Post-/Long-Covid

ICD U08.9, U09.9, U10.9

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Since the outbreak of the corona pandemic at the end of 2019, late effects have been observed in infected people. About every 10th infected person suffers from the so-called Post-/Long-Covid syndrome. The number of people affected worldwide is estimated at 100 million. Nevertheless, these patients hardly get any attention, therapies have been comparatively little researched and doctors lack information and support.

The symptoms of Post-/Long-Covid range from physical weakness, extreme exhaustion, and dizziness when sitting upright, to cognitive disorders and far-reaching limitations in mobility. Many of those affected have been struggling with the consequences of their corona infection for 1-2 years.

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With or without vaccination, previously completely healthy, or with a previous condition, everyone can be affected by Post-/Long-Covid. With regard to the risk factors, however, there are indications that chronic pre-existing conditions and a severe course of COVID-19 disease favor the development of Post-/Long-Covid. It also appears to occur more frequently in young to middle-aged adults. Although research on Post-/Long-Covid is still in its infancy, there are already some hopeful and promising therapeutic approaches. What is certain is that the greatest improvements in the patient's condition are recorded when treatment is started as soon as possible after infection, preferably within the first 3-6 months. In this way, an irreversible Long-Covid state can be prevented.

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What is Post-/Long-Covid?

Post-/Long-Covid is understood to mean a symptom complex that is manifested either by persistent symptoms of the Covid infection, new symptoms, or worsening of previous illnesses. One speaks of a Post-Covid syndrome when the symptoms do not last longer than three months after the infection. Long-Covid syndrome is therefore the generic term for long-term health consequences that last more than 12 weeks after infection with the SARS-CoV-2 coronavirus.

When do post/long Covid symptoms appear and how long do they last?

The first symptoms usually appear directly after the active infection. Initially, there is an apparent improvement before the symptoms worsen. No long-term results are known on the duration of the Post-/Long-Covid syndrome. However, it has been observed that they can last for months and sometimes for years.

What long-term effects of COVID-19 are known?

So far, research in this area has not yet yielded satisfactory results. However, it is becoming apparent that permanent neurocognitive, cardiovascular, and inflammatory impairments or diseases may occur.

Can children get Post-/Long-Covid and what is their course?

Although children are less likely to contract COVID-19 than adults, they too can experience Post-/Long-Covid symptoms after infection. Similar to adults, the main symptoms are exhaustion, memory and concentration disorders, headaches, stomach achessore throats, coughing, sleep problems, a limited sense of smell, and muscle and joint pain.

Can you do sports with post-/long-Covid?

Since those affected show different symptoms of different intensities, this depends on the individual resilience. As long as you are physically able and your cardiovascular system is not impaired, there is nothing wrong with it.

Can you get Post-/Long-Covid despite a Corona vaccination?

Since you can also get COVID-19 as a vaccinated person, there is also the possibility of getting Post-/Long-Covid symptoms after this infection.

What are the differences between Post/Long Covid Syndrome and Post/Long Vaccine Syndrome?

Post-/Long-vaccine syndrome can occur after vaccination against the coronavirus. Blood clotting disorders and inflammatory diseases of the heart muscle are common symptoms. Apart from that, the course is very similar to that of Post-/Long-Covid syndrome.

So far, there are three known factors that trigger Post-/Long-Covid symptoms:

1. Impaired blood flow

The coronavirus infects the vessel walls, which disrupts the blood flow in small vessels. This activates inflammation in the vessels and blood clotting. This leads to an insufficient supply of oxygen to the muscles and brain, which impairs mobility and cognitive abilities. The following combined treatment approaches are available:

  • drugs to improve blood circulation
  • drugs to reduce inflammation
  • blood washing (apheresis)
  • hyperbaric oxygen therapy
  • high-dose ozone therapy
  • mitochondrial therapy
  • infusion therapy

2. Misdirected immune system

The coronavirus triggers autoantibodies that turn against your own nerve cells. The following combined treatment approaches are available:

  • drugs to neutralize the auto-antibodies
  • immunoadsorption apheresis to filter out auto-antibodies
  • high-dose ozone therapy
  • infusion therapy

3. Virus residues (spike protein)

Remains of the coronavirus remain in the tissue and permanently overstimulate the immune system. The following therapeutic approaches are available:

  • use of Covid antibodies
  • immunoadsorption apheresis to filter out auto-antibodies

How can Long-Covid be treated?

There are currently promising therapies that can help improve it. The aim of the treatment is to remove the cause, disease-causing immune complexes, from the body as much as possible and to strengthen the weakened immune system. Immunoadsorption apheresis and individual infusion therapies are used for this.

SYMPTOMS

Cardiovascular symptoms

  • tightness in the chest
  • chest pain
  • palpitations

Mental illness

  • insomnia
  • anxiety
  • mood swings

breathing problems

  • shortness of breath
  • gentle breathing
  • Cough/cough irritation

Skin and hair related symptoms

  • skin rashes
  • hair loss

General symptoms

  • fatigue
  • exhaustion
  • powerlessness
  • fever
  • pain

Throat, nose, or ear symptoms

  • tinnitus
  • earache
  • sore throat
  • dizziness
  • loss/change of taste and/or smell

Muscular and skeletal symptoms

  • joint pain
  • muscle aches
  • muscle weakness
  • rapid muscle fatigue

Gastrointestinal symptoms

  • abdominal pain
  • nausea
  • diarrhea
  • loss of appetite and decreased appetite (in the elderly)

Neurological symptoms

  • loss of concentration
  • memory problems
  • word-finding disorders
  • headache
  • sleep disorders
  • numbness
  • dizziness
  • confusion (in the elderly)

psychological/psychiatric

  • symptoms of a depression
  • symptoms of anxiety

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