Postacute COVID-19 syndrome
Alerts and Notices
Synopsis

The pathophysiology of PCS is still unknown.
PCS can develop regardless of initial COVID-19 illness severity, but it is more common among those with higher illness severity and hospitalization. Patients requiring intensive care unit (ICU) level of care are somewhat more likely to have PCS; however, those with only mild initial COVID-19 illness may develop PCS as well. Rates as high as 87% have been reported following COVID-19-related hospitalization at 60 days from diagnosis. Other risk factors include older age and comorbid illness, such as chronic kidney disease.
In a large study, about one-fifth of fully vaccinated patients diagnosed with breakthrough infection reported having "long-COVID" symptoms at 6 weeks after diagnosis. Another published study in September 2021 found that vaccination was protective against development of PCS; those who were fully vaccinated when they contracted SARS-CoV-2 developed PCS at approximately half the rate of those who were unvaccinated when they contracted SARS-CoV-2 (5.2% vs 10.7%, respectively).
Related topics: multisystem inflammatory syndrome in children (MIS-C), multisystem inflammatory syndrome in adults (MIS-A)
Codes
ICD10CM:U09.9 – Post COVID-19 condition, unspecified
SNOMEDCT:
1119303003 – Post-acute COVID-19
Look For
Subscription Required
Diagnostic Pearls
Subscription Required
Differential Diagnosis & Pitfalls
- Bacterial or viral pneumonia – look for current fevers and chills
- Bronchiectasis – look for significant, chronic sputum production
- Pulmonary fibrosis
- Pulmonary embolism
- Asthma / chronic obstructive pulmonary disease (COPD)
- Gastroesophageal reflux disease (GERD)-associated cough
- Pericarditis
- Costochondritis
- Acute coronary syndrome / myocardial infarction
- Congestive heart failure
- Renal failure (acute kidney injury, chronic kidney disease) / uremia
- Anemia
- Depression
- Generalized anxiety disorder
- Chronic fatigue syndrome
- Fibromyalgia
- Posttraumatic stress disorder
- Postintensive care syndrome
- Migraine
- Cerebral venous sinus thrombosis
- Dementia
- Hypothyroidism or hyperthyroidism
- Parkinson disease – associated with anosmia
Best Tests
Subscription Required
Management Pearls
Subscription Required
Therapy
Subscription Required
References
Subscription Required
Last Reviewed:05/27/2021
Last Updated:09/22/2021
Last Updated:09/22/2021