Dr John Campbell
@campbellteaching·3.3M subscribers·3.1K videos
Long term COVID
Posted
October 9, 2020
Views
155,638
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5,114
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October 9, 2020
155,638
5,114
1,738
4.40%
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32:58Now PlayingLong-term Health Consequences of COVID-19
(JAMA, 5th October)
Ongoing symptoms to substantial end-organ dysfunction
Post-Acute COVID
Persistent severe symptoms, beyond 3 weeks
Chronic COVID-19
Beyond 12 weeks
Common complaints
Crippling fatigue
Breathlessness
Persistent cough
Joint pain
Muscle aches
Chest pain
Hearing and eyesight problems
Headaches
Loss of smell and taste
Damage to the heart, lungs, kidneys and gut
Depression
Anxiety
Struggling to think clearly
Not directly related to severity of acute phase
Some cases may be related to pneumonia
Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19
US CDC
Random sample of 292 adults who had tested positive
35% of 274 symptomatic respondents, not returned to usual health 14 – 16 days after testing
18 – 34 year olds
N = 85, 26%. (74% returned to normal)
35-49 years
N = 96, 32% (68% returned to normal)
50 and older
N = 89, 47% (53% returned to normal)
Post–intensive care syndrome
6 – 12 months, cognitive, mental health, physical function
Persistent Symptoms in Patients After Acute COVID-19 (JAMA, July 2020, Rome)
143 patients discharged from the hospital
18 patients (12.6%) were completely free of any COVID-19–related symptoms after a mean of 60 days
Therefore 87.4 not returned to full normal
Manifestations
None of the patients had fever or any signs or symptoms of acute illness
Worsened quality of life, 44.1%
Pathogenesis
Direct tissue invasion by the virus
The virus cleares from most of the body, but lingers in some small pockets
If there's long-term diarrhoea then you find the virus in the gut, if there's loss of smell it is in the nerves - so that could be what's causing the problem (Tim Spector)
Metabolic effects
New-Onset Diabetes in Covid-19
COVID induced diabetes
Profound inflammation and cytokine storm
Immune system does not return to normal
Ongoing immunological effects
Organ damage
Seen in MERS and SARS
Lung function abnormalities
Psychological impairment
Reduced exercise capacity
Brain alterations
Cerebral Micro-Structural Changes in COVID-19 Patients. An MRI-based 3-month Follow-up Study
)302285/fulltext
Hypercoagulable state
Blood vessel damage
Possible inflammation of coronary arteries
The Post-hospitalisation COVID-19 study (PHOSP-COVID)
MRC study under Professor Chris Brightling
Following up 10, 000 people post COVID
Develop trials of new strategies for clinical care
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