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Postacute COVID-19 syndrome
Other Resources UpToDate PubMed

Postacute COVID-19 syndrome

Contributors: Linden Brown MD, Paritosh Prasad MD
Other Resources UpToDate PubMed

Synopsis

Postacute COVID-19 syndrome (PCS) is a collection of prolonged symptoms identified in individuals recovering from SARS-CoV-2 infection or COVID-19 disease. Although there is no delineated consensus definition for the condition, it is generally defined as one or more lingering symptoms persisting beyond 28 days from the initial COVID-19 diagnosis. Most commonly, patients may experience fatigue, generalized weakness, and dyspnea, but symptoms can include arthralgias, myalgias, cough, chest discomfort, palpitations, anosmia, dysgeusia, nausea, abdominal pain, diarrhea, headache, poor sleep, difficulty concentrating, memory impairment, depression, and anxiety. Objective features, such as diminished diffusion capacity on pulmonary function tests (PFTs) and persistent abnormalities on chest imaging (eg, x-ray or CT scan), may also be present but are not necessary for diagnosis. Symptoms can persist beyond 6 months in some individuals, although patients most often progressively improve with time. Eventually, most patients report returning to their usual state of health.

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

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Last Reviewed:05/27/2021
Last Updated:09/22/2021
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Postacute COVID-19 syndrome
Postacute COVID-19 syndrome (Common Physical Symptoms) : Cough, Fatigue, Dyspnea, Chest discomfort, Anosmia
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