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    Home / Archives / Vol. 18 No.2 (2565) : July - December 2022 / Review Article  
 
   
 

Long COVID and Long-term Pulmonary Complications of COVID-19
   
 
   
   
     
 
Pongsakorn Kampan
Department of Medicine, General Hospital, Bangkok Metropolitan Administration

Abstract

Introduction: Significant numbers of patients recovering from COVID-19 have persistent or new symptoms which can affect more than one organ including mental and psychiatric symptoms. This constellation of symptoms is defined as Long COVID, causing sufferings and detrimental qualities of life to those affected. Potential late pulmonary complications of COVID-19 include lung fibrosis and pulmonary embolism. Long COVID is gaining more public heath importance as many people having been infected. Knowledge in pathogenesis, symptoms, and treatment of Long COVID are essential.


Objective: This article aims to review the current knowledge of Long COVID and long-term pulmonary complications of COVID-19 in epidemiology, pathogenesis, and treatment for caring of patients with Long COVID and long-term pulmonary complications.


Method of study: Literature review


Results: Long COVID is a constellation of symptoms occurring 1-3 months after patients have recovered from acute COVID-19. The incidence of Long COVID was 11% to 93% after the acute infection owing to disparities in definitions of Long COVID, population assessed, accuracy of self-reporting of symptoms, and length of follow-up period among studies. Long COVID can affect single or multiple organs causing different symptoms in each individual patient. The common symptoms are fatigue, dyspnea, cough, headache, dizziness, cognitive impairment, anxiety, depression, and insomnia. These symptoms either happen for the first time or persist after the acute COVID-19. Risk factors for Long COVID include female sex, comorbidities especially hypertension, obesity, immune suppressed, psychiatric conditions, having symptoms from more than 5 organs, and hospitalization during acute COVID-19. Pathogenesis of Long COVID is currently based on direct organs invasion from SARS-CoV-2 and organ inflammation elicited by immune system after infection. The duration of Long COVID is not yet known exactly in the present. The management of Long COVID comprises accurate exclusion from other diseases with symptoms mimicking Long COVID, pharmacological therapies based on symptoms of individuals and non-pharmacological approaches such as physical and mental rehabilitation, and counselling with multidisciplinary approach. Patients with COVID-19 pneumonia should be followed with chest radiography at 12 weeks after recovery and symptoms including those of Long COVID. Lung function tests or computed tomography may be required in some patients with persistent chest symptoms or being suspected of pulmonary vascular disease or pulmonary fibrosis. Symptoms of Long COVID should be inquired when following up patients. Long-term pulmonary complications of COVID-19 comprises pulmonary fibrosis and pulmonary embolism which are associated with severe COVID-19. Ongoing clinical trials are investigating antifibrotic drugs used in idiopathic pulmonary fibrosis in patients with recent hospitalization with COVID-19 and persistent lung involvement. Extended use of anticoagulants after discharge from hospital may reduce venous thromboembolism (VTE) and death in selected patients with high risk of VTE.


Conclusion: Given the SARS-CoV-2 pandemic situation, it is believed that Long COVID, and long-term pulmonary complications of COVID-19 will be imminently problematic for patients suffering from symptoms and will be of public health concern. It is important that research continue to explore Long COVID in aspects such as pathogenesis, natural history, precise epidemiology, clinical classification of syndrome, optimal treatments, and impact of the novel variants of the virus. Development of holistic multidisciplinary cares for patients with Long COVID is essential and challenging.

  
     
     
 
    How to Cite  
     
Kampan, P. (2022). Long COVID and Long-term Pulmonary Complications of COVID-19. Journal of Charoenkrung Pracharak Hospital, 18(2), 79–96. Retrieved from https://he02.tci-thaijo.org/index.php/JCP/article/view/258038  
     

 
 
     
     
 
    Issue  
     
Vol. 18 No. 2 (2565): July - December 2022  

 
 
     
     
 
    Section  
     
Review article  

 
 
     
     
     
 

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