What might COVID-19 Patients Experience after Recovery? A Systematic Review

Abstract

Objectives: To determine post-COVID-19 complications after recovery and investigate the reported cases of re-infection. Methods: The researchers systematically reviewed three databases: PubMed, Google Scholar, and Word Health Organization (WHO) COVID-19 database looking for studies reported post-COVID-19 complications and COVID-19 reinfection. The search was conducted between November 21, 2020 and January 14, 2021. Inclusion criteria were articles written in English and had primary data. The studies reported the complications of COVID-19 after full recovery were included. Case reports were only included in the COVID-19 reinfection section. Results: The review included 69 studies related to post-COVID-19 complications and 13 case studies related to COVID-19 reinfection. Thirty-six studies reported post-cure respiratory complications including dyspnea to residual pulmonary fibrosis. Cardiac symptoms were reported in nine studies including palpitation, chest pain and diastolic dysfunction. Neurological complications included post-traumatic stress syndrome (PTSD), anxiety, depression, memory issues, insomnia and sleeping disturbance, cognitive impairments, and stigma. Gastrointestinal symptoms included nausea, vomiting, diarrhoea, and acute liver injury. Physical decline was the most common symptom reported in the musculoskeletal complications. Thirteen cases COVID-19 reinfection from nine countries were reported. Four patients had severe symptoms in the second infection while the symptoms of nine patient ranged from mild to moderate. The time taken for the reinfection ranged from 26 days to 145 days. Conclusion: COVID-19 may cause several types of complications after recovery. Lung abnormalities, neurological complications, and exercise intolerance were frequently identified complications among COVID-19 survivors. Reinfection can occur among COVID-19 survivors. Thus, COVID-19 may need long-term follow-up and should take preventive measures to prevent the reinfection.

The Musculoskeletal Involvement After Mild to Moderate COVID-19 Infection

“…It has been reported that long-haulers can have sequelae from one or more systems such as pulmonary, cardiovascular, gastrointestinal, renal, neural and musculoskeletal ( Leviner, 2021 ). Studies showed that regarding the musculoskeletal system sequelae, COVID-19 survivors, including those who also had the mild to moderate forms of the infection, can experience exacerbated muscle and joint pain ( Elhiny et al, 2021 ), and intense myalgia (muscle pain) ( Aiyegbusi et al, 2021 ; Carvalho-Schneider et al, 2021 ). Another sequel is intolerance to physical activities associated with a chronic fatigue condition and a difficulty in returning to a normal daily life ( Miyazato et al, 2020 ; Humphreys et al, 2021 ).…”

An overview of post‐COVID‐19 complications

“…6 Nine studies in China, Italy, Australia, and Germany have reported cardiovascular events of COVID-9. 3 The longest duration of follow-up documented among these studies was 3 months posthospital discharge. 7 The cardiovascular complications included an increase in heart rates, increase palpitations, elevation in blood pressure, chest tightness, pericardial chest pain, myocardial infarction, myocardial oedema, pericardial effusion, diastolic dysfunction, pulmonary hypertension and cardiac arrhythmia.…”

“…Italy, the UK, Netherland, Canada, Saudi Arabia, Iran, France, Spain and the United States). 3 The commonly reported symptoms were breathlessness, lung function abnormalities, pulmonary fibrosis (interstitial thickening and crazy paving), residual ground-glass opacity, abnormal diffusion, pneumonia and pulmonary embolism. The longest duration of follow-up that reported respiratory sequelae was 4 months post-hospital discharge.…”

“…6,8 However, 28 studies in China, Egypt, Germany, the UK, Italy, Ireland, Spain, Korea, the USA and Bangladesh have reported neurological complications among COVID-19 survivors. 3 In these studies, COVID-19 survivors were presented with multiple symptoms included post-traumatic stress disorder, depression, anxiety, memory problems (immediate memory and delayed memory), cognitive impairment, insomnia and sleeping disorder. 4,6 Chieffo et al reported neurological sequelae among survivors 4 months post-hospital discharge.…”

“…4 In addition, 23 studies from 12 countries reported musculoskeletal complications including generalised pain, joint and muscle pain, fatigue and reduction in exercise tolerance as consequences after COVID-19 recovery. 3 Fatigue and physical decline were attributed to pulmonary impairment and shortness of breath which are commonly reported among the survivors. 4,5,10 Furthermore, gastrointestinal tract (GIT) complications including nausea, vomiting, diarrhoea and acute liver injury (non-specific pattern) were among the prolonged complications which lasted in some cases up to 3 months after recovery.…”