For more than two years now, we have been immersed in a pandemic that has already resulted in nearly 600 million confirmed cases and more than 6.5 million official deaths, although the real death toll is estimated at over 20 million.
Moreover, although most people who develop COVID-19 make a full recovery from acute COVID, which can take from 7 to 20 days to clear, the World Health Organisation (WHO) estimates that approximately 10-20% of the population experience various medium- and long-term effects after recovering from the initial illness. These medium- and long-term effects, now known as long COVID-19, post COVID-19 or persistent COVID-19 syndrome, differ from the effects of COVID experienced by immunocompromised or particularly vulnerable patients.
This new COVID-related illness is still largely unknown, as are its causes. It has also been silenced, under-diagnosed and under-treated for many months. However, in a process led by the WHO in Geneva, an international panel of 265 patients, physicians, researchers and WHO personnel was created to develop a consensus definition for this complex condition.
Definition of post COVID-19
Post-COVID-19 condition occurs in individuals with a history of probable or confirmed SARS-CoV-2 infection, usually 3 months from the onset, with symptoms that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include, but are not limited to, fatigue, shortness of breath, and cognitive dysfunction, and generally have an impact on everyday functioning. Symptoms might be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms might also fluctuate or relapse over time.
Recent studies and publications have provided increasing knowledge of post COVID-19, but many aspects are still unknown. In this debate we will attempt to answer, among others, the following questions: What do we know about the causes of post COVID-19? What are its main and secondary symptoms? Do we have sufficient, objective data for its study? Are the symptoms continuous or do they occur in outbreaks? How long can the illness last? Are there still doctors who believe that some patients make up the illness? Do different patients experience different degrees of it? What treatments are currently available? Is there a difference between the symptoms of people who have been hospitalised and those who have not? What about immunosuppressed people who became ill with COVID-19 and whose symptoms are prolonged over time – does their condition have any similarities with post COVID-19? How are patients with post COVID-19 treated at present in the Spanish healthcare system? With the current high rate of vaccination against COVID-19 in our country, has the number of cases of post COVID-19 fallen in recent months?
Lourdes Mateu, Coordinator of the Post COVID-19 Unit, specialist physician in the Infectious Disease Service at the Hospital Germans Trias i Pujol, and associate lecturer in Medicine at the UAB.
Gema María Lledó Ibáñez, Head of Post-COVID Condition, and attending physician in the Internal Medicine Service and the Systemic Autoimmune Diseases Service at the Hospital Clínic de Barcelona.