Late health-related effects of COVID-19

Feature by Robert Pisani & Amy Xuereb

FILE PHOTO: A computer image created by Nexu Science Communication together with Trinity College in Dublin, shows a model structurally representative of a betacoronavirus which is the type of virus linked to COVID-19, better known as the coronavirus linked to the Wuhan outbreak, shared with Reuters on February 18, 2020. NEXU Science Communication/via REUTERS

Coronaviruses represent a large family of viruses, typically causing mild or severe upper respiratory tract infections. Within the past two decades, three such viruses have emerged which cause life-threatening disease in humans. These include the severe acute respiratory syndrome (SARS) coronavirus and the Middle East respiratory syndrome coronavirus.

The third coronavirus was first detected in Wuhan, China, prior to spreading globally. The virus was termed the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and causes coronavirus disease 2019 (COVID-19).

In cases of novel life-threatening viruses, the acute management and treatment is crucial, and therefore receive the bulk of the attention. However, following recovery from COVID-19, late health-related effects of the virus may develop in individuals. These may thereby negatively impact the individual’s quality of life, and may be temporary or permanent

Acute Presentation and Testing of COVID-19

A healthcare provider uses a long swab to take a sample which would then be sent for
laboratory testing. Apart from this, other tests include blood work, as well as imaging by means of a chest x-ray or computed tomography (CT). Symptoms usually include fever, a runny nose; head and body aches; and a sore throat amongst others.

Late Complications of the Respiratory System

Since COVID-19 is predominantly a respiratory illness, the lungs are most frequently affected. The lung damage is primarily caused by the infection itself, treatments and complications. The development of acute respiratory distress syndrome (ARDS), (i.e. a type of respiratory failure characterised by widespread lung inflammation), is the most common acute complication which may lead to late complications.

Abnormalities in lung function up to six months following recovery of ARDS may remain,
however these abnormalities were shown to significantly improve over time. Following
recovery from COVID-19, a reduction in lung capacity by up to 30% may occur. Moreover, fibrosis of the lungs (i.e. hardening) may also develop following ARDS, which would further limit lung function. Comparatively, most individuals with lung damage from SARS recovered following two years, especially with rehabilitation.

Therefore, regular follow-ups with individuals following recovery from COVID-19 are crucial. Additionally, further research into the late impact of COVID-19 specifically, and how it compares to previous coronaviruses, on the respiratory system would allow for more appropriate management.

Late Neurological Complications

The SARS-CoV-2 virus has previously been detected in the brain and cerebrospinal fluid,
resulting in acute conditions, such as seizures and comas. Apart from the acute neurological effects of the viral infection, a number of disorders may develop following recovery, such as multiple sclerosis and narcolepsy. Further elucidation of the late effect COVID-19 may have specifically is required.

Therefore, regular neurology follow-ups are necessary for early detection of such late
complications. However, with neurological viral infections, the acute effects are more pronounced and frequent as opposed to the late complications.

Late Cardiovascular and Renal Complications

COVID-19 has been shown to cause acute heart conditions, such as a heart attack. These may translate to the development of late cardiovascular complications. The development of congestive heart failure following a heart attack is one such complication, and is a major source of mortality.

Other conditions include the development of cardiac aneurysms and abnormal heart rhythms.However, heart conditions from COVID-19 are uncommon. Additionally, drugs used to treat COVID-19 may also aggravate such complications, however this is rare.

Chronic renal failure may also develop as a result of COVID-19. Although uncommon, an
overwhelming viral infection may develop, damaging the kidneys and leading to lifelong
morbidities and possibly dialysis. Thereby, cardiac and renal function monitoring during
COVID-19 and following recovery are necessary to reduce the risk of these late complications.

Late Psychological Effects

The late complications aren’t the only factors which might leave an impact on us in the long run. The threat of disease and the resulting deaths are destabilising entire communities and the psychological implications cannot be taken lightly.

This pandemic has undoubtedly brought with it varied levels of anxiety, loneliness, fear of the unknown, besides the distress of unemployment, especially for those with certain lifestyles and commitments.

Post-traumatic stress disorder and depression may leave an impact on us. The severity of this will of course be dependent on one’s character as well as how badly this pandemic has troubled them. With a free-fall in confidence levels, job losses and bankruptcies on the horizon, deep scars will hinder healing for a long time to come. We will get used to a different style of living; the economy will change, the way people work, travel, shop and communicate will all have a different meaning.

On a positive note, this pandemic has also led to several positive effects. Some of which include the reduction of pollution due to a reduction in the amount of cars on the roads, and perhaps also a time to calm down from the hectic usual day-to-day life.

In conclusion, several late effects of COVID-19 may arise. Routine follow-ups, such as
radiographic imaging and lung function tests are required after recovery, to detect such effects. Psychological assistance and information must be made available for individuals, both in the acute setting and following recovery. Research on the specific late complications of COVID-19 will allow for better management and prevention.

The Authors

Robert Pisani

Robert is a final year student currently reading for the Bachelor of Science (Honours) in Radiography. Currently, he works as a trainee radiographer at the Sir Anthony Mamo Oncology Centre, to help during the COVID-19 pandemic. Apart from radiography, he has a passion for music, and holds two higher diplomas in piano. Moreover, he is adept in IT, occasionally carrying out IT-related work in his free time. Through both the course and prior work in hospital environments, Robert has gained modest experience in his field, and is always keen on learning and disseminating knowledge.

Amy Xuereb

Amy is a second year radiography student as well as MHSA’s External Affairs Officer. This has given her the opportunity to involve herself and coordinate  various events such as Science in the City, World Radiography day, Freshers’ Week, Conference 360, University Survival Workshop amongst others.  With a passion for music, travelling and dance, she has successfully achieved advanced level certificates in both ballet and modern dance together with scholarships in both disciplines. She also enjoys reading about her course and is excited to further enrich her knowledge on the subject as well as promote radiography to others.

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