{"id":15462,"date":"2020-09-16T09:25:33","date_gmt":"2020-09-16T13:25:33","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=15462"},"modified":"2021-05-20T13:08:20","modified_gmt":"2021-05-20T17:08:20","slug":"coronavirus-sequelae","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/coronavirus-sequelae\/","title":{"rendered":"What we know about sequelae and lingering COVID-19 symptoms"},"content":{"rendered":"<p><i>CORONAVIRUS UPDATE: As experts learn more about the novel coronavirus, news and information changes. For the latest on the COVID-19 pandemic, please visit the<\/i> <a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\"><i>Centers for Disease Control and Prevention<\/i><\/a><i>.<\/i><\/p>\n<p><span style=\"font-weight: 400;\">There is a lot that we still don\u2019t understand about COVID-19, the disease caused by the SARS-CoV-2 virus that started in Wuhan, China, in 2019 and turned into a worldwide pandemic. Because this coronavirus is a novel virus (a virus that has not been previously identified), scientists and healthcare workers are still in the beginning stages of understanding its effects on the body. But, new research is revealing more every day.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">One area that is gaining more attention are the long-term, or lingering symptoms (called sequelae), that some people experience from COVID-19 after \u201crecovering\u201d from the virus. How concerned should you be about coronavirus sequelae? First, it\u2019s important to understand the classic symptoms of COVID-19.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the symptoms of COVID-19 and how long do they typically last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Originally, the most common symptoms of COVID-19 included:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Cough<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Shortness of breath<\/span><\/li>\n<\/ul>\n<p><a href=\"https:\/\/www.singlecare.com\/blog\/news\/coronavirus-update\/\"><span style=\"font-weight: 400;\">Experts have since expanded on this list<\/span><\/a><span style=\"font-weight: 400;\"> to include these additional possible indicators:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Muscle or body aches<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fatigue<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Loss of taste (ageusia)\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Loss of smell (anosmia)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Sore throat<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Congestion or runny nose<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nausea or vomiting\u00a0<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Diarrhea<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">These symptoms typically appear <\/span><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/symptoms-testing\/symptoms.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">two to 14 days after exposure to the virus<\/span><\/a><span style=\"font-weight: 400;\">, according to the U.S. Centers for Disease Control and Prevention (CDC). The duration of symptoms can be <\/span><a href=\"https:\/\/www.hopkinsmedicine.org\/health\/conditions-and-diseases\/coronavirus\/diagnosed-with-covid-19-what-to-expect\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">up to two weeks for mild cases and up to six weeks or more for severe cases<\/span><\/a><span style=\"font-weight: 400;\">. What is becoming apparent, however, is that some patients may also experience coronavirus sequelae, or lasting complications that continue far beyond this time frame.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are coronavirus sequelae?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Sequelae is a term used to describe the aftereffect of a disease, condition, or injury. Any viral infection can cause post-viral syndrome, which involves lingering symptoms (or sequelae) long after you fight off an infection. What those symptoms are\u2014and if you\u2019ll experience them at all\u2014can vary, and may depend on risk factors or your body\u2019s immune response.<\/span><\/p>\n<p><b>Sequelae may be particularly common for coronavirus infections.<\/b><span style=\"font-weight: 400;\"> For example, after the <\/span><span style=\"font-weight: 400;\">severe acute respiratory syndrome (<\/span><span style=\"font-weight: 400;\">SARS) outbreak of 2002-2003, <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7194715\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">one study found<\/span><\/a><span style=\"font-weight: 400;\"> that people who were infected with the virus reported feeling fatigue, muscle weakness, and sleeping problems up to three years later. Early evidence indicates that similar symptoms could stick around for some COVID-19 patients as well.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Anthony Fauci, director of NIH\u2019s National Institute of Allergy and Infectious Diseases, has been vocal about the risks of post-viral syndrome with COVID-19. During a <\/span><a href=\"https:\/\/www.youtube.com\/watch?v=UMmT48IC0us&amp;feature=emb_logo\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">press conference<\/span><\/a><span style=\"font-weight: 400;\">, he indicated that many people with severe COVID-19 experience brain fog, fatigue, difficulty concentrating that affect them for many weeks after recovering from other symptoms.