Wednesday, October 27, 2021 | Rabi' al-awwal 20, 1443 H
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Encountering post-Covid fatigue

A large number of people who have recovered from coronavirus infection still complain about continuing breathlessness and fatigue even months after the onset of the disease. The infection often does not end with the acute phase of the disease but leaves medium and long-term effects.

The experience can be harsh and make many feel discouraged to perform daily tasks and experience difficulty in concentrating and recalling memories.

While coronavirus induced fatigue can be exhausting, fatigues are somehow common after a viral infection. In research report published in Oman Medical Journal, experts following up with patients discharged from the hospital have found that fatigue appears as a prominent feature, even at 12 weeks post-discharge.

According to the report, there is no clear definition of post-acute Covid-19 syndrome. In general, it is an illness described among patients who have recovered from Covid-19 but still have ongoing symptoms or among those who continued to have symptoms for longer than normally expected.

British Medical Journal defines ‘long Covid’ as “illness in people who have either recovered from Covid-19 but are still reporting lasting effects of the infection or have had the usual symptoms for far longer than would be expected

“Patients assert that they were unable to return to their baseline activity level. They find trivial daily activities fatigue-inducing. This is a major complaint that has been acknowledged by the literature”, says the report.

Another prominent feature of long Covid-19 experienced by the patients is shortness of breath, points out the report prepared jointly by Issa al Jahdhami, Khalid al Numani and Adhra al Maawali at Department of Medicine, Armed Forces Hospital, Muscat.

“This was more significant among patients with severe Covid-19 who were admitted to ICU and required either non-invasive or mechanical ventilation”, the physicians opine in the report.

Further investigations have revealed mild anaemia in some patients, evidence of pulmonary embolism in some, and changes suggestive of pulmonary fibrosis in computer tomography of the chest among others. Cardiac causes such as heart failure with preserved ejection fraction or impaired ventricular function were found in a small number of patients.

However, there was no cause identifiable in the majority of patients.

A recent observational survey conducted in Italy involved about 200 subjects reporting chronic fatigue after Covid-19 infection.

There is no consensus on the benefit, or duration, of prolonged prophylaxis, with low molecular weight heparin, post-discharge. Management of post-Covid-19 pulmonary fibrosis is also unclear.

Clinical, radiological and biochemical markers are required to help clinicians anticipate which patients with Covid-19-related ARDS are susceptible to developing pulmonary fibrosis following the resolution of Covid-19.

“We have used systemic steroids in some patients with good results. The role of the antifibrotic drugs, pirfenidone and nintedanib, is awaiting clinical trial evidence”, the doctors reveal in the report.

A unified definition of long Covid-19 and characterisation of its manifestation are important for early detection. In addition, more research should be directed to identify risk factors and exact mechanisms leading to the development of long syndrome.

Such knowledge may enhance further research aimed at the prevention of such a complication, adds the report.

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