Long Covid, also known as post-acute Covid syndrome, is a newly identified group of persistent symptoms that can occur following infection with the novel coronavirus (SARS-CoV-2). Symptoms may last for weeks, months or even longer after initial infection. Reported symptoms associated with Long Covid include fatigue and tiredness, difficulty breathing and shortness of breath, persistent cough, joint and muscle pain, headache, chest pain or tightness, palpitations (heart racing), depression or anxiety, memory loss, inability to focus, disorientation, dilerium, blood clots with high risk of pulmonary emobolism or stroke, and renovascular hypertension (high blood pressure due to kidney inflamation.
Due to the recent emergence of Long Covid, there is no current professional standard as of this writing for making a proper diagnosis. One important aspect to consider in diagnosing Long Covid is to determine if the individual has previously been infected with SARS-CoV-2. The diagnosis should first be based on a thorough clinical history of symptoms. After this, laboratory tests such as complete blood count with platalets, complete metabolic panel (includes kidney and liver function), and B-Type Natriuretic Peptide (BNP) for presence of congestive heart failure. Additionally, cytokine panel and the level of C-reactive proteins are usefull in quantifying systemic inflammation as well as coagulation studies to determine the risk of forming potentially lethal blood clots. In addition to the blood tests, chest x-ray followed by chest CT scan is required if respiratory symptoms persist for more than 2 months.
MRI of the Kidneys are also needed if the patient has high blood pressure that spiked after the Covid infection. Moreover, MRI’s are indicated for liver function abnormalities, heart disrythmia, and/or brain function deficits. Relating these complications to the original Covid infection is a process of elimination. If the scans and MRIs turn out negative for tumors or other visible anomalies, we conclude that the complications are Covid-related. This way, we avoid missing diagnoses that are not obviously Covid-related. Finally, the patient should be tested for SARS-CoV-2 antibodies. If there is a positive result, this confirms that the individual had been previously infected with SARS-CoV-2.
The presence of these antibodies can also help to determine if Long Covid-like symptoms are likely to be related or unrelated to the previous Covid infection. The above criteria are useful in diagnosing Long Covid, however further research is needed to better understand the full spectrum of this condition and its long-term effects. Healthcare professionals should remain aware of new developments related to Long Covid and work closely with patients to ensure proper diagnosis and treatment.
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