What are the dangers that await people with Kovid 19 infection?

WHAT ARE THE HAZARDS FOR PEOPLE WITH COVID 19 INFECTION?
1* What is post covid syndrome?
Symptoms such as weakness, fatigue, shortness of breath, persistent cough, joint and muscle pain, sleep disorders, memory and concentration disorders, headache, loss of taste and smell, depression and anxiety after Covid 19 infection persist for more than 12 weeks, other reasons to explain this situation. defined as patient exclusion. This process can take up to 20 weeks. Regular follow-up and evaluation of the patient who has covid is important.
2* What is the pathogenesis of post covid syndrome? How is it formed? The continuation of the hyperinflammatory process and the ongoing virus activity in the host viral reserve are held responsible for the process.
3 *Post covid syndrome is more common in whom?
It is common in people with diseases such as severe covid requiring hospitalization in the service and intensive care unit, being over 50 years old, female gender (2 times more), D.Mellitus, COPD, coronary artery disease.
5** What are the changes and damages in the Lungs in post covid syndrome?
Shortness of breath and cough are the most common findings. In the studies conducted, shortness of breath was found at a rate of 30-40% in mild-moderate covid and 65% in severe covid. Pulmonary fibrosis, post viral reactive airway dysfunction, organizing pneumonia, bronchiectasis, small airway disease, thromboembolism, pulmonary hypertension, subcutaneous emphysema, pneumothorax, pneumomediastinum are lung diseases caused by covid. For this reason, patients should be followed by a pulmonologist (pulmonologist). The recommended time for pulmonary function testing for appropriate evaluation is 3 months. Clinical improvement in follow-up is earlier than radiological recovery. The presence of a lesion on lung imaging at the end of treatment does not indicate active disease. Even in mild disease, tomography findings can be seen in cases with complete clinical recovery in the 4th month. Oxygen monitoring at home in post-covid patients with shortness of breath, chest diseases in those with low oxygen
Cortisone therapy and oxygen therapy, pulmonary rehabilitation are recommended under the control of a specialist.
Due to the risk of embolism in patients with high D-dimer levels, anticoagulant therapy is started and followed up frequently. If the patient with stable (controlled) asthma or COPD has PCR +, his routine treatment is continued.
6* When is LUNG CANCER OPERATION suitable after Covid?
While Pcr + in a person with covid infection, the operation mortality is 26%. The risk of waiting 7 weeks in people whose symptoms regressed was found to be the same as in those who did not have covid. Therefore, it is recommended to wait 7 weeks.
6* What are the changes in the HEART AND VASCULAR SYSTEM in post covid syndrome?
Palpitations, chest pain and feeling of pressure, shortness of breath are the most common findings. Kovid can cause Myocarditis, Pericarditis, Arrhythmia, post tachycardia dysautonomia and heart failure in the heart. Obesity, D.mellitus, Hypertension and advanced age are known to increase the risk of affecting the heart. Studies have reported that the rate of cardiac involvement is 50% in the USA and 70% in Germany. The virus directly penetrates and damages the vascular structure, disrupts the atheroma plaques, creates heart attack with plaque rupture, thrombus / clot (embolism) with vascular endothelial damage, and fatal rhythm disorder with direct myocardial damage. Venous thrombosis was found in 27% of the patients and arterial-arterial thrombosis in 3.7%. The risk of venous thromboembolism continues for 90 days after acute illness. In this process, the patient should be evaluated in terms of anticoagulant therapy. Cardiac and lung involvement has been detected in 50% of asymptomatic (asymptomatic) covid patients, and it is recommended to follow up with echo and cardiac MRI for athletes who have had covid. For this reason, it can be dangerous for athletes to start their sports life without being checked by a cardiologist in terms of rhythm disturbance and sudden death. Cardiac involvement was detected in 70% of symptomatic covid patients, and 6-8 weeks of treatment is recommended. Untreated people can develop heart failure. In Kovid follow-ups, 1 out of every 5 people has increased troponin and follow-up should be considered. If PCR positivity is detected in a person with known heart disease, Echo and Holter examination is recommended. Consensus for precautionary purposes: People with high troponin and d-dimer should take LMWH (blood thinner) for 2 weeks at discharge and should be followed by a cardiologist.
7* What are the changes in the BRAIN in post covid syndrome?
Neurological effects occur due to direct virus involvement and damage to neurons, autoimmunity, blood-brain barrier damage, thrombosis (blood coagulation). Neurological involvement was found in 80% of those hospitalized for COVID-19. brain even in asymptomatic patients.
vascular inflammation was detected. Symptoms of stroke (paralysis), epilepsy, headache, sleep disorders, neuropathy, myopathy, loss of smell and taste may manifest clinically. If the person has muscle pain, general weakness, paresthesia, and loss of sensation, imaging and electrophysiological examination are recommended by a neurologist. In addition, 10% of those who have covid and 30% of those who have severe illness may have a special clinical picture called “BRAIN FOG”. It is a picture that manifests itself with headache, concentration disorder, forgetting words, mental confusion, irritability attacks, anxiety, difficulty in speaking, dizziness, difficulty in decision making, inability to multitask, loss of taste and smell.
There is a predisposition to Alzheimer’s and dementia. According to the data of France, 30% of those who had covid had memory loss and concentration disorder. In a survey study of 4 million people in the USA, brain fog was detected in 1 out of 20 people in the 2nd month of the disease, and the more noisy the covit disease was, the higher the frequency of brain fog was seen. Multidisciplinary approach is important in treatment. Oxygen level should be corrected, regular sleep, nutrition, exercise, 20 minutes in the open air. Hiking is recommended. Psychologist support should be sought in case of anxiety. Attention should be paid to nutrition, especially glutathione, amino acids, selenium, vitamins and minerals (b vit, c vit, magnesium)
Omega 3 is recommended. In addition, the effectiveness of Ozone therapy has been found to be 90% in 2-3 weeks, with its anti-inflammatory, antiviral, immune-regulating and blood thinning effects. It has been found to reduce mortality according to data from Spain and Italy.
8*What are the PSYCHIATRIC changes of post covid syndrome?
The psychiatric effects of Covid are manifested by insomnia, memory problems, difficulty concentrating, anxiety disorder, and depression. Anxiety and depression were observed in 22% of the patients hospitalized in the ward and 33% of those hospitalized in the intensive care unit. According to Chinese data, 50% of the patients had post-traumatic stress disorder, 25% had depression, 20% had anxiety disorder, 8% had insomnia, and 32% had an increase in alcohol dependence. According to Canadian data, psychological support was required in 50% of the cases. regular treatment
exercise, psychotherapy, meditation group therapies are recommended.
9* What are the other organs affected in the post covid process? Kovid has a high affinity for organs carrying the ACE -2 receptor. It causes thyroiditis, d.mellitus (development of pancreatitis-related diabetes) and kidney diseases, especially by causing vascular inflammation (vasculitis).
IT IS IMPORTANT TO KNOW AND BE AWARE OF THE HAZARDS WAITING FOR PEOPLE WITH COVID 19 INFECTION AND POST COVID PATIENTS MUST BE FOLLOWED. CHEST DISEASES, CARDIOLOGY, NEUROLOGY AND PSYCHIATRY SPECIALISTS WILL SUPPORT YOU IN THIS WAY.
WE WISH YOU HEALTHY DAYS….
Specialist Dr. SERAP KET ALKAN
Chest Diseases Specialist