Recently, as the pandemic has affected more and more parts of the country, there has been more and more discussion of the sequelae of COVID-19.
Does it affect sexual function? Will I lose my sense of smell and taste forever? Will COVID-19 cause brain atrophy? What are the sequelae of COVID-19 infection?
We have compiled some of the information we have obtained based on current research.
This is not an article that discusses whether the sequelae of COVID-19 are serious. As far as the known sequelae are concerned, whether it is loss of taste or exhaustion and fatigue, it is a negative feeling for each individual. Once a large number of people are infected, it places a heavy burden on the health care system.
Instead of worrying about various sequelae, one of the more critical things is to avoid infection and avoid severe illness. This requires each of us to master the weapons of preventing the virus, vaccinations, wearing masks, gathering less, washing hands frequently, and so on.
The epidemic is still ongoing for a long time, and we hope that everyone can fully understand the knowledge about the sequelae of the new crown in the current scientific progress. Protect yourself and your family before the virus.
What are the sequelae of COVID-19?
Although the term "covid-19 sequelae" is all over the Internet, there is still a certain degree of inaccuracy in reliable Chinese authoritative journals, or the definition of various professional medical organizations.
This is mainly because "sequelae" are easy to associate with cause and effect, and are not accurate enough. At present, some aspects of "COVID-19 sequelae" may be unique to COVID-19, but there are also many aspects that appear to be similar to the recovery period of other viral infections, serious diseases, or sepsis. For example, patients who have been in intensive care units also have significant physical decline and cognitive decline after discharge, which is very similar to the sequelae of the new crown.
Therefore, many studies prefer to say "symptoms after infection" rather than "sequelae". In order to facilitate the discussion later, we will still use the familiar "sequelae" title.
In general, according to the DEFINITION OF WHO, we define the post-COVID-19 situation period as what we often call "POST-COVID-19 sequelae", which is called "sequelae" And the conditions that need to be met are:
Various symptoms that appear in/after COVID-19 infection, both physically and mentally;
Symptoms persist for at least two months (i.e. three months from the onset of illness), affecting the patient's life;
These symptoms cannot be explained by other diagnoses [1].
For example, a positive patient goes out after a few weeks of isolation, and if he walks too much or is a little wheezing when he goes uphill at the beginning, it may be caused by long-term lack of activity, and most of them will slowly recover after a period of time, which is a normal rehabilitation process. Only if the symptoms persist for at least two months are not good, the diagnosis of sequelae is met.
What sequelae are biased?
Research on COVID-19 is currently in a blowout period, with DR Soumya Swaminathan, WHO's Chief Scientist, saying that hundreds of papers on COVID-19 appear every day. In such a complex amount of information, we need to know more about background science.
Let's start with a few of the sequelae that have spread over the pan.
1. Does COVID-19 last 230 days and spread to all organs?
It doesn't make much sense.
This is a study uploaded to this site in December 2021 [2].
Image source: Literature[2]
It is true that one case of the virus was detected in the body after 230 days, but the study was 44 corpses, representing patients who died unable to defeat the virus infection. Patients were barely vaccinated before death, 96% had at least one underlying medical condition, were hospitalized for an average of 26 days before death, and 82% required invasive mechanical ventilation with intubation or tracheostomy.
This study is of little significance to the hundreds of millions of people who have been vaccinated and successfully defeated the virus even after being infected with COVID-19.
In addition, the preprint that swept the Internet four months ago has not yet been officially published by expert review.
2. Is COVID-19 causing brain atrophy?
It doesn't make much sense.
The study was published in the Journal Of Nature on March 7, 2022. This is the first study to compare brain images before and after infection with COVID-19 in a longitudinal manner [3].
Image source: Literature[3]
The authors themselves point out that the study only observed some changes in the brain, "but did not confirm whether these changes were partially reversible or long-term."
The subjects of the study were all older (51 to 81 years old), 97% of whom were white, and the patients were almost unvaccinated, mainly infected with alpha strains, not the currently circulating Omilon strains.
3. Will I lose my sense of taste and smell forever if I get COVID-19?
Most people can recover.
The phrase "forever" is an exaggeration. A study in the journal Clinical Medical Research found that the majority (88%) of people who lost their sense of taste and smell recovered within two months [4].
Judging from the current survey of the post-infection of Omi kerong, the proportion of loss of taste and smell has been greatly reduced. According to the UK Health and Safety Agency(i.e. The Department of Public Health) technical briefing on the outbreak on 14 January 2022, the proportion of taste-loss-olfactory perceptions fell from 34% in Delta to 13% in Omiqueron [5].
