around the world, but within weeks of recovery left hundreds of people with prolonged or entirely new symptoms.
Much is unknown about the causes and duration of these symptoms. However, since March last year, about 740,000 COVIDs have been reported in New York City and 28 million in the United States, and doctors are increasingly looking at these “long-haul carriers” in their practice.
“During the summer, we began to understand what problems these people had,” said a Cardiology Fellow at Columbia University Vagelos College. New review of COVID-19 after acute phase..
“Reviews of all these possible issues felt important not only to healthcare providers but also to patients. Patients may be experiencing COVID-19 infection as a result of their experience. Yes, it is important to know that you are not the only one experiencing the protracted effects of COVID-19 infection. “
Nalbandian, along with Harvard Medical School and Dr. Cartix Segal, MD, co-lead author of the Dana-Farber Cancer Institute, led the review effort with more than 30 people from Colombia and other medical centers hit by the first wave. Gathered experts from. This review summarizes what doctors saw in their patients and what others reported in the literature. Experts represented a wide range of disciplines, including neurology, cardiology, and nephrology.
CUIMC News is the lead author of the review, Nalbandian and Elaine Y, assistant professors of cardiology and cardiac electrophysiology. We talked to Wan, MD about the symptoms patients and healthcare providers should be aware of about the COVID-19 long-haul carrier.
It ’s not just the “brain fog”
Chest pain has been reported in up to 20% of COVID-19 survivors 2 months after recovery from infection, and COVID-19 can reveal previously unrecognized cases of diabetes. A few percent of patients experience stroke, pulmonary embolism, and other complications. Blood clot.
One’s specialty is electrophysiology, and during the pandemic, she and her colleagues published more than 10 articles on COVID and cardiac arrhythmias.
“Arrhythmias can lead to stroke, heart failure, and long-term damage to the heart,” she says. “And that’s something the patient may not be aware of.”
In addition, multiple organs can be affected at the same time. “If you go to a cardiologist, the cardiologist may focus only on the heart,” says Nalbandian. “But COVID can affect many organs, especially those that are hospitalized, so we need to think about the whole person.”
Everyone is vulnerable
Most people who experience long-term symptoms may have had health problems before being infected with the virus or developed a very serious illness during COVID-19 infection.
“But in reality, all of these problems can occur in all patients infected with COVID-19,” says Wan. “For example, I’ve seen young patients without previous medical illness who developed autonomic dysfunction and fast heart rate after COVID-19. Only the most vulnerable people have problems after COVID-19. Not. “
“In reality, we have post-COVID syndrome, which does not always correlate with the severity of the acute COVID infection itself,” says Nalbandian.
The majority of COVID patients do not come to the hospital for treatment. “We may not be checking in these patients with the same urgency, but they must not be forgotten,” she adds.
Symptoms may appear weeks or months after recovery
“I’ve seen young patients weeks to months after COVID-19 infection, and they suddenly developed new onsets of heart racing, palpitations, and chronic fatigue,” says Wang.
Other patients complain of new chest discomfort and difficulty in decision-making, memory, and concentration after a few weeks.
“When we think of COVID-19, we mainly think of respiratory illness,” says Wang. “But even after recovering from a respiratory illness, other organ system problems may leave other clinical symptoms.”
Patients need a dedicated “COVID-19 Clinic”
“COVID-19 is the first infection I have encountered and has such effects on a wide variety of organs,” says Wang. “It changed my clinical practice. No matter what the patients came for, I now ask if they have been infected with COVID-19. It changes the range of diagnosis. I will. “
“Based on this review, we all realized that interdisciplinary care was needed to treat patients in the long term,” says Nalbandian. “Care for patients with COVID-19 should not end at discharge.”
To provide interdisciplinary care, the healthcare system needs to establish a dedicated “COVID-19 Clinic” similar to that currently found in Italy.
Nalbandian said it would be difficult to establish such a clinic in the United States as doctors are still busy caring for new COVID patients as the subsequent waves rush. And the patients with the highest burden of persistent symptoms. “
Patient needs to speak out
Nalbandian said many patients complained that their doctors weren’t aware that their symptoms might be related to COVID, which she and her co-authors reviewed. This is one of the reasons for organizing.
“Here in New York, there are patients struggling for weeks and months looking for a knowledgeable doctor,” says Nalbandian. “Physicians need to be careful, justify patient concerns, and thoroughly document their symptoms.”
Patients should not be afraid to speak up about their symptoms. “If you’re not sure if your symptoms are due to a COVID infection, contact your doctor,” she says. “The situation is still in flux and we are learning more every month.”
Participate in clinical trials with patient advocacy groups
The activities of the new patient support group helped identify persistent symptoms and helped emphasize the persistence of symptoms in people who did not require hospitalization.
“Active involvement with these groups is very important,” says Nalbandian. “With participation in clinical trials for longitudinal evaluation.”
The medical community is now better aware of the constellation of long-term symptoms that occur after COVID, but “I don’t know the duration and long-term complications,” Nalbandian adds.
“To learn more, we need to refer the trial to patients, and we have listed many active studies in our review.
“Healthcare providers are still burdened with caring for patients with acute COVID, but that is a joint responsibility of the entire medical community.”
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