Madrid, February 9, 2021.- Coronavirus or COVID-19 is a disease that is potentially serious. With more than two million deaths around the world, officially more than 55,000 in Spain1, as the pandemic has developed, some patients have manifested long-term sequelae after infection. “Most patients make a full recovery, but those who have not, report persistent symptoms that last for weeks or months after the acute phase of the illness. Long-term studies are being carried out to understand the nature of these symptoms”, states Victoria Martinez, specialist in Internal Medicine at MD Anderson Cancer Center Madrid.
The department evaluates patients with chronic COVID, or long COVID, that is, subjects with signs and symptoms that develop during or after an infection compatible with COVID-19, and that persist for more than 12 weeks and are not explained by an alternative diagnosis. As with other infections, virological and inflammatory after effects can develop.
Therefore, the percentage of those affected by long COVID varies according to different studies, as Dr. Martinez explains, but it would seem to affect at least 10% of the total patients. Symptoms, which can occur in up to two-thirds of patients, include fatigue, shortness of breath after exertion, cognitive dysfunction, muscle and joint pain, gastrointestinal discomfort, skin rashes, metabolic disorders, like poor diabetes or cholesterol control, thromboembolic disease, and mental illness.
So, monitoring the health of patients who have been through the condition is key, since even asymptomatic patients have had complications afterwards. There have been sequelae that did not show symptoms, and without a general check-up to follow up, they may not have been detected in time. For that reason, MD Anderson Madrid is offering single-day post-COVID check-ups in the specialties of cardiology, pulmonology and hematology, which are where there are usually more complications after the disease.
In hematology, tests done for the check-up are to elicit the patient’s medical history and a complete blood test. "Alterations and imbalances have been observed in the inflammatory processes of patients who have been through COVID-19, which are accompanied by anomalies in coagulation. The idea behind the check-up is, without being alarmist and using the least invasive tests possible, to rule out post-infection problems, such as the risk of a thrombotic event”, says Adolfo de la Fuente, head of the Hematology Service at MD Anderson Madrid.
Cardiology and Pulmonology, specialties affected by COVID
In cardiology, "the most common complications we are seeing are the appearance of thrombosis in the lungs and legs and a higher incidence of pericarditis and myocarditis (inflammation of the heart)”, states Dr. David Vivas, of the Cardiology Service at MD Anderson Madrid.
In addition, although these problems tend to appear more frequently in men with a history of heart disease, respiratory disease or with cardiovascular risk factors (high blood pressure, diabetes, being overweight or obesity, high cholesterol, smoking and so on), the reality is that anyone who has been through this disease is susceptible to developing some type of ailment. Young people, without risk factors and who have suffered Covid-19 mildly or have not had any symptoms, also have a higher chance of developing these complications in the coming months.
For that reason, although it is always advisable to see a specialist after having COVID-19, it is even more so in the case of patients who have cardiovascular, pulmonary or hematological risk factors, or symptoms like tiredness, fatigue, chest pain or palpitations.
"For this check-up, what we do is perform a baseline assessment of the risk of cardiovascular involvement of the patient even before contracting COVID-19, focusing, above all, on the symptoms reported by the patient," explains Dr. Vivas. Depending on the characteristics of each person, a series of non-invasive tests like the echocardiogram, electrocardiogram, Doppler echocardiogram, a stress test, a Holter, ergometry, etc., is recommended to reach a diagnosis.