Breaking Down Post-Acute COVID Syndrome

As the world endures its second spin around the sun bearing the weight of a global pandemic, the medical community is benefitting from new research about the phenomenon of persistent COVID-19 symptoms, colloquially known as long COVID or long-haul COVID. This condition, which is marked by symptoms that linger long after an initial diagnosis of COVID-19 disease, has recently been given the clinical name of Post-Acute Sequelae of SARS-CoV-2, or PASC.

Read on to learn more about this elusive syndrome.

Reviewing the Nature of Initial COVID-19 Illness

People who contract the SARS-CoV-2 virus may experience a range of symptoms, spanning from none at all to severe COVID-19 disease, which can be fatal. Symptoms, which typically appear within 14 days of exposure to the virus, include fever, chills, cough, shortness of breath, fatigue, muscle aches, headache, loss of taste or smell, sore throat, nasal discharge, and gastrointestinal dysfunction. For the majority of people, these symptoms dissipate after a few weeks.

What Is the Definition of PASC?

The definition of PASC is fluid, but the US National Institutes of Health suggests that it applies to people who have symptoms that still present for four or more weeks after their initial COVID-19 diagnosis.

Symptoms of PASC can include the following:

• Chest pain
• Fatigue (present in more than 75% of patients, according to some studies)
• Gastrointestinal symptoms
• Headaches
• Joint pain
• Loss of smell (found in more than 50% of healthcare workers, according to a recent study)
• Lower respiratory symptoms
• Neuropsychiatric concerns
• Shortness of breath

The U.S. Centers for Disease Control and Prevention (CDC) also cites brain fog as a common lingering symptom. The medical community continually develops knowledge of PASC, and the syndrome itself is not uncontested. As more information emerges, the medical community will further hone its definition.

How Common is PASC?

Many scientists are focused on determining the prevalence of PASC within the population. One recent study that evaluated patients with COVID-19 for 10 to 14 weeks after their initial illness found that 50 percent had either lingering symptoms or an abnormal test finding. Another recent study found that 76 percent of patients still had at least one symptom when evaluated six months after their initial illness.

What Causes PASC?

Some researchers believe that PASC symptoms could result from residual inflammation or from having been in intensive care settings. However, even people with mild COVID-19 disease have demonstrated signs of PASC.

Who Is Most Likely to Get PASC?

Researchers believe that anyone who has had COVID-19 is susceptible to PASC, regardless of their disease severity or age. However, a recent analysis published in the journal Nature noted that the following characteristics made people infected with COVID-19 more likely to develop PASC:

• Being female
• Being hospitalized
• Being older than age 70
• Having an increased body mass index
• Having asthma as a comorbid condition
• Having five or more symptoms in the first week of their initial COVID-19 illness

Other researchers found that people who had severe COVID-19 pneumonia (as evidenced by their chest x-ray or by a high heart rate when admitted to the hospital) remained more likely to have PASCS

Potential Therapies for PASC

According to guidance published in the British Medical Journal, many patients with PASC have successfully recovered with rest, treatment of their symptoms with over-the-counter medications such as NSAIDs or acetaminophen, and slow increases in their activity level. As researchers learn more about the condition, more therapeutics will become available. Recently, anecdotal reports have shown that lingering symptoms may improve after people with PASC receive a COVID-19 vaccination.

How to Learn More About PASC

As our collective understanding of PASC rapidly expands, more information will invariably come to light in the future. You can learn more about the syndrome by visiting this collaboration between the CDC and the Infectious Diseases Society of America as they compile data to help people suffering from PASC.

Libby Pellegrini is a nationally certified physician assistant. She has worked in numerous healthcare settings, including the rural United States, an inner-city Level I trauma center, several suburban acute care centers, and a boutique, personalized medicine clinic in Southeast Asia. She graduated Magna Cum Laude from Northwestern University’s Medill School of Journalism.

References:

https://reference.medscape.com/viewarticle/947023?&src=WNLinfoc210304MSCPEDITlong_COVID&uac=&spon=3&impID=2947343&faf=1

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https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html

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