Masoud Mardani – Archives of Clinical Infection, 2020*
The findings in a nutshell
The author presents the common characteristics observed in ‘post COVID-19 syndrome’ and the pathways that may cause long term health conditions. Importantly, COVID-19 symptoms may persist after the original infection and the virus can cause long-term health complications such as heart failure/disease, neurological diseases and lung diseases.
The author advocates that the prevalence of fatigue induced symptoms from initial COVID-19 infection should be considered as a priority in terms of health and quality of life and proposes that treatment include a course in psychotherapy or increasing exercise with considerations to reassurance, self-care and symptomatic control (including sleep hygiene measures, cognitive behavioural therapy and exercise recommendations).
Implications for Australian workplaces
It is critical that insurers, employers, healthcare providers and government understand the different symptoms from Post COVID-19 syndrome. Important approaches include the management of chronic fatigue syndrome and pain (including muscle pain) and psychotherapies.
Employers can support the wellbeing of employees through knowledge and recognition of the symptoms of Post COVID-19 syndrome. Support systems and work flexibility should be tailored with the aim to reduce any potential long-term implications and improve quality of life for employees.
Overview of paper
The author discusses how COVID-19 has the ability to cross the brain-blood-barrier and affect the brain and its lymphatic drainage system. Effects from this range from cognitive impairments (e.g. person may notice difficulty with reading), inflammation of organs and disruptions to the sleep-wake cycle. Common symptoms reported include fatigue, brain-fog, anxiety, depression, cough, high fever, muscle pain, loss of smell and dry skin. A study in Italy revealed that patients discharged post COVID-19 infection had fatigue (53%), shortness of breath (43%), joint pain (23%) and/or chest pain (21%), with more than half presenting with three or more symptoms (55%), nearly a third with one or two symptoms (32%) and only 12 percent with no symptoms. In terms of long-term health implications, 87 percent had persistence of at least one symptom, especially fatigue and shortness of breath. The impact these symptoms have on long-term health indicate serious health burden, with a significant minority being homebound, some even bedbound. After the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak, some patients who were followed up after an initial diagnosis did not return to work for nearly 20 months because of chronic fatigue syndrome, suggesting that a subgroup of patients are likely to experience these long-term adverse health effects with COVID-19.
Furthermore, according to the Centers for Disease Control and Prevention (CDC) in the United States, the majority of people that suffer from chronic fatigue report that their disease started with an acute episode of infectious disease (mostly mononucleosis/flu). As there is no effective medicine to treat chronic fatigue syndrome that is also linked to Post COVID syndrome (through the associated post-exertional neuroimmune exhaustion), it remains commonly dismissed by physicians, employers and families. Such dismissal of the impacts of these conditions can lead to a further downward spiral of muscular atrophy, sleep disorders and mental illness. Some COVID-19 patients report that their troubling Post COVID-19 Syndrome symptoms may be due to anxiety, depression or post-traumatic stress.
To find out more about Post COVID-19 Syndrome, read Masoud Mardani’s full article here.
Date published: 13 September 2020
*Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
The author of this paper is from Infectious Diseases and Tropical Medicine Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.