Acta Scientific Pharmaceutical Sciences (ASPS)(ISSN: 2581-5423)

Review Article Volume 5 Issue 10

Post COVID-19 Syndrome. Incidence, Causes and Management

Farah Hisham1, Salma Rafaat Abdel Aziz2, Rana Ab El Rahman3, Radwa El Borolossy4 and Nagwa Ali Sabri4*

1Inpatient Clinical Pharmacist, El Demerdash hospital, Cairo, Egypt
2Inpatient Clinical Pharmacist, Dar El Shefa hospital, Cairo, Egypt
3Inpatient Clinical Pharmacist, Mansyet El Bakry hospital, Cairo, Egypt
4Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt

*Corresponding Author: Nagwa Ali Sabri, Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo, Egypt.

Received: August 28, 2021; Published: September 18, 2021

Abstract

Background: The highly infectious and pathogenic novel coronavirus has emerged causing a global pandemic. Covid-19 causes complications that affect a lot of system in the body and may be without known pathophysiology as delirium, musculoskeletal, neurological, gastrointestinal and hematological complications.

Methods: A literature search was performed to obtain data regarding incidence, causes, clinical presentation, and how to manage post covid-19 syndrome.

Results: Patients need to be rehabilitated to prevent these chronic symptoms. It was reported that 7.5% of individuals has impaired consciousness as a post covid-19 complication. On the other hand, cardiac consequences, musculoskeletal events, and hepatic impairment as a result of prolonged ICU admission may occur. Further complications like thrombotic events, psychological events, neuropathy, and GIT problems as diarrhea are likely to occur. Different anticoagulation therapies betrixaban, rivaroxaban, LMW heparin are used for thrombotic events prophylaxis/management. For pulmonary, cardiac, psychological, and musculoskeletal rehabilitation management different protocols are used.

Conclusion: We can conclude that post covid-19 follow-up is necessary for cured patients, as 45% of the discharged patients may require healthcare and social assistance, and 4% may require rehabilitation.

Keywords: Post Covid-19 Syndrome; Delirium; GI; Hepatic; Musculoskeletal; Neuropathy

