The Chronic Effects of COVID-19 or “Long COVID”

The term “long COVID” is used to refer to patients who have persisting symptoms for 4 weeks or more after onset of COVID-19. The prevalence of these symptoms is reported to range from 10-80%. The commonest symptoms include fatigue, dyspnoea, chest pain, hair loss, loss of sense of taste and smell, cognitive difficulties, anxiety and depression. Serious complications in this period include thrombo embolic events (stroke, myocardial infarction, limb ischemia and venous thromboembolism), infections, pulmonary fibrosis and multi system inflammatory syndrome. Patients with post COVID-19 symptoms should be first evaluated in primary care and those with serious issues referred to appropriate specialties. The others should be provided with supportive and symptomatic care including respiratory care, nutrition, immunization, mental health support, management of comorbidities and if indicated anticoagulation and treatment of infections. The routine use of steroids, antifibrotics, anticoagulants, anti depressents and antibiotics in these patients should be avoided.