Post-Covid Syndrome: The Second Pandemic?

June 1, 2021

Although most people with COVID-19 get better within weeks of illness, some people experience post-COVID conditions. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19. And this is turning out to be a greater concern than previously thought. Even the term ‘second pandemic’ has been given by some for these conditions.

Survivors of previous coronavirus infections, including the SARS epidemic of 2003 and the Middle East respiratory syndrome (MERS) outbreak of 2012, have demonstrated a similar situation of persistent symptoms, reinforcing concern to understand about the clinically significant sequelae of COVID-19.

In community, the usual term coined for all symptoms related to sequelae of COVID 19 is ‘long COVID’. In fact, it can also be termed post-COVID syndrome. Post-COVID syndrome can have different types and combinations of health problems for different lengths of time. But we need to have a clear understanding about how to identify, define and classify various types of this so called ‘long COVID’ or ‘PCS’.

What are the different types of PCS?

  1. Acute PCS, if symptoms persist from 4–12 weeks after the onset of COVID and not attributable to alternative diagnoses
  2. Long PCS, if symptoms persist beyond 12 weeks and upto 24 weeks of the onset of COVID
  3. Persistent PCS: if symptoms persist beyond 24 weeks
  4. MIS (multisystem inflammatory syndrome): Multiorgan effects  can affect multiple body systems including heart, lung, kidney, skin, and brain functions.
  5. PICS (post intensive care syndrome):Patients who required ICU care during COVID, can have post-intensive care syndrome (PICS), which refers to health effects that remain after a critical illness. Symptoms can include severe weakness due to myopathy or neuropathy, and post-traumatic stress disorder (PTSD). PTSD involves long-term reactions to a very stressful event.

What are the symptoms of PCS?

Some of the more common symptoms are

  • Chest tightness
  • Cough
  • Shortness of breath
  • Feeling tired all the time
  • Lack of concentration

Some less common but equally or sometimes more debilitating symptoms are

  • Muscle pains
  • Joint pains
  • Palpitations (fast heart beats)
  • Dizziness
  • Light headedness
  • Tingling / pains in fingers and toes
  • Anxiety
  • Depression
  • Headache
  • PTSD
  • Skin rashes

I would like to reinforce here that none of these symptoms should be taken lightly. Patient feels that she / he is not being taken seriously or diagnosis is not being done, because many of the times most of the investigations and tests are normal.

How common is this PCS?

As per our experience, 70% of the hospitalized patients, and 25% of non-hospitalised patients get post- COVID symptoms, in some or the other form.

Who is most likely to get PCS?

Post-COVID syndrome can be seen in people who had advanced symptoms and required a hospital/ICU stay, but it can also occur in people who had mild symptoms and settled with home care only. Still, the probability is high for senior citizens, severe category COVID patients, and patients with underlying health conditions, particularly hypertension, diabetes, obesity or pulmonary issues

Whether PCS symptoms improve? How long do they last?  Do these symptoms eventually resolve?

There are ways to help manage post-COVID conditions, and many patients with these symptoms are getting better with time. There are no criteria to know how long these symptoms can persist, but on the basis of present experience we do know that many of these patients would benefit from specialized care and, in some cases, regular follow up.” If you think you have a post-COVID condition, talk to your healthcare provider about options for treating your symptoms.

Care for patients with COVID-19 does not conclude at the time of hospital discharge.

Can we prevent PCS?

The only way to prevent post-COVID syndrome is to avoid COVID. And to avoid COVID, following measures need to be strengthened once again

  • Social distancing / avoid crowds
  • Practice excellent hand hygiene
  • Avoid touching your face / To keep your face clean
  • Proper use of mask
  • COVID Vaccination whenever you are eligible

Blog Written By

Dr. Ashish Gupta

Consultant Critical Care Medicine

Apollo Spectra Hospitals, Karol Bagh