Covid-19 Podcast

Long COVID is a condition where symptoms persist for weeks or months after the initial infection with COVID-19. These symptoms can include fatigue, cognitive dysfunction, shortness of breath, joint pain, chest pain, anxiety, and depression. Factors that contribute to developing Long COVID include the severity of the acute infection, viral load, pre-existing conditions like diabetes and asthma, and certain demographics like advanced age and Hispanic ethnicity. Vaccination and general health promotion can help protect against Long COVID. Early viral clearance and patient education are also important. Long COVID can have serious cardiovascular, neurological, and psychological complications that strain the healthcare system. Preventing these complications requires promoting vaccination, health screenings, patient education, and effective treatment of acute infections. Hello and welcome. In today's episode, we will discuss the etiology, impact, and outlook for Long COVID. My name is Zoe, and I will be your host today. I am currently a nursing student at Front Range Community College, and I am happy to be sharing in on this journey with you. We are going to start by exploring the history of COVID-19 and identifying the differences between acute COVID and Long COVID. COVID-19 is a respiratory infection caused by SARS-CoV-2 that has the potential to cause acute respiratory distress syndrome. It was first identified in December 2019 and became a global pandemic that has led to 6.3 million deaths to date. It has impacted healthcare, education, and changed how we view social relationships and our own health. Acute COVID is defined as the first five weeks of infection. This is when the viral load peaks and symptoms such as fever, cough, fatigue, muscle aches, headache, loss of taste, and shortness of breath dominate. In severe cases, people may experience acute respiratory distress and develop pneumonia, septic shock, and multiple system organ failure. Long COVID occurs when symptoms persist after the initial infection for weeks or months. It can share symptoms with the acute infection or have new symptoms altogether. Common Long COVID symptoms include fatigue, cognitive dysfunction, shortness of breath, joint pain, chest pain, palpitations, pins and needle sensations, anxiety, and depression. In order to be considered Long COVID, there must be one or more symptoms that persist following the acute infection or that follow a relapsing-remitting pattern after initial recovery. New-onset cardiovascular disease, cerebrovascular disease, type 2 diabetes, chronic fatigue syndrome, and POTS has also been associated with Long COVID. Research shows that acute infection causes a widespread inflammation and development of reactive oxygen species. This chronic inflammation damages endothelial tissue and this leads to hypercoagulability, which then has a downstream effect on highly vascular organs such as the brain, heart, and kidneys. Now, you may be thinking to yourself, I had COVID several times and didn't develop Long COVID. What places people at risk for having Long COVID? Well, there are several factors that contribute to this. First, the severity of acute infection and viral load were associated with Long COVID. Patients requiring mechanical ventilation and with a history of ICU admission were more likely to report Long COVID symptoms. Vaccination against COVID has shown to be protective against developing Long COVID because it decreases illness severity. Certain pre-existing conditions also have a strong correlation with Long COVID. These include type 2 diabetes, asthma, psychiatric conditions, obesity, Epstein-Barr virus, infection like mono, connective tissue disorders, and allergies. Other risk factors include advanced age, female gender, history of smoking, low socioeconomic status, and Hispanic ethnicity. Pre-existing conditions likely contribute to Long COVID because they compound inflammation and decrease immune function, while the other social determinants of health limit the education and availability of resources. There are also several different variants and these possess different degrees of transmission and virulence. Studies have demonstrated that the Delta variant was more likely to cause Long COVID than the Omicron variant. With this in mind, it is essential to educate patients on the need for COVID boosters to accommodate for the virus's evolution and protect against Long COVID. We care about Long COVID because it places an undue burden on those affected. The cardiovascular complications can lead to heart attack, stroke, and further dependence on medical services. The neurocognitive symptoms make it difficult for people to return to work, care for their families, and reduces the overall quality of life. Chronic pain is both difficult to diagnose and has barriers to its treatment. All in all, Long COVID significantly impairs the health and well-being of our community and continues to exhaust the healthcare system. Now let's explore protective factors, public health response, and appropriate screening for Long COVID so we can examine the path forward. The greatest protective factors involve vaccination, general health promotion, early viral clearance, patient education, and continued use of PPE during active infection. Studies show that COVID vaccine reduces morbidity, mortality, and rates of Long COVID. Additionally, a study of healthcare workers demonstrated that receiving a flu vaccine provided additional protection from severe COVID-19 infection by reducing DVT, sepsis, and stroke incidents. While the flu vaccine doesn't act directly on the COVID-19 virus, it reduces the complications of both influenza and COVID in high-risk populations. And I just thought that was really cool how the combined effect offered more protection. Promoting general health habits such as a balanced diet, daily exercise, sleep, and smoking cessation is also protective against acute and Long COVID. This is because under or over nutrition is known to decrease immune response. Daily exercise promotes cardiovascular health, mood, and immunity, and sleep enhances immune function. So when we look holistically to support health, we reduce risk of severe illness. As was previously discussed, the viral load and illness severity is associated with Long COVID. And early viral clearance essentially means that we treat the disease quickly, effectively, and avoid any unnecessary treatments. Common treatments include antivirals, immune modulators, monoclonal antibodies, leukocorticoids, and supplemental oxygen or mechanical ventilation. Patients should be taught the importance of vaccination, signs of acute and Long COVID, how to use PPE, maintain health and hygiene, and when to seek medical care. And this goes back to the general concern that the public doesn't necessarily know how to identify Long COVID because it shares a lot of similarities with pre-existing conditions. Overall, there's still a lot we don't know about the long-term effects of COVID-19. What we have seen is that high-risk populations can develop cardiovascular, neurological, and psychological complications that impair functioning and places significant strain on the healthcare system. In order to prevent these complications, it is essential to promote vaccine engagement, health screenings, patient education, and effectively treat acute infections. Thank you for listening. I implore you to reflect on how COVID-19 has impacted you and will inform your nursing practice.