Post-Viral Syndrome and COVID-19: What Is It and What Do We Know?

The long-term consequences of infection with the SARS-CoV-2 virus, or COVID-19, are still relatively unknown. But in case you needed yet another reason to wear your mask, some people who have recovered from COVID-19 are reporting symptoms of post-viral syndrome months after infection with the virus.

Post-viral syndrome has been observed in patients infected with several other viruses, including Epstein-Barr virus (mononucleosis) and West Nile virus. However, we are still learning about the emerging connection between COVID-19 and post-viral syndrome. Here’s everything we know so far about post-viral syndrome, including what it is and what you can do to stay safe from it.

What is post-viral syndrome?

Post-viral syndrome, otherwise known as post-viral fatigue, is a collection of symptoms that linger after a viral infection. Post-viral syndrome causes symptoms similar to those of chronic fatigue syndrome (CFS), including:

●      Severe fatigue

●      Concentration or memory problems (“brain fog”)

●      Sleep problems

●      Sore throat

●      Headache

●      Swollen lymph nodes

●      Unexplained muscle or joint pain

●      Low mood

●      Dizziness or nausea

Scientists and doctors aren’t completely sure why some patients get post-viral syndrome and others do not. Some believe that it develops due to an unusual immune response to the virus or increased levels of inflammatory cytokines in the body. However, this is just speculation and has yet to be proven by research.

Post-Viral Syndrome and COVID-19

At the 2020 International AIDS Conference, Dr. Anthony Fauci, leader of the White House Coronavirus Task Force, warned of long-term consequences of COVID-19, including “brain fog, fatigue, and difficulty in concentrating.” The symptoms he described seemed to indicate that some patients recovering from COVID-19 were developing a form of post-viral syndrome.

The reason why COVID-19 causes post-viral syndrome is unknown, but there are some clues from what we know about previous forms of the SARS coronavirus. According to recent research, some patients infected with other forms of the SARS virus developed a chronic fatigue-like illness that prevented them from returning to work for over a year. 

Post-mortem research showed that the coronavirus causing this form of SARS crossed the blood-brain barrier, disturbing lymphatic drainage in the brain. This mechanism is similar to the one theorized to cause chronic fatigue syndrome (CFS), suggesting that patients recovering from SARS viruses may develop a form of post-viral CFS. 

Because COVID-19 itself is still a relatively new virus, we are still learning about how this form of the SARS coronavirus causes post-viral fatigue. However, many doctors report seeing moderate to severe levels of fatigue in previously healthy patients after infection with COVID-19. This has led some medical professionals to coin the term “post-COVID syndrome” to describe the collection of CFS-like symptoms in patients recovering from SARS-CoV-2. 

Who gets post-COVID syndrome?

About 10% of patients who get COVID-19 go on to develop so-called “post-COVID syndrome.” However, up to 70% may experience milder forms of post-viral syndrome, with symptoms of the virus lingering even after they test negative.

One might assume that patients infected with severe forms of the virus are the only ones who suffer from this “post-COVID syndrome.” In reality, symptoms of post-viral syndrome have been observed in both patients with severe symptoms that sent them to the emergency room and patients with mild to moderate symptoms who self-treated at home.

Still, some people appear to be at higher risk of developing “post-COVID syndrome.” Some risk factors for post-viral fatigue following infection with COVID-19 include:

●      Being age 50 or older

●      Experiencing a longer, more severe illness

●      Having underlying health conditions, especially

○      Heart problems

○      Lung problems

○      High blood pressure

○      Diabetes

○      Obesity

Doctors have speculated that people with weaker immune systems may have a longer battle with COVID-19. Previous research shows that the length of illness is directly associated with the likelihood of developing post-viral syndrome: the longer you are sick, the more likely you are to develop post-viral fatigue. 

Ultimately, anyone infected with COVID-19 could go on to develop post-viral syndrome. This begs the question: is there any way to prevent post-viral syndrome if you come down with the SARS-CoV-2 virus? Read on to discover the answer, which we’ll discuss in the next section.

