Respiratory symptoms after COVID-19, what you need to know

According to the World Health Organization (WHO), most people will fully recover from COVID-19. But 10 to 20 percent of people have long-term effects, ranging in severity from mild to severe, known as post-COVID-19 disease.

1. When does it happen after COVID-19?
WHO defines post-COVID-19 as an illness that occurs in people with a history of SARS-CoV-2 infection, usually with symptoms that affect the body within 3 months of contracting COVID-19. . . and last for at least 2 months. Its symptoms and effects should also be noted in the differential diagnosis of other diseases.

Most post-COVID-19 symptoms appear in seriously ill patients requiring hospitalization. Especially those who need mechanical ventilation, emergency hospitalization, the elderly, diabetes, hypertension, obesity, cardiovascular disease, smoking and other basic diseases. , alcoholism, chronic kidney disease.

Lymphopenia, thrombocytopenia, D-dimer, LDH, elevated troponin, elevated CRP, elevated ferritin, elevated IL-6, and coagulation disorders.

Other risk factors include having more than 5 symptoms within the first week of illness. Women in their 50s and 60s are also vulnerable to secondary infections after contracting COVID-19. However, unlike some other types of post-illness syndrome, post-COVID-19 can happen to anyone with COVID-19, even mild illness, even while sick. If they don’t have symptoms, they can still get COVID-19.

According to the 2021 Census, 10-35% of patients with COVID-19 who do not require hospitalization remain symptomatic after COVID-19, regardless of their underlying medical conditions. Post-COVID-19 infection rates are as high as 80% for patients with underlying medical conditions hospitalized for COVID-19.

Post-COVID-19 patients develop symptoms in many organs and systems of the body, such as respiratory, cardiovascular, neuropsychiatric, cutaneous, and systemic systems…but the most common are sequelae. In the respiratory system (about 50% of all post-COVID-19 manifestations).

2. Respiratory manifestations after COVID-19
Common presentations are dyspnea and persistent cough, chest pain, thrombosis, pulmonary embolism, and especially post-COVID-19 interstitial pulmonary fibrosis.

– Shortness of breath and prolonged cough, chest pain:
Often persistent after treatment for COVID-19, this phenomenon usually occurs after a respiratory viral infection, and the main symptom is a cough, usually just a dry cough, wheezing, chest tightness, and is common in patients. IL-6 is elevated in patients treated for COVID-19. and lipocalin-2.

This manifestation is known as post-inflammatory tracheal hypersecretion syndrome.

– Thrombosis, pulmonary embolism:
Patients may have small blood vessel damage in their lungs, large and small blood clots that appear in the early stages of COVID-19, which is more common in COVID-19 than other viral diseases. On the other hand, the potential for overcrowding may persist into the post-COVID-19 era. The mechanisms of thrombosis, pulmonary embolism, are due to blood stasis, endothelial damage, and increased coagulation.

When a patient presents with the following symptoms: shortness of breath, chest pain, cough, and possible hemoptysis, D-dimer testing and chest X-ray, electrocardiogram, and echocardiography are required if embolism is suspected. artery. Contrast-enhanced computed tomography (CT-Scan) of the lungs is required to confirm the diagnosis of pulmonary thrombosis.

Interstitial pulmonary fibrosis after COVID-19:
This is the most serious complication after COVID-19, the mechanism of which can be explained by the increased activation of CRP, IL-6 and LDH by fibroblasts causing pulmonary fibrosis. Interstitial pulmonary fibrosis is common in mechanically ventilated patients. Severe pneumonia, smoking, alcohol abuse, and high-dose oxygen therapy can cause oxidative stress. Ventilator-related trauma also increases the likelihood of pulmonary fibrosis. However, there is concern that pulmonary fibrosis may still develop in young, mildly infected outpatients with COVID-19.

The clinical presentation is that these patients frequently experience dyspnea, which worsens with exertion and oxygen dependence, fatigue, chest CT scan, progressive interstitial fibrosis, and physical impairment. Grass. 2 lungs, measure respiratory function in patients with restrictive ventilatory disorders, manifest as significantly reduced vital capacity and the ability of air to diffuse through the alveolar membrane of pulmonary capillaries (significantly reduced Dlco measure), measure hypoxic arterial gas, if severe, it shows Respiratory failure. . .

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