References

  1. Klok FA., et al. “Confrmation of the high cumulative incidence of thrombotic complications in critically ill ICU patients with COVID-19: an updated analysis”. Thrombosis Research (2020).
  2. Lodigiani C., et al. “Venous and arterial thromboembolic complications in COVID-19 patients admitted to an academic hospital in Milan”. Italy Thrombosis Research (2020).
  3. Salamanna Francesca., et al. “Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data”. Frontiers in Medicine 8 (2021): 392.
  4. Middeldorp S., et al. “Incidence of venous thromboembolism in hospitalized patients with COVID-19”. Journal of Thrombosis and Haemostasis8 (2020): 1995-2002.
  5. Tansey CM., et al. “One-Year outcomes and health care utilization insurvivors of severe acute respiratory syndrome”. Archives of Internal Medicine 167 (2007): 1312-20.
  6. Helms J., et al. “High risk of thrombosis in patients with severe SARS-CoV-2 infection: a multicenter prospective cohort study”. Intensive Care Medicine 6 (2020): 1089-1098.
  7. Wichmann D., et al. “Autopsy fndings and venous thromboembolism in patients with COVID 19: a prospective cohort study”. Annals of Internal Medicine (2020).
  8. Murray A., et al. “Need a Nightingale model for rehab after covid-19” (2020).
  9. Mao L., et al. “Neurologic Manifestations of Hospitalized Patients With Coronavirus Disease 2019 in Wuhan, China”. JAMA Neurology (2020): e201127.
  10. Grossmann FF., et al. “Screening, detection and management of delirium in the emergency department - a pilot study on the feasibility of a new algorithm for use inolder emergency department patients: the modified Confusion Assessment Method for the Emergency Department (mCAM-ED)”. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 22 (2014): 19.
  11. McGonagle D., et al. “Immune mechanisms of pulmonary intravascular coagulopathy in COVID-19 pneumonia”. Lancet Rheumatology7 (2020): e437-e445.
  12. Bösmüller H., et al. “The evolution of pulmonary pathology in fatal COVID- 19 disease: an autopsy study with clinical correlation”. Virchows Arch (2020).
  13. Macciò A., et al. “Multifactorial pathogenesis of COVID-19-related coagulopathy: can defbrotide have a role in the early phases of coagulation disorders?”. Journal of Thrombosis and Haemostasis (2020).
  14. Ballve LP., et al. “Weakness acquired in the intensive care unit. Incidence, risk factors and their association with inspiratory weakness. Observational cohort study”. Revista Brasileira de Terapia Intensiva 29 (2017): 466-475.
  15. Deem S. “Intensive-care-unit-acquired muscle weakness”. Respiratory Care 51 (2006): 1042-1053.
  16. Kochi AN., et al. “Cardiac and arrhythmic complications in patients with COVID-19”. Journal of Cardiovascular Electrophysiology 31 (2020): 1003-1008.
  17. Madjid M., et al. “Potential effects of coronaviruses on the cardiovascular system: a review”. JAMA Cardiology (2020).
  18. Gardner PJ and Moallef P. “Psychological impact on SARS survivors: critical review of the English language literature”. Canadian Psychology/Psychologie Canadienne 56 (2015): 123-135.
  19. Stevens RD., et al. “A framework for diagnosing and classifying intensive care unit-acquired weakness”. Critical Care Medicine 37 (2009): S299-308.
  20. Needham DM., et al. “Improving long-term outcomes after discharge from intensive care unit: report from a stakeholders’ conference”. Critical Care Medicine 40 (2012): 502-509.
  21. Zhao K., et al. “Acute myelitis after SARS-CoV-2 infection: a case report”. medRxiv (2020).
  22. Bohmwald K., et al. “Neurologic alterations due to respiratory virus infections”. Frontiers in Cell Neuroscience 12 (2018): 386.
  23. Guan W-jie., et al. “Clinical characteristics of coronavirus disease 2019 in China”. New England Journal of Medicine 382 (2020): 1708-1720.
  24. Zhang C., et al. “Liver injury in COVID-19: management and challenges”. Lancet Gastroenterology and Hepatology 5 (2020): 428-430.
  25. Bangash MN., et al. “COVID-19 and the liver: little cause for concern”. Lancet Gastroenterology and Hepatology (2020).
  26. https://emergencymedicinecases.com/wp-content/uploads/2020/04/COVID-19-Anticoagulation-Algorithm-version_fnal_1.1.pdf
  27. https://www.massgeneral.org/assets/MGH/pdf/news/coronavirus/guidance-from-mass-general-hematology.pdf
  28. Puthucheary ZA., et al. “Acute skeletal muscle wasting in criticalillness”. JAMA 310 (2013): 1591-1600.
  29. Parry SM and Puthucheary ZA. “The impact of extended bed rest on the musculoskeletalsystem in the critical care environment”. Extreme Physiology and Medicine 4 (2015): 16.
  30. Mao L., et al. “Neurological manifestations of hospitalized patientswith COVID-19 in Wuhan, China: a retrospective case series study”. SSRN Journal (2020).
  31. Filatov A., et al. “Neurological complications of coronavirus disease (COVID-19): encephalopathy”. Cureus 12 (2020): e7352.
  32. Poyiadji N., et al. “COVID-19-associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features”. Radiology (2020): 201187.
  33. American Society of Hematology. COVID-19 and VTE/anticoagulation: frequently asked questions (2020).
  34. Thachil J., et al. “ISTH interim guidance on recognition and management of coagulopathy in COVID-19”. Journal of Thrombosis and Haemostasis 18 (2020): 1023-1026.
  35. Poterucha TJ., et al. “More than an anticoagulant: do heparins have direct anti-inflammatory effects?”. Thrombosis and Haemostasis3 (2017): 437-444.
  36. Thachil J. “The versatile heparin in COVID-19”. Journal of Thrombosis and Haemostasis5 (2020): 1020-1022.
  37. Barrett CD., et al. “ISTH interim guidance on recognition and management of coagulopathy in COVID-19: a comment”. Journal of Thrombosis and Haemostasis8 (2020): 2060-2063.
  38. Iba T., et al. “Coagulopathy of coronavirus disease 2019”. Critical Care Medicine9 (2020): 1358-1364.
  39. Wang TF., et al. “Efficacy and safety of high dose thromboprophylaxis in morbidly obese inpatients”. Thrombosis and Haemostasis1 (2014): 88-93.
  40. Tang N., et al. “Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy”. Journal of Thrombosis and Haemostasis5 (2020): 1094-1099.
  41. “Antithrombotic therapy in patients with COVID-19” (2020).
  42. Connors JM and Levy JH. “COVID-19 and its implications for thrombosis and anticoagulation”. Blood 23 (2020): 2033-2040.
  43. Asakura H and Ogawa H. “Potential of heparin and nafamostat combination therapy for COVID-19”. Journal of Thrombosis and Haemostasis6 (2020): 1521-1522.
  44. Hardaway RM., et al. “Prevention of adult respiratory distress syndrome with plasminogen activator in pigs”. Critical Care Medicine 18 (1990): 1413-1418.
  45. Wang J., et al. “Tissue plasminogen activator (tPA) treatment for COVID-19 associated acute respiratory distress syndrome (ARDS): a case series”. Journal of Thrombosis and Haemostasis (2020).
  46. Thachil J., et al. “DOACs and “newer” haemophilia therapies in COVID-19”. Journal of Thrombosis and Haemostasis7 (2020): 1795-1796.
  47. Pun BT., et al. “Caring for critically ill patients with the ABCDEF bundle: results of the ICU liberation collaborative in over 15,000 adults”. Critical Care Medicine1 (2019): 3-14.
  48. Ely EW. “The ABCDEF bundle: science and philosophy of how ICU liberation serves patients and families”. Critical Care Medicine2 (2017): 321-330.
  49. Cowie A., et al. “Standards and core components for cardiovascular disease prevention and rehabilitation”. Heart 105 (2019): 510-515.
  50. Denehy L and Elliott D. “Strategies for post ICU rehabilitation”. Current Opinion in Critical Care 18 (2012): 503-508.

Citation

Citation: Nagwa Ali Sabri., et al. “Post COVID-19 Syndrome. Incidence, Causes and Management". Acta Scientific Pharmaceutical Sciences 5.10 (2021): 59-66.

Copyright

Copyright: © 2021 Nagwa Ali Sabri., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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Impact Factor1.020

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