How to Prevent Post-COVID Syndrome

By some estimates, more than one-third of patients with COVID-19 don’t feel fully recovered, even weeks or months after being infected with the virus. You might be wondering if there is anything you can do to prevent becoming part of this one-third.

The best thing you can do to prevent post-COVID syndrome, assuming you have not already been infected with the virus, is to avoid catching COVID-19 in the first place. While it is impossible to avoid all potential exposure to the virus, you can take precautions, such as wearing a mask that covers your mouth and nose and washing your hands frequently, to stay healthy and safe during the pandemic.

If you or someone you care about already has COVID-19 and is concerned about post-viral syndrome, you may want to take some of the following precautions to speed your recovery:

Seek Treatment Early

We already know that having a longer course of illness is associated with a greater likelihood of developing post-viral syndrome. If you think you may have been exposed to the coronavirus, do not wait to visit your doctor’s office and get tested. The earlier you know that you have been infected, the earlier you can start resting, drinking fluids, and practicing self-care to speed your recovery. 

Eat a Healthy Diet

Consuming processed foods, having high blood sugar, and drinking too much alcohol can all contribute to post-viral syndrome. You are less likely to develop post-viral syndrome if you maintain a healthy diet and avoid inflammatory foods, such as red meat, sugar, alcohol, and trans fats.

Return to Exercise Gradually

After a viral infection, it’s common to see something called post-exertional malaise (PEM). PEM is a loss of physical and mental energy after exercise and can happen if you try to return to vigorous physical activity too soon after a viral infection. PEM can increase the likelihood of experiencing post-viral fatigue, so be sure to start slowly when returning to exercise after being sick with COVID-19.

Managing Post-Viral Syndrome 

If you are experiencing fatigue and malaise following a viral infection and suspect you may have post-viral syndrome, you may be wondering what you can do to manage your symptoms. Unfortunately, there is no quick fix or miracle pill for post-viral syndrome — but you can potentially improve your symptoms by trying some of the following coping strategies:

Acupuncture

If you are no longer contagious (i.e. testing negative for COVID-19), then acupuncture may be a good strategy to help you manage the symptoms of post-viral syndrome. There is limited research to support the use of acupuncture for post-viral fatigue, but many people report that it has helped them return to their everyday activities. In one case study, a woman reported that acupuncture facilitated her return to work following post-viral syndrome.

Cognitive-Behavioral Therapy (CBT)

A type of mental health therapy called cognitive-behavioral therapy (CBT) can help some people with post-viral syndrome. That is not to say that their symptoms are psychological or “all in their head.” The symptoms of post-viral syndrome are real and physical. However, changing the way you think about your symptoms can actually improve the way you feel. The goal of CBT is to manage unhelpful thinking about your illness and replace negative thoughts with more positive ones, so that you no longer feel limited by your symptoms of post-viral fatigue.

Reduced Activity

People with post-viral syndrome may benefit from reducing their daily activities until they feel better. This can mean taking additional time off of school or work; taking a break from extra-curricular activities, clubs, or volunteer positions; and getting help with chores around the house from a spouse, relative, or friend. By reducing the amount of activity you perform on a daily basis, you’re conserving what limited energy you do have for your most important tasks.

Scheduling Tasks

Brain fog can present a challenge when it comes to remembering tasks and getting things done on time. Keeping a regular schedule, with all of your tasks written down (or typed in), can help you keep track of what you need to do. Schedule everything, even eating and sleeping, as maintaining regular meal and sleep times can help you manage chronic fatigue by reducing stress and forgetfulness. 

. . . .

Post-viral syndrome can present a challenge to COVID-19 patients hoping to return to work or school. In some cases, the symptoms of post-viral syndrome can last for weeks to months after overcoming a viral infection. Ultimately, you can prevent post-viral syndrome by taking precautions against COVID-19 and maintaining good physical and mental health. However, if you do develop post-viral syndrome after an infection with COVID-19, there are steps you can take to manage the symptoms of post-viral syndrome so that they do not hold you back from living your life. 

The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.

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