Long COVID or postacute COVID-19 sequelae

Tijekom još uvijek prisutne pandemije COVID-19 uočen je problem velikog broja bolesnika s perzistirajućim simptomima nakon akutne infekcije. Postoje brojne definicije ovog sindroma, ali „dugi COVID“ (od engl. Long COVID) ili post-akutni COVID definira se kao prisutnost protrahiranih simptoma ili ponovno javljanje simptoma mjesec dana nakon početka akutne bolesti. „Dugi COVID“ dijeli se na „produljeni simptomatski COVID-19“ ako simptomi traju od 4 do 12 tjedana te „post-COVID sindrom“ ako simptomi traju dulje od 12 tjedana nakon infekcije koja klinički i epidemiološki odgovara COVID-19, a ne mogu se pripisati drugoj dijagnozi. Zahvaćen može biti svaki organski sustav, a najčešći simptomi uključuju umor, nedostatak zraka, palpitacije, vrtoglavicu, bol, neurokognitivnu disfunkciju, nesanicu, intoleranciju napora, smanjenu mogućnost obavljanja svakodnevnih aktivnosti i sveukupno smanjenu kvaliteta života. Patofiziologija je multifaktorijalna i sam mehanizam nastanka bolesti nije u potpunosti razjašnjen. Usprkos brojnim studijama, komplikacije, liječenje i prognoza postakutnih posljedica COVID-19 nisu još dovoljno istraženi. S obzirom na raznolikost kliničke prezentacije, liječenje i prevencija zahtijevaju multidisciplinarni pristup bolesti. Potrebna su daljnja istraživanja kako bi se utvrdili čimbenici rizika i patofiziološki mehanizmi i postavili pouzdaniji algoritmi dijagnostičke obrade, liječenja i praćenja bolesnika. U ovom radu prikazujemo pregled dosadašnjih svjetskih spoznaja o „dugom COVID-u“ uz prikaz najčešćih post-COVID radioloških promjena u bolesnika liječenih u Klinici za infektivne bolesti „Dr. Fran Mihaljević“.In addition to the COVID-19 pandemic itself, a new problem of the rising number of people with persisting symptoms after an acute infection emerged. There are various definitions, but long COVID or post-acute COVID is defined as the presence of prolonged symptoms or long-term complications of an acute infection longer than one month after the first symptoms. Long COVID can be divided into “prolonged symptomatic COVID-19” if symptoms last from 4 to 12 weeks and “post-COVID syndrome” if symptoms last longer than 12 weeks after infection that clinically and epidemiologically corresponds to COVID-19 and cannot be attributed to any another diagnosis. Any organ system can be affected, the most common symptoms include fatigue, dyspnea, palpitations, dizziness, pain, neurocognitive dysfunction, sleep problems, exercise intolerance, functional disability in daily activities and reduced quality of life. The pathophysiology is multifactorial and the mechanism of the disease is still not fully elucidated. Despite numerous studies, complications, treatment, and prognosis of post-acute consequences of COVID-19 are still not sufficiently investigated. Given the variety of clinical presentations, treatment and prevention require a multidisciplinary approach to the disease. Further research is needed to determine risk factors and pathophysiological mechanisms so more reliable diagnostic algorithms, treatment, and patient follow-up could be established. In this article we present an overview of the current knowledge about the long COVID syndrome and an overview of the most common post-COVID radiological presentations in patients treated at the University Hospital for Infectious Diseases “Dr. Fran Mihaljević”