Long covid—mechanisms, risk factors, and management

July 26, 2021

Harry Crook, Sanara Raza, Megan Young, Paul Edison

The BMJ

Symptoms can remain long after SAR-CoV-2 infection has disappeared in all types of patients and all forms of disease, is known as "prolonged COVID" and is defined as symptoms present after four weeks of infection. Fatigue is one of the most commonly reported symptoms of prolonged COVID and no association was found between fatigue and severity of COVID. Dyspnea is another commonly reported symptom of prolonged COVID, but only those prone to respiratory distress were found to have fibrotic-type changes in the lungs. In contrast, cardiac abnormalities are a common symptom of prolonged COVID regardless of risk factors. Several neurologic conditions are common in patients after acute SARS-CoV-2 infection, but their presentation is diverse. Some present as symptoms similar to moderate traumatic brain injury, Alzheimer's disease, stroke, "mental confusion" and headache. Finally, olfactory and gustatory abnormalities are prevalent in those with prolonged COVID. Risk factors for developing prolonged COVID are similar to risk factors for developing severe disease, which include: advanced age, having pre-existing conditions, having an immunosuppressive condition, etc. In addition, those who have a more severe acute infection are more likely to have a COVID-19 Symptoms.

Crook H, Raza S, Nowell J, Young M, Edison P. Long covid—mechanisms, risk factors, and management. BMJ 2021; 374: n1648.

Partners