COVID-19, was declared a global pandemic by the World Health Organization (WHO) on March 11, 2020. COVID‐19 is caused by the Severe Acute Respiratory Syndrome Coronavirus-2 or SARS‐CoV‐2 (check our previous post here for more information). Initially, COVID-19 disease was identified as a respiratory infection. However, it is affecting other organs as well, as shown with studies from newly infected, recovering, and post-mortem examinations. It is important to note that because COVID-19 is still ongoing, with research being done every day, information is constantly updating.
Here is a list of the main adverse effects of COVID-19, with accurate information to date:
Breathlessness: Shortness of breath is the cardinal symptom of COVID-19 [1]. Approximately 5-8% of infected patients develop adult respiratory distress syndrome (ARDS), which is characterized by low oxygen in the blood (hypoxemia) and decreased lung compliance, often requiring mechanical ventilation. ARDS can progress to pulmonary fibrosis, which results in experiencing exercise-induced breathlessness and chronic dry cough, that may last for up to 5 years post-ARDS [2]. Studies are showing that the degree of fibrosis was more severe in patients with critical COVID-19 than those with moderate infection [3].
Cardiac Fibrosis, Dysfunction: The International Society and Federation of Cardiology of the World Health Organization defines myocarditis as an inflammation of the heart’s muscle tissue (myocardium). Signs of myocardial injury in COVID-19 patients include heart failure, myocarditis, and/or exacerbation of an existing cardiovascular disease. Myocarditis can either result from a direct invasion of the virus in the muscle cells of the heart, or through the inflammation caused by the immune system’s response [4].
In adults, the cardiovascular complications of COVID-19 have been diverse. At one end of the spectrum, there have been cases of temporary myocarditis (subclinical myocarditis). While at the other end, arrhythmias that may result in cardiac arrest and sudden death. This can happen even among asymptomatic patients without pre-existent cardiovascular conditions, although mostly in patients that require hospital care.
In young children, although 45% asymptomatic, there are a significant number of them suffering from myocarditis. While it is too early to predict long term consequences, cardiovascular abnormalities are very likely [4].
Blood Coagulation Abnormalities: The significantly increased amount of blood clots created is a complication of COVID-19 (also referred to as thromboembolic events). These blood clots can break off and travel to several organs, such as the lungs (causing pulmonary embolism) and the brain (causing a stroke). It is also possible to have the reverse, an impairment of clot formation (also referred as coagulopathy). Since the coagulation enzymes are being consumed by the immune system, there is a delay in clotting time and low platelet count [5,6].
Neurological Dysfunction: There are several neurological symptoms presented with COVID-19;
Loss of taste/smell. Over 90% of patients regain their gustatory and olfactory sensation within the first month post COVID-19, however it can persist and result in complete loss of smell (anosmia) [7].
Worsening of Alzheimer’s or mild cognitive impairment.
Obsessive-compulsive disorder (OCD), mainly reported by female patients [8].
PTSD, mostly on patients hospitalized in the ICU [8].
Brain fog.
Ringing in ears (tinnitus).
Poor sleep quality.
Depression & anxiety.
Confusion.
It is still unclear whether these manifestations are related to the overall stress of infection or the actual COVID-19 infection. Furthermore, it is unknown if these manifestations will persist post-recovery [9] but there is a lot of research being done regarding Persistent Post-COVID Syndrome (PPCS). For now, scientists keep unravelling new things about this novel disease every day, and we will keep you updated.
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Written by: Phaedra
Edited by: María and Natasha
BioDecoded is a volunteer group committed to sharing accurate scientific information. We cannot offer any specific health advice. If you have any doubts about getting vaccinated due to previous health conditions, please speak with your healthcare professional or family physician. Your doctor can revise your medical history and advise you on the best path to follow. If you have any questions about this topic, please comment or send them to our email.
References:
Olliaro PL. (2021). An integrated understanding of long-term sequelae after acute COVID-19. The Lancet Respiratory Medicine. https://doi.org/10.1016/S2213-2600(21)00206-X
Oronsky B, Larson C, Hammond TC, Oronsky A, Kesari S, Lybeck M, Reid TR. (2021) A Review of Persistent Post-COVID Syndrome (PPCS). Clinical Reviews in Allergy & Immunology: 1-9. https://doi.org/10.1007/s12016-021-08848-3
Zou JN, Sun L, Wang BR, Zou Y, Xu S, Ding YJ,…& Chen SM. (2021) The characteristics and evolution of pulmonary fibrosis in COVID-29 patients as assessed by AI-Assisted chest HRCT. PloS one, 16(3), e0248957. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0248957
McMurray JC, May JW, Cunningham MW, Jones OY. (2020). Multisystem Inflammatory Syndrome in Children (MISC-C), a Post-viral Myocarditis and Systemic Vasculitis- A Critical Review of Its Pathogenesis and Treatment. Front. Pediatr. 8:626182 doi:10.3389/fped.2020.626182
Weerahandi H, Hochman KA, Simon E, Blaum C, Chodosh J, Duan E, … & Horwitz LI. (2021). Post-discharge health status and symptoms in patients with severe COVID-19. Journal of general internal medicine, 36(3), 738-745. https://doi.org/10.1007/s11606-020-06338-4.
Iqbal A, Iqbal K, Arshad Ali S, et al. (2021) The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors. Cureus 13(2): e13080. DOI 10.7759/cureus.13080
Iqbal A, Iqbal K, Arshad Ali S, et al. (2021) The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors. Cureus 13(2): e13080. DOI 10.7759/cureus.13080
Kamal M, Abo Omirah M, Hussein A, Saeed H. (2021) Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract. 75:e13746. https://doi.org/10.1111/ijcp.13746
Weerahandi H, Hochman KA, Simon E, Blaum C, Chodosh J, Duan E, … & Horwitz LI. (2021). Post-discharge health status and symptoms in patients with severe COVID-19. Journal of general internal medicine, 36(3), 738-745. https://doi.org/10.1007/s11606-020-06338-4.
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