Susan M. Tiso DNP, APRN, FNP-BC
As we climb out of this pandemic, a new syndrome is emerging: Post-Acute Sequelae of SARS-CoV-2 Infection (PASC), also known as post-COVID conditions or long COVID syndrome. There are a wide range of symptoms reported by survivors of COVID-19, many of whom initially had asymptomatic or mild illness.
In a recently published study by Lambert et al of 5163 subjects reporting symptoms for more than 21 days after COVID-19 infection, symptoms included fatigue (79.0%), headache (55.3%), shortness of breath (55.3%), difficulty concentrating (53.6%), cough (49.0%), changed sense of taste (44.9%), diarrhea (43.9%), and muscle or body aches (43.5%). In all, 93 specific symptoms were reported by study participants. The timing of symptom onset varied and was described as occurring in waves over long periods of time. The symptoms impacted survivors' ability to work and created great distress.
The CDC defines post-COVID conditions as a range of new, returning, or ongoing health problems continuing or occurring over more than 4 weeks after first being infected with COVID-19. These include multiorgan effects and can impact most body systems, including functions of the cardiac, respiratory, renal, dermatologic, or neurologic systems. A patient I saw recently in clinic developed Sjögren's syndrome after having COVID-19 months ago; other patients with PASC develop peripheral neuropathy and/or thromboembolic sequelae. The most common symptoms in my patients with PASC are fatigue, shortness of breath, 'brain fog,' and cough, aligning with the most frequently reported symptoms in the study by Lambert et al.
There is no specific treatment for PASC, but research on this important sequela is ongoing, with Post-COVID Clinics opening at academic medical centers across the US—including at the University of California, Irvine, where I work. As with everything, prevention is the best approach, and patients who have not yet been vaccinated should be encouraged to do so.