The risks of long COVID/PACS (Post Acute COVID-19 Syndrome)

The risks of long COVID/PACS (Post Acute COVID-19 Syndrome)

More than a year after COVID-19 first started becoming a pandemic, it is becoming clear that the disease is more dangerous than first thought. If you survive COVID-19, your health may not return to normal right away, or even at all. COVID-19 can cause long-term changes in the way your body works. It is now considered a systemic illness. It affects not just the lungs but multiple organs and organ systems, including

  • the heart
  • the brain
  • the kidneys
  • the liver
  • the digestive system

Prolonged symptoms have been recorded even in patients who had mild cases of COVID-19 and did not need hospitalisation. This phenomenon is known by various names, including

  • long COVID
  • chronic COVID
  • post-acute COVID syndrome/PACS
  • post-acute COVID-19
  • long-term effects of COVID
  • long-haul COVID

PACS or is characterized by symptoms that persist for 4 to 12 weeks after the initial infection. One train of thought is that your immune system’s response to COVID-19 triggers these symptoms through a continuing inflammatory process.

Who is at risk?

Risk factors for PACS include

  • being a woman
  • being admitted to the ICU for COVID-19
  • needing ventilator support during COVID-19
  • pre-existing heart or lung conditions
  • old age
  • obesity
  • diabetes
  • chronic kidney, liver or heart disease
  • lung disease
  • being an organ transplant recipient
  • current or recent pregnancy within the last 2 weeks
  • lung disease
  • disorders of the brain or nervous system

What are the symptoms?

PACS can show itself as a combination of symptoms that affect different systems of the body. These symptoms may be constant or come and go:

  • Fatigue, even from daily activities
  • Shortness of breath
  • Lung fibrosis or scarring
  • Muscle pain
  • Joint pain
  • Trouble sleeping
  • Coughing
  • Swelling in the leg
  • Chest pain
  • Dysautonomia, or an inability to regulate autonomic nervous functions such as blood pressure, breathing rate, and temperature control
  • Anemia
  • Blood clots in the lungs
  • Heart problems
  • Brain fog or difficulty concentrating
  • Headache
  • Loss of smell
  • Loss of taste
  • Depression
  • Anxiety
  • Low fever
  • Heart palpitations
  • Dizziness or lightheadedness
  • Hair loss
  • Hormone imbalance
  • Mood swings
  • Sensitivity to light
  • Sensitivity to sound
  • Gastrointestinal problems
  • Gynaecological issues
  • Stroke
  • Kidney disfunction
  • Diarrhoea
  • Loss of appetite
  • Nausea/vomiting
  • Stomach pain
  • Gastrointestinal bleeding
  • Infertility or sterility
  • Skin rashes
  • Pins and needles sensation

MIS-C/Multisystem Inflammatory Syndrome in Children

MIS-C is a new clinical condition. It is defined as fever, multiple organ dysfunction and increased inflammatory markers in a patient under 21 who has contracted COVID-19. It is likely caused by an excessive immune response. Symptoms include

  • fever
  • abdominal pain
  • vomiting
  • diarrhoea
  • rash
  • ulcers
  • low blood pressure
  • heart/brain problems

While earlier it was believed that children do not suffer as badly with the symptoms of COVID-19, the Delta variant has also proved infectious to children. They must also be protected from the effects and aftereffects of the disease.

How can you deal with it?

Because PACS is so new, there are no official guidelines right now. A patient might receive anticoagulants to prevent blood clots. Some doctors report that corticosteroid or systemic steroid treatment may be helpful. If you have developed PACS, the best way to deal with issues as they occur is to:

  • continue treatment for any existing conditions you may have
  • be extra vigilant while self-monitoring your pulse, blood pressure and blood glucose
  • eat a balanced and healthy diet
  • get a proper amount of sleep each night
  • limit alcohol consumption
  • quit smoking, or don’t start

Is there a cure or support for PACS?

There is currently no cure. A patient’s prognosis depends on the severity of their symptoms.

Various patient advocacy groups have been key in identifying the symptoms of PACS and advocating for more medical attention and research. These groups include

The current best way to prevent PACS is to not become infected by COVID-19, and prevent severe infections. Get vaccinated with the first vaccine available to you, and encourage others to do the same. Together, we can keep each other safe.

References

Centers for Disease Control and Prevention (2021) Post-COVID Conditions [Accessed: 10 Aug 2021] Available at: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html 

Chippa V, Aleem A, Anjum F. (2021) Post Acute Coronavirus (COVID-19) Syndrome. [Updated 2021 Jul 18] [Accessed: 10 Aug 2021] Available at: https://www.ncbi.nlm.nih.gov/books/NBK570608/ 

Dysautonomia International (2021) Coronavirus & Dysautonomia [Accessed: 10 Aug 2021] Available at: http://www.dysautonomiainternational.org/page.php?ID=227 

Issa A., Khalid A., Adhra A. (2021) Al-Jahdhami, I., Al-Naamani, K., & Al-Mawali, A. (2021). The Post-acute COVID-19 Syndrome (Long COVID) [Accessed: 10 Aug 2021] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7838343/ 

Nalbandian, A., Sehgal, K., Gupta, A. et al. (2021) Post-acute COVID-19 syndrome [Accessed: 10 Aug 2021] Available at: https://www.nature.com/articles/s41591-021-01283-z 

Rakhee K. R., Tarek K., Qutayba H., Rabih H., Imad M. T. (2021) Unraveling the Mystery Surrounding Post-Acute Sequelae of COVID-19 [Accessed: 10 Aug 2021] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8278217/ 

Stephen J H., Claire M., Gemma W., Anastasia A., Olivia H., Lyndsay M., Christopher W., Steven K., Joanna C., Rajinder S., Tamsin C., Rory J O., Manoj S. (2021) Postdischarge symptoms and rehabilitation needs in survivors of COVID-19 infection: A cross-sectional evaluation [Accessed: 10 Aug 2021] Available at: https://pubmed.ncbi.nlm.nih.gov/32729939/