4. Can a COVID-19 infection cause genital contraction or impotence?
It doesn't make much sense.
The claim comes from an American audio program: "An unnamed man in the United States said that after contracting the new crown virus, his genitals shrank by 3.8 centimeters."
Although the man was only in his 30s, he had a severe COVID-19 and needed to be hospitalized, and after being discharged from the hospital, he had erectile dysfunction and felt that his genitals seemed to be smaller. Some urologists also said they received similar patient statements.
图片来源：Insider. Man says COVID caused his penis to shrink by an inch and a half
However, at the same time, some doctors believe that erectile dysfunction can generally explain the doubts of smaller penises. So this is a problem of seeing flowers in the fog and looking at the moon in the water.
We still look at it from a scientific point of view. In the current study, it is reflected that the virus may have an effect on various systems throughout the body in severe patients, but it has not been shown to specifically target the reproductive system.
In the above statement about sequelae, the study subjects were infected with previous strains. Scientists are also paying attention to the sequelae of Omiljung, but because the virus is new, more research needs to wait.
What is the reliable information about sequelae?
1. At present, there are common "sequelae" of COVID-19.
The study focused on past strains. According to UpToDate, a common reference platform used by clinicians, there are two main types of symptoms:
The first is physical symptoms, of which fatigue is the most common symptom.
The proportions of common physical symptoms are as follows:
Fatigue (15% - 87%)
Difficulty breathing (10% - 71%)
Chest pain or tightness (12% to 44%)
Cough (17% - 34%)
Less common symptoms include loss of smell, joint pain, headache, Sjögren syndrome, rhinitis, taste disturbances, loss of appetite, dizziness, myalgia, insomnia, hair loss, sweating, and diarrhea.
The second is psychological symptoms, such as anxiety, depression, memory loss, cognitive dissonance, etc.
2. The after-effects of Omikeron remain to be studied.
The latest strain, Olmikeron, only emerged in Africa at the end of November 2021, and the outbreak in Europe and the United States reached its climax in January 2022. Now the time is too short, and the data on the sequelae has not yet come out.
3. There are certain limitations in the study of various sequelae.
First, there are a variety of research methods, some have sequelae after four weeks of illness, and some are eight weeks or longer, so these studies are oranges and apples, which are not very good with each other.
Second, many studies on sequelae do not have a strict control group, and many just collect questionnaires for patients. Various legends about sequelae on the Internet may also give patients nocebo (negative placebo effect). A typical example is that in a vaccine clinical trial, 1/3 of the subjects who were treated with saline felt tired, and 1/3 said they had a headache.
Third, the current research on sequelae that everyone sees is almost all about past virus strains. When looking at "old" data, interpret it with caution.
In response to the global sweep of Omi kerong, scientists are improving research methods, doing control and prospective studies. For example, 6 hospitals, including Massachusetts General Hospital, have joined forces to plan to enroll about 900 COVID-19 patients and continue to follow them for 3 years. In this way, it is possible to observe the recovery of patients, what factors affect rehabilitation, the proportion of sequelae, and so on.
We are still waiting for the latest research to give us more reliable information.
Before that, instead of worrying about the various problems of sequelae, fall into excessive panic and anxiety. It is better to actively vaccinate and protect against it.
For the vast majority of people, avoiding infection and avoiding severe illness is more important than excessive panic.
This article is co-authored by experts
This article is reviewed by experts
bibliography
[1] Soriano J B, Murthy S, Marshall J C, et al. A clinical case definition of post-COVID-19 condition by a Delphi consensus[J]. The Lancet Infectious Diseases, 2021.
[2] Chertow D, Stein S, Ramelli S, et al. SARS-CoV-2 infection and persistence throughout the human body and brain[J]. 2021.
[3] Douaud G, Lee S, Alfaro-Almagro F, et al. SARS-CoV-2 is associated with changes in brain structure in UK Biobank[J]. Nature, 2022: 1-17.
[4] Printza A, Katotomichelakis M, Valsamidis K, et al. Smell and taste loss recovery time in COVID-19 patients and disease severity[J]. Journal of Clinical Medicine, 2021, 10(5): 966.
[5] SARS-CoV-2 variants of concern and variants under investigation in England. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1050236/technical-briefing-34-14-january-2022.pdf
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