Symptoms and Sequelae

Common cold symptoms with acute infection, but can there be long term after effects of infection.

Link to free download of my 2 textbooks,

Long COVID continues to affect more than a million people

1.3 million people (2%)

in the four weeks to 6 December 2021

LC for less than 12 weeks

21% (270,000 people)

LC for more than 12 weeks

70% (892,000 people)

LC for a year or more

40% (506,000 people)

20% reported their ability to undertake day-to-day activities had been “limited a lot”

Symptoms

Fatigue, 51%

Loss of smell, 37%

Shortness of breath, 36%

Difficulty in concentrating, 28%

Self-reported long COVID was greatest in:

aged 35 to 69 years

females

people living in more deprived areas

those working in health care and social care

those with another activity-limiting health condition or disability

those in teaching and education

Encephalitis lethargica

Sleepy sickness

Brain disease

Statue-like condition, speechless, motionless

One million victims or more

Half a million deaths

Most survivors never returned to their pre-morbid vigour

Oliver Sacks

They would be conscious and aware – yet not fully awake;

they would sit motionless and speechless all day in their chairs, totally lacking energy, impetus, initiative, motive, appetite, affect or desire;

they registered what went on about them without active attention, and with profound indifference.

They neither conveyed nor felt the feeling of life; they were as insubstantial as ghosts, and as passive as zombies

English sweats (England, 1529)

mal mazzuco (Italy, 1597)

Kriebelkrankheit

(Germany, 1672–75)

Rafania (Sweden, 1754–57)

nona (Italy, 1890–91)

Post encephalitic Parkinsonism

Risk of post covid diabetes

Increased risk of severe COVID-19

European pediatric populations during the COVID-19 pandemic

Increases in the number of type 1 diabetes diagnoses

Increased frequency and severity of diabetic ketoacidosis

CDC

Group 1

Diabetes incidence among patients aged less than 18 years after covid diagnosis

Group 2

Diabetes incidence among those matched by age and sex, no covid diagnosis

Group 3

Received a pre pandemic non–COVID-19 acute respiratory infection diagnosis

Result

N = 80,893 patients with COVID-19

New diabetes diagnosis 0.08%, 64 patients

New diabetes diagnosis was 31% more likely to occur

N = 439,439 patients with COVID-19

New diabetes diagnosis 0.25%, 1,233 patients

New diabetes diagnoses were 166% more likely to occur

New diabetes diagnosis in less than 18s

116% more likely to occur among those with COVID-19 than among those with ARI during the pre pandemic period

Non–SARS-CoV-2 respiratory infection was not associated with diabetes.

More severe covid may increase risk of DM

Implications

highlights the importance of COVID-19 prevention strategies in 18s and under

Monitoring for long-term consequences, DM 1 and DM2

More than 30 days after the index date

Screen for diabetes symptoms post covid

Polyuria

Thirst

Weight loss

Increased hunger

Fatigue

Stomach pain

Nausea or vomiting

Also

Genital itching or thrush

Cuts and wounds take longer to heal.

Blurred eyesight

Developing DKA

breath that smells fruity (like pear drop sweets, or nail varnish remover)

deep or fast breathing

dry skin

low blood pressure

confusion

feeling very tired or sleepy

passing out

Aetiology of post covid DM

? direct attack of pancreatic cells expressing angiotensin converting enzyme 2 receptors

? stress hyperglycemia resulting from the cytokine storm

? alterations in glucose metabolism caused by infection

? precipitation of prediabetes to diabetes