What is ‘long covid syndrome’ and How should you treat it?

After contracting the disease in November last year, 28-year-old Senaara Ailawadi developed the symptoms of the coronavirus again in April and began treatment. She said, “I was exposed to a Covid positive person and was isolating to monitor my symptoms. The fever spiked to 103 twice and then stayed constant at 99 for a few days.”

However, even after 17 days of taking the necessary precautions and medication, Ailawadi continued to show covid symptoms.

On consulting her doctor, she was informed that the infection had impacted her lungs and post the isolation period, Ailawadi restarted the medications.

Similar prolonged symptoms were also experienced by 29-year-old Neha Rajpal, who tested positive for Covid on April 16. Post-recovery, Rajpal has continued to complain of “lingering cough and weakness”.

What Ailawadi and Rajpal experienced is being termed “long COVID syndrome“, where a Covid patient continues to show symptoms even post-recovery and can last over six months.

According to Dr Vikas Maurya, Director and HOD, Pulmonology, Fortis Hospital Shalimar Bagh, patients with moderate to severe symptoms have a higher tendency of experiencing post-COVID symptoms. “Patients may experience post-COVID symptoms such as extreme fatigue, headache, muscular pain, or some may experience cardiac problems also,” Maurya told indianexpress.com. However, in the majority of cases, patients are recovering without any post-COVID symptoms, he added.

What post-COVID symptoms to expect?

As several cases of ‘long covid syndrome’ have been reported, doctors recommend covid patients to closely watch their symptoms post-recovery, follow a healthy diet and try going back to their usual routine to prevent psychological problems. Moreover, it is also suggested to pay close attention to Mucormycosis or black fungus infection, which is being detected in various post-recovery Covid patients.

Mucormycosis is a rare but serious fungal infection being detected among Covid-19 patients. The disease often manifests in the skin and affects the lungs and the brain.

According to Dr Reshma Tewari, Director Critical care, Artemis Hospitals Gurgaon, patients who recovered at home with mild to moderate disease may continue to expect early fatigue, muscle pains. However, they must watch out for signs of Mucormycosis such as pain or swelling around the eye, cheekbone or lower jaw and connect with a doctor immediately

“Patients who are still in hospital on ventilatory support or O2 support even after becoming negative would need continued hospital care till they improve. They would be at high risk for secondary infections, multi-organ failure and mucormycosis,” she added.

Isolating while experiencing post-COVID symptoms

While the transmission rate of coronavirus is extremely high, such is not the case of symptoms that patients experience post-Covid. Experts do not recommend isolation after testing negative and instead encourage resuming regular, daily activities.

“Since the patient has already recovered from COVID, even if someone is experiencing post-COVID symptoms, isolation is not required. In order to overcome the psychological issues, it is better to start normalising regular activities post-recovery,” says Dr Maurya. However, Dr Tewari recommends up to 14 days of isolation for patients with moderate disease who received steroids and/or O2 therapy at home.

When experiencing post-COVID symptoms or recovering from COVID, when can a patient resume normal activity?

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Experts do not recommend isolation after testing negative and instead encourage resuming regular, daily activities.

As the virus affects each individual differently, Dr Tewari suggests that resuming activity depends on the nature of symptoms and complications of the virus. “If at home with fatigue, muscle pain patient needs to give more time and accept extended convalescence.”

In agreement, Dr Maurya suggests that a patient can definitely follow their usual routine even during their isolation. “For example, if a person used to exercise regularly, he/she can do it at home even during isolation. A patient can start his/her office work slowly post isolation. But how much they are affected, that factor is very much important.”

Vaccination post-COVID

With the second wave of Covid-19 infecting a major population of India, getting vaccinated is a sure-shot way of preventing the spread of the virus. However, the question of vaccinating infected people often lingers

While the US-based Centers for Disease Control and Prevention (CDC) suggests patients wait for 90 days before getting a COVID-19 vaccine if treated with monoclonal antibodies or convalescent plasma, there are reports that the NTAGI has stated that those tested for SARS-CoV-2 illness should defer Covid vaccination for six months after recovery.

“There will be no issues if a patient gets vaccinated after two-three weeks post-recovery. But it is important to consider the fact whether at that point in time a vaccine is required or not since a patient develops an antibody post-Covid and the antibody can prevent them from getting infected further,” Dr Maurya said.

Commenting on the recent change in guideline stating a wait of 6 months post-recovery, Dr Maurya adds that even if a patient takes a vaccine after four weeks post his/her recovery, the vaccine may not work fully because the patient would have developed an antibody that is effective enough to prevent him/her from further infection.

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