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Research is limited about COVID-19 and post-viral syndrome, but according to a <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jama\/fullarticle\/2768351\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">letter from the <\/span><i><span style=\"font-weight: 400;\">Journal of the American Medical Association<\/span><\/i><\/a><span style=\"font-weight: 400;\">, 87% of 143 previously hospitalized patients in Rome, Italy, reported experiencing at least one persistent symptom for two months or longer; particularly fatigue or difficulty breathing.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">Who will experience coronavirus sequelae?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It can be difficult to predict who will experience lingering symptoms, and who won\u2019t. Research is still emerging, and there is not consensus among doctors treating COVID-19 patients.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWhat we have learned about SARS-CoV-2, so far, is that post-viral syndrome is not uncommon, especially for those who were hospitalized due to the severity of their infection, those with pre-existing conditions (i.e., diabetes, hypertension, etc.), and potentially those of the female gender,\u201d says Robert Quigley, MD, immunologist and senior vice president and regional medical director of<\/span> <a href=\"https:\/\/www.internationalsos.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">International SOS<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><a href=\"http:\/\/maggiecadetmd.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Magdalena Cadet, MD<\/span><\/a><span style=\"font-weight: 400;\">, <\/span><span style=\"font-weight: 400;\">a New York\u2013based rheumatologist and associate attending at NYU Langone Medical Center says it goes beyond those with severe cases. \u201cLong-lasting complications are not always associated with patients who had serious infections or hospitalization,\u201d Dr. Cadet says. \u201cSequelae of the disease have been seen in people with mild cases of COVID-19.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">In other words, it\u2019s not yet proven who is affected by sequelae.<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What are the symptoms of coronavirus sequelae?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">While most people will make a full recovery from COVID-19, there are some lingering symptoms that people should know about. \u201cFirst and foremost, it\u2019s important to state that this is a novel virus (meaning never before seen) and we are continuing to learn and have much more to learn about it,\u201d says Dr. Quigley. \u201cWhat we have learned thus far, lingering symptoms can occur and may vary from person to person.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">These symptoms include:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fever<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Fatigue<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Muscle or body aches<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Joint pain<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Weakness<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Shortness of breath<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Difficulty concentrating (or \u201cbrain fog\u201d)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Inability to focus<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Reduced memory<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Nausea, heartburn, or vomiting<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Headache<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Difficulty sleeping<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Prolonged loss of taste or smell<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Hair loss<\/span><\/li>\n<li><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7355084\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Erectile dysfunction <\/span><\/a><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Dr. Cadet has seen these symptoms in some COVID-19 patients. <\/span><span style=\"font-weight: 400;\">\u201cThey are simply not able to recover their former energy or activity level pre-COVID-19 infection state,\u201d she says. \u201cThere are some individuals who may have long-lasting kidney damage, blood clots, or other problems of the blood vessels and skin as well as worsening hypertension (high blood pressure).\u201d\u00a0<\/span><\/p>\n<p><b>I<\/b><span style=\"font-weight: 400;\">n addition to post-viral syndrome, COVID-19 can cause long-term organ damage. <\/span><a href=\"https:\/\/jamanetwork.com\/journals\/jamacardiology\/fullarticle\/2768916\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">According to one study<\/span><\/a><span style=\"font-weight: 400;\">, COVID-19 may have lasting effects on the heart. In the study, of the 100 people who recently recovered from COVID-19 and received MRIs, 78 showed cardiac involvement, and 60 had signs of myocardial inflammation; which were independent of preexisting conditions.<\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC7176214\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\"> Evidence also shows<\/span><\/a><span style=\"font-weight: 400;\"> that COVID-19 may lead to lasting damage to the lungs, including post-COVID fibrosis.\u00a0<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">How long will coronavirus sequelae last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">It may be too early to tell. \u201cUnfortunately, the likelihood and timeframe of experiencing lingering symptoms, among those who contracted COVID-19 and are recovering, is nearly impossible to predict,\u201d Dr. Quigley says. However, he says that with other virus infections \u201cthose that acquire [post-viral syndrome] generally improve over time.