In many Countries, COVID-19 overrun the healthcare system; however, most patients managed to recover. Unfortunately, even though a significant fraction of patients recovered from COVID-19, returned to their routine, some are experiencing or have experienced short- and long-term health consequences associated with COVID-19. These health consequences are referred to as post-COVID-19 syndrome/conditions.

Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience more than four weeks after first being infected with the virus that causes COVID-19.” It is defined as persistent symptoms and delayed or long-term complications beyond four weeks from the onset of symptoms. The common symptoms observed in post-COVID-19 are shortness of breath, chest pain or tightness, brain fog (problems with memory and concentration), insomnia, heart palpitations, dizziness, tingling, joint pain, depression and anxiety, earaches, diarrhoea, loss of appetite, headaches, sore throat, changes of smell or taste, a high temperature, rashes, fatigue and decline in quality of life.

A Study from Italy, one of the earliest affected countries, stated that 87% of people discharged from a hospital in Rome remained to experience at least one symptom 60 days after the onset on Covid19. Moreover, 55% had three or more symptoms, including fatigue (53%), difficulty in breathing (43%), joint pain (27%), and chest pain (22%), with 40% saying it had reduced the quality of their life.

With different length of time, combinations of health complications these conditions can affect individuals had COVID-19. Pieces of evidence suggest that people who did not show any symptoms when they were infected more likely to show post-COVID-19 symptoms. Experts worldwide are working to understand more about short- and long-term health effects associated with COVID-19, who gets them, and why.

Now that we are a year into the COVID-19 Pandemic, it is paramount to understand the lasting long-term effects the disease has. Prolonged symptoms have been called long COVID, and those who are experiencing these symptoms are often referred to as long haulers. Post-COVID may also be referred to as long-term COVID, chronic COVID, or long COVID syndrome, as no authorised term has been recognised yet.

Aetiology of post-COVID syndrome?

It has been noticed that even if the infection does not persist, the virus is not alive and active in people with ongoing symptoms, but it triggers a response in the body that causes persistent symptoms.

Worldwide, researchers and medical practitioners are trying to figure out what that response is. By now, there are a few prospective suspects.

What can be done to treat post-COVID syndrome?

Identified by NHS, UK, the energy levels are likely to fluctuate when a person recovering from COVID-19; conserving energy is significant. The NHS recommends sticking to the following four ‘P’s to do so

The four ‘P’s of energy conservation

· Planning: Plan activities according to the times of the day when a person feels most energetic. Think ahead about the steps involved and fix the things needed to get the work done beforehand.

· Pacing: Break activities into smaller steps and pace through them instead of rushing. This will help in sustaining the energy levels better.

· Prioritising: Analyse personal, professional, familial, and social roles and prioritise only the critical or necessary ones. Postpone unnecessary tasks for a time when one feels better.

· Positioning: Place or store all necessities within a short distance. Positioning this way can help to avoid wasting energy on smaller tasks.

A comprehensive understanding of patient care needs beyond the acute phase will help develop COVID-19 clinics equipped to provide combined multispecialty care in the outpatient setting. In addition, the imaging and epidemiologic features of COVID-19 in all phases (acute, subacute and chronic) of disease will help us better understand the phenomenon and pathophysiology of this novel virus entity.

There is no doubt that COVID-19 patients will continue to have healthcare needs for the foreseeable future. Unfortunately, services for health and social care are insufficient to support people living with Covid19. Essentially, the medical and public health workforce needs better facts and training on the constant effects. To fully comprehend the impact of COVID-19, health care and social services will have to determine what future research questions are most relevant for future explorations.

Ongoing COVID-19 requirements need to be measured holistically (equally in clinical services and in research). As there are many questions unanswered that can only be countered through further research, such as who is at utmost risk of experiencing long-term problems?

Besides, it is clear that care for patients with COVID-19 does not conclude at the time of hospital discharge, and interdisciplinary cooperation is desirable for the complete care of the patients in the outpatient setting.

An ending or the beginning of health consequences? Post-COVID condition
By Benzeer Siddique, Health economist, Sanrachana