ABSTRACT
Since WHO declared COVID-19 a pandemic, globally more than 212 milion people were infected and approximately 4.4 milion died (25 August 2021). As the pandemic evolved, it became clear that there are many more things to research and discover about the SARS-CoV-2 infection. Besides the fact that SARS-CoV-2 primarily affects the respiratory system, more and more articles indicate a systemic involvement which could be responsible for long term consequences. The aim of this review was to evaluate the long-term signs and symptoms of COVID-19 infection. We looked for information regarding the prevalence and persistence of symptoms associated with COVID-19 infection and the persistence of organ dysfunction beyond the acute phase. We also searched data regarding the impact of the infection on the quality of life, physical, mental and psychosocial function. Recent studies have shown that some symptoms can persist a long time after the acute episode of COVID-19. Fur-thermore, organ sequalae can be present after the acute episode. The most common symptoms of “long COVID” are: fatigue and shortness of breath, lack of taste/smell, cough, myalgia and arthralgia, headache. Also, cardiac abnormalities, cognitive impairment, insomnia, anxiety and concentration issues can be present. © 2021, Amaltea Medical Publishing House. All rights reserved.
ABSTRACT
Background: The severe manifestations of the coronavirus disease 2019 (COVID-19) are linked to viral hyper-inflammation, cytokine release syndrome and subsequent coagulation disturbances. The most common coagulation abnormality observed in COM-19 patients is the elevation of the plasma levels of D-dimers. The aim of this study was to evaluate the characteristics of COVID-19-associated inflammatory syndrome and coagulopathy, in correlation with disease severity. Methods: We performed a cross-sectional study, enrolling all consecutive COVID-19 patients treated in the Adulti 3 Department of the Prof Dr. Matei Bals National Institute of Infectious Diseases, Bucharest, Romania, between 1st march and 30th September 2020. We recorded clinical and epidemiological characteristics, inflammatory markers, coagulation abnormalities and lymphocyte count. The severity of lung involvement was assessed using native Computed Tomography examination. Results: We included 106 patients with SARS-COV2 infection, 50 males (47.2%) and 56 females (52.8%), age range 14-91 years. All markers of inflammation were increased in our study in patients with severe disease, as were lactate dehydrogenase, monocyte distribution width, and neutrophil-to-lymphocyte ratio. An elevated level of serum D-dimers was observed in approximately half of our subjects and was associated with disease severity. Our best linear regression model for predicting COVID-19 coagulopathy (manifested as abnormal D-dimer levels) included age, fibrinogen, and lymphocyte count. Conclusion: Our findings emphasize the association between COVID-19 coagulopathy and the presence of systemic inflammation. A significant proportion of patients with moderate and severe disease had coagulation abnormalities and these were linked with the presence of inflammation and older age..