By Yin Nwe Ko
IT HAS been for over two years since COVID-19 stepped on our planet. Since it was a pandemic, it devoured over 6 million human lives in a short while. Because of its cunning and cruelness, many countries that were attacked lost their economy, education, health, and many other sectors. It can be said that it is under somewhat control because the vaccine to prevent it has been discovered and manufactured in some countries. To have complete control, there might be many measures to be implemented.
Some experts and physicians said it will never vanish from the world and human beings will have to seek ways of living together with the pandemic. However, there will be so many things to be done in the frail and weak situations due to its serious effect that the post-COVID-19 Period may take longer than expected. There have been some interesting reports published by respective organizations and research teams. Among them, this is also an interesting one that people should more or less take notice of and contemplate.
National Institutes of Health (NIH) and WHO sponsored conferences have drawn attention to an increasing number of people experiencing health consequences following the acute phase of SARS-CoV-2 infection and are calling for research into the risk factors, clinical features, diagnosis, management, and outcomes. Increasing funding opportunities have subsequently followed. It is important to note that most data regarding the post-COVID-19 conditions have been generated prior to the condition definition announcement.
Thus, earlier studies may not fit the proposed definition criteria. Post-COVID-19 condition extends beyond the cardio-respiratory system to affect most other bodily systems both anatomically and physiologically. Although the causes of the post-COVID-19 condition are unclear, persistent immune activation may be involved. Risk factors for different syndromes of post-acute SARS-CoV-2 sequela have not been characterized, but it has been hypothesized that several post-COVID-19 condition phenotypes may exist, although pathophysiology, management, and outcomes are currently unknown.
Long-term health consequences of COVID-19 remain unknown, but reports suggest that prolonged symptom duration and limitations in functioning are common among hospitalized as well as non-hospitalized adults and children. The spectrum of long-lasting symptoms is wide and varies from mild discomfort to severe adverse effects on physical, cognitive, and psychosocial health, with important wider implications on functioning, including employment and school attendance.
Multiple studies from different countries found that many individuals experienced persistent symptoms 6 months after COVID-19, with fatigue or muscle weakness, sleep difficulties, and anxiety or depression among the most common sequelae. A recent study suggests that although most COVID-19 survivors recover both physically and functionally a year after acute infection, some still experience problems with mobility, pain or discomfort, and anxiety or depression compared with non-COVID-19 controls. The data emerging from the controlled studies are in agreement with the earlier reports. A recent analysis of the data from over 250,000 electronic health records demonstrated that more than one in three individuals had one or more features of post-COVID-19 condition recorded between 3 and 6 months after a diagnosis of COVID-19, which was significantly higher when compared with individuals with influenza. Disease severity, female sex, and younger age were associated with a higher risk of post-COVID-19 condition development.
Yet, it is unknown whether persistent symptoms and associated abnormalities will fully resolve or whether some may leave life-long dysfunction. It is also worth noting that investigations into the post-COVID-19 condition can be difficult, with high loss of follow-up, frequent use of unvalidated measurement instruments, lack of inclusion of controls during the pandemic, and censoring of data (e.g., for death) not always fully considered in published studies. Differential diagnosis can be challenging with specific symptoms attributed to the post-COVID-19 condition being a sign of an ongoing problem (e.g., dysautonomia in people reporting heart rate variability.
Investigation of potential post-COVID-19 condition treatment options is still in its early days. Approaches mainly focus on rehabilitation and symptomatic management. Some experts suggest that antibodies and T cells able to recognize SARS-CoV-2 induced by vaccine “may help the immune system to stop the virus during its first few replications before it can establish hidden reservoirs in the body”; however, the evidence regarding the effectiveness of SARSCoV-2 vaccines in post-COVID-19 condition treatment is somehow conflicting. One of the major obstacles in the development of intervention strategies for the post-COVID-19 condition is the lack of agreed outcomes to be assessed in clinical trials.
The pandemic and subsequent mitigation strategies have also had a substantial impact on the psychosocial well-being of the general population worldwide, with many people experiencing anxiety and depression, due to isolation, economic instability, job insecurity, sickness/death of infected family members, COVID-19-related stigma, lack of trust in government agencies, and constant media attention focused on the pandemic threats. Disruption of care for those with pre-existing conditions has also had a large impact. For example, according to the WHO Pulse survey on continuity of essential health services during the COVID-19 pandemic, 45% of countries still reported disruptions to services for mental, neurological, and substance use disorders in the first quarter of 2021. On a similar scale, rehabilitation services disruptions continue to be reported by 53% (of 89 countries).
In addition, indirect impacts of COVID-19 on mental health, psychosocial, and neurological sequelae have been reported in adults following COVID-19, and many patients are facing a variety of consequences including fatigue, shortness of breath, and cognitive dysfunction as well as reduced quality of life with an impact on everyday functioning, even months following acute infection.
With millions of people affected by COVID-19, even a small percentage developing the post-COVID-19 condition will result in a detrimental effect on society and public health, with many people in need of longterm follow-up, management, and support. A recent study has reported that previously hospitalized patients with COVID-19 had increased rates of multiorgan dysfunction compared with the general population.
To sum up the article, we have seen so many measures to be done by the respectively responsible personals and followed by the respective citizens of the countries by individually or in groups. These will be complex issues for the countries. Nevertheless, humans never give up on the difficulties they have been facing with. Whether they will overcome that dark age or not depends upon the unity of their societies and their endeavour of them, I think.