\u201d<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What causes coronavirus sequelae?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">There are plenty of mysteries still surrounding the effects of the novel coronavirus disease, but researchers and scientists are beginning to make some predictions as to why the SARS-COV-2 infection may be affecting some people so much worse than others, and it appears there may be a connection to inflammation that COVID-19 can trigger.\u00a0\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201c<\/span><span style=\"font-weight: 400;\">Scientists now know that the SARS-COV-2 utilizes the spiky protein on its membrane to interact and bind to the ACE 2 receptors, which can be seen in the lungs, heart, and various organs to trigger an inflammatory response,\u201d Dr. Cadet says. This inflammatory response can trigger many problems in the body. \u201cWhen the inflammatory response is in overdrive, a cytokine storm may result in numerous cytokines or chemicals that can cause immune cells to target healthy tissues and organs leading to damage and sometimes death.\u201d\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It appears that there may be a connection between sequelae and this inflammation. \u201cThere is preliminary evidence that lingering symptoms from a COVID-19 infection could <\/span><span style=\"font-weight: 400;\">be the result of the body\u2019s inflammatory response,\u201d Dr. Quigley says.\u00a0\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Inflammation can affect major organs, such as the heart and lungs, as well. <\/span><span style=\"font-weight: 400;\">\u201cSince the ACE 2 receptors in the heart are affected by this virus, inflammation of the heart muscle can occur,\u201d Dr. Cadet says. \u201cSome individuals describe heart palpitations, fast heart rate (tachycardia), irregular heartbeat or chest pressure.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It remains unclear why some people\u2019s immune system responds this way. \u201cWe know that this response is variable depending on multiple (host) factors,\u201d Dr. Quigley says. \u201cIn general, the body\u2019s response to a foreign invader is to generate an inflammatory response. Part of the cascade of events includes the release of cytokines, in the blood, which mediate subsequent immune responses against the foreign invader (the virus). In the event where such mediators cross the blood brain barrier and accumulate in the central nervous system, they can activate the primitive regulatory parts of the brain phenomenon, resulting in many of the symptoms seen in post-viral syndrome. This was also observed in select patients who contracted SARS during the 2002-2003 outbreak.\u201d<\/span><\/p>\n<h2><span style=\"font-weight: 400;\">What should you do if you experience coronavirus sequelae?\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">If you continue to experience lingering symptoms from COVID-19 that concern you, there are some steps you can take. For post-viral syndrome, treatment focuses on managing your symptoms and may include:\u00a0<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Taking over-the-counter pain relievers such as <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/tylenol-8-hour\"><span style=\"font-weight: 400;\">Tylenol <\/span><\/a><span style=\"font-weight: 400;\">or <\/span><a href=\"https:\/\/www.singlecare.com\/prescription\/ibuprofen\"><span style=\"font-weight: 400;\">ibuprofen<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Eating a balanced and healthy diet<\/span><\/li>\n<li style=\"font-weight: 400;\"><a href=\"https:\/\/www.singlecare.com\/blog\/sleep-remedies-for-coronavirus-anxiety\/\"><span style=\"font-weight: 400;\">Getting plenty of sleep<\/span><\/a><span style=\"font-weight: 400;\"> and resting during the day as needed<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Practicing relaxation techniques such as yoga, massage therapy, and meditation<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">Maintaining an open dialogue with your healthcare provider is crucial, especially for more serious lingering COVID-19 symptoms. \u201cIt is important if you have a COVID-19 infection to keep follow-up appointments with your internists as well as other specialists, including a cardiologist, pulmonologist, neurologist, hematologist, and physiatrist,\u201d Dr. Cadet advises.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Most people who test positive for COVID-19 will make a full recovery and can expect to feel better once the virus has run its course. If you think you\u2019re experiencing lingering symptoms, track them and report them to your physician. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>CORONAVIRUS UPDATE: As experts learn more about the novel coronavirus, news and information changes. For the latest on the COVID-19 pandemic, please visit the Centers for Disease Control and Prevention. There is a lot that we still don\u2019t understand about COVID-19, the disease caused by the SARS-CoV-2 virus that started in Wuhan, China, in 2019 [&hellip;]<\/p>\n","protected":false},"author":94,"featured_media":15557,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[14636],"coauthors":[12545],"class_list":["post-15462","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-coronavirus","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Post-viral syndrome: Should we worry about coronavirus sequelae?<\/title>\n<meta name=\"description\" content=\"It\u2019s becoming clear that some people experience lingering symptoms of COVID-19, sometimes called coronavirus sequelae, after recovering from infection. 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