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Post-COVID syndrome also known as long COVID refers to symptoms persisting for more than three weeks after the diagnosis of COVID-19. We reviewed the current evidence on post-COVID syndrome, focusing on its clinical manifestations and addressing the challenges for its management in primary healthcare. The incidence of post-COVID syndrome is estimated at 10–35%, while for hospitalized patients it may reach 85%. Fatigue is the most common symptom reported in 17.5–72% of post-COVID cases, followed by residual dyspnea with an incidence ranging from 10–40%. Mental problems, chest pain, and olfactory and gustatory dysfunction may affect up to 26, 22 and 11% of patients, respectively. More than one third of patients with post-COVID syndrome have pre-existing comorbidities, hypertension and diabetes mellitus being the most common. Beyond the prolonged duration of symptoms, the scarce published data indicate that most patients with post-COVID syndrome have a good prognosis with no further complications or fatal outcomes reported. Given the clinical spectrum of patients with post-COVID syndrome, most of them will be managed by primary healthcare professionals, in conjunction with pre-existing or new co-morbidities, which, in turn, may increase the burden of COVID-19 on primary healthcare. In conclusion approximately 10% of patients with COVID-19 may have symptoms persisting beyond three weeks, fulfilling the criteria of post-COVID syndrome. Primary healthcare professionals have a key role in the management of patients with post-COVID syndrome. Research is needed to elucidate the pathogenesis, clinical spectrum, and prognosis of post-COVID syndrome.
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Kingstone T, Taylor AK, O'Donnell CA, et al. Finding the “right” GP: a qualitative study of the experiences of people with long-COVID. BJGP Open. 2020;4 bjgpopen20X101143.
Wiersinga WJ, Rhodes A, Cheng AC, et al. Pathophysiology, transmission, diagnosis, and treatment of coronavirus disease 2019 (COVID-19): a review. JAMA. 2020;324:782–793.
National Institute of Health Director's blog. Post-covid syndrome. Available at https://directorsblog.nih.gov/tag/post-covid-syndrome/(Accessed March 15, 2021).
Greenhalgh T, Knight M, A'Court M, et al. Management of post-acute covid-19 in primary care. BMJ. 2020;370:m3026. doi: 10.1136/bmj.m3026.
Bhavana V, Thakor P, Singh SB, et al. COVID-19: pathophysiology, treatment options, nanotechnology approaches, and research agenda to combating the SARS-CoV-2 pandemic. Life Sci. 2020;2020(261)
Alpert O, Begun L, Gerren P, et al. Cytokine storm induced new onset depression in patients with COVID-19. A new look into the association between depression and cytokines – two case reports. Brain Behav Immun Health. 2020;9
Tenforde M, Kim S, Lindsell C, et al. Symptom duration and risk factors for delayed return to usual health among outpatients with COVID-19 in a multistate health care systems network – United States, March–June 2020. MMWR Morb Mortal Wkly Rep. 2020;69:993–998.
Covid-19-long-term-health-effects. Available at https://www.gov.uk/government/publications/covid-19-long-term-health-effects/covid-19-long-term-health-effects (Accessed March 15, 2021).
Huang C, Huang L, Wang Y, et al. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. Lancet. 2021;397:220–232.
Simani L, Ramezani M, Darazam IA, et al. Prevalence and correlates of chronic fatigue syndrome and post-traumatic stress disorder after the outbreak of the COVID-19. J Neurovirol. 2021;27:154–159.
Carfi A, Bernabei R, Landi R, et al. Persistent symptoms in patients after acute COVID-19. JAMA. 2020;324:603–605.
Addison AB, Wong B, Ahmed T, et al. Clinical Olfactory Working Group Consensus Statement on the Treatment of Post Infectious Olfactory Dysfunction. J Allergy Clin Immunol. 2021 doi: 10.1016/j.jaci.2020.12.641. S0091-6749(21)00004-X.
Le Bon SD, Pisarski N, Verbeke J, et al. Psychophysical evaluation of chemosensory functions 5 weeks after olfactory loss due to COVID-19: a prospective cohort study on 72 patients. Eur Arch Otorhinolaryngol. 2020;278:101–108.
Moreno-Pérez O, Merino E, Leon-Ramirez JM, et al. COVID19-ALC research Post-acute COVID-19 Syndrome. Incidence and risk factors: a Mediterranean cohort study. J Infect. 2021 doi: 10.1016/j.jinf.2021.01.004. S0163-4453(21)00009-8.
Garg P, Arora U, Kumar A, et al. The “post-COVID” syndrome: How deep is the damage? J Med Virol. 2021;93:673–674.
Liang L, Yang B, Jiang N, et al. Three-month Follow-up Study of Survivors of Coronavirus Disease 2019 after Discharge. J Korean Med. Sci. 2020;35:e418. doi: 10.3346/jkms.2020.35.e418. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Moldofsky H, Patcai J. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study. BMC Neurol. 2011;11:37. doi: 10.1186/1471-2377-11-37.
Mukhammadieva M.I. (2022). Modern Clinical and Biochemical Characteristics of Liver Cirrhosis Patients of Viral Etiology with Spontaneous Bacterial Peritonitis //Texas Journal of Medical Science. – 2022.- P. 86-90.
Carvalho-Schneider C, Laurent E, Lemaignen A, et al. Follow-up of adults with noncritical COVID-19 two months after symptom onset. Clin Microbiol Infect. 2021;27:258–263. [PMC free article] [PubMed] [Google Scholar]
Garrigues E, Janvier P, Kherabi Y, et al. Post-discharge persistent symptoms and health-related quality of life after hospitalization for COVID-19. J Infect. 2020;81:e4–e6. doi: 10.1016/j.jinf.2020.08.029. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Oblokulov. A.R., M.I. Mukhammadieva.(2022). Clinical and biochemical characteristics of liver cirrhosis patients of viral etiology with spontaneous bacterial peritonitis//ACADEMICIA GLOBE: INDERSCIENSE RESEARCH.-2022.- P. 210-216
Bellan M, Soddu D, Balbo PE, et al. Respiratory and Psychophysical Sequelae Among Patients With COVID-19 Four Months After Hospital Discharge. JAMA Netw Open. 2021;4 doi: 10.1001/jamanetworkopen.2020.36142. PMID: 33502487.
Oblokulov, A.R., Niyozov, G.E. Clinical and epidemiological characteristics of patients with COVID-19 (2020) International Journal of Pharmaceutical Research, 12 (4), pp. 3749-3752.