Afflicting millions of people across the world, “long COVID” is a new disease entity that can present with a diverse array of symptoms of variable severity, affecting nearly every organ system. The presumptive diagnosis of long COVID is largely clinical, and should be made only after other serious etiologies have been excluded. Workup is driven by the patient‘s presenting acute symptoms, comorbidities, and physical examination findings.
Our recent issue A Practice-Based Approach to Emergency Department Evaluation and Management of Patients With Postacute Sequelae after COVID-19 Infection: Long COVID reviews the research and current evidence on the etiology of COVID-19 infection and long COVID and presents a practice-based approach to the management of patients presenting with its postacute sequelae.
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Here are a few key points:
- Presentation may include lasting effects of infection, persistence of symptoms, or onset of new chronic symptoms or diagnoses.
- Long COVID is a multisystem disease, and may follow severe, mild, or even asymptomatic disease.
- Analyses have shown that 33% to 40% of COVID-19 infections are asymptomatic.
- The most common symptoms of long COVID are dyspnea, fatigue, and cough.
- Patients may present to the ED with acute complaints including chest pain, palpitations, arthralgias and myalgias, gastrointestinal distress, rashes, and neurological and cognitive deficits.