Post-COVID Syndrome: Changing the Prognosis of Chronic Non-communicable Diseases

Manuel Alejandro Jaramillo-Acosta; Camilo Andres Ramírez-Salgado; Natalia Andrea Castillo Narvaez; Md Moshiur Rahman

doi:10.37871/jbres1453

ISSN: 2766-2276

Medicine Group . 2022 April 23;3(4):391-392. doi: 10.37871/jbres1453.

Subject area(s)

Public Health

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Editorial

Post-COVID Syndrome: Changing the Prognosis of Chronic Non-communicable Diseases

Manuel Alejandro Jaramillo-Acosta^4, Camilo Andres Ramírez-Salgado², Natalia Andrea Castillo Narvaez³ and Md Moshiur Rahman^4

¹School of Medicine, Universidad del Quindio, Armenia, Colombia
²School of Medicine, Universidad Simón Bolivar, Barranquilla, Colombia
³School of Medicine, Universidad Del Valle, Cali, Colombia
⁴Department of Neurosurgery, Holy Family Red Crescent Medical College, Dhaka, Bangladesh

*Corresponding author: Moshiur Rahman Md, Department of Neurosurgery, Holy Family Red Crescent Medical College, Dhaka, Bangladesh E-mail:

Received: 21 April 2022 | Accepted: 22 April 2022 | Published: 23 April 2022

How to cite this article: Jaramillo-Acosta MA, Ramírez-Salgado CA, Castillo Narvaez NA, Rahman MM. Post-COVID Syndrome: Changing the Prognosis of Chronic Non-communicable Diseases. J Biomed Res Environ Sci. 2022 Apr 23; 3(4): 391-392. doi: 10.37871/jbres1453, Article ID: jbres1453

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Post-COVID-19 syndrome is defined as the persistence of signs or symptoms following the acute phase of COVID-19 [1], which may persist for an indeterminate period of time; or it is defined as the period of risk following the acute phase of COVID-19 [1], in which major complications may occur depending on organ injury during the first phase of COVID-19 [1-3]. The management of this syndrome has been reported to be challenging due to the difficulty in defining whether any clinical picture presented in this time period is derived from COVID-19, or is an isolated condition associated with a personal history or a de novo disease [1,4]. In addition, the management of complications that persist for a prolonged period of time entails high health costs, decreases the functional capacity of the affected person and, in case of a history of chronic non-communicable diseases, modifies the control and prognosis of these, increasing the risk of morbidity and mortality [1,4]. Hence the importance of estimating the real impact of COVID-19 on chronic non-communicable diseases.

One of the main barriers in the prognosis of patients with chronic non-communicable diseases, with or without a history of COVID-19, is their care [4]. Sahoo, et al. [4] conducted a study where they assessed the difficulties of chronically ill patients in accessing their disease management in India, observing that about 70% encountered inconveniences during the routine monitoring process, 67% in getting their daily care procedures, 61% in accessing the hospital, 59% in getting to their doctor's appointment, 56% in receiving emergency treatment, 47% in receiving their medication plan and about 50% reported delays in their disease care; This has a substantial impact on the care, control and prognosis of cardio metabolic, neurological and renal diseases [4]. However, if we want to estimate the magnitude of this problem, the EPICOVID-19 Brazil study [5] found that out of 77.075 individuals between 20 and 59 years old, about 45% had at least one chronic disease, being mostly indigenous, with a low-educational level and belonging to a low-socioeconomic stratum, which makes access to health services even more difficult [5]. If we extrapolate this situation to the real world, we can presume that the number of people affected is gigantic.

Another factor, and probably the most important in the short-term, is the role played by the COVID-19 phenotype developed during the acute phase of the disease, and the impact it has on the pathophysiology of the post-COVID-19 syndrome, considering the organ injury during the acute phase. Alves, et al. [6] conducted a systematic review and meta-analysis, where they found that patients with dementia, diabetes, hypertension and chronic kidney disease, during their hospital stay or during the post-COVID phase, have a cumulative case fatality of 27.68 (95% CI; 15.66 - 41.57) [6]. Another very interesting study, which even demonstrated target organ injury without immediate manifestation, was that of Drakos, et al. [7], who evaluated coronary microvascular disease in COVID-19 patients by cardiovascular magnetic resonance imaging, showing that patients who had COVID-19 had significantly reduced global myocardial perfusion reserve (2.73 [2.10 - 4.15 - 11] vs. 4.82 [3.70 - 6. 68], p = 0.005), significantly increased coronary sinus flow at rest (1.78 ml/min [1.19 - 2.23 ml/min] vs. 1.14 ml/min [0.91 - 1.32 ml/min], p = 0.048), , and reduced coronary sinus flow during stress activity (3.33 ml/min [2.76 - 4.20 ml/min] vs. 5.32 ml/min [3.66 - 5.52 ml/min], p = 0.05), compared to controls [7]. Based on the above, the authors concluded that there is a cardiac microvascular injury in COVID-19 patients, which may trigger major cardiovascular events in the post-COVID-19 phase, and this is one of the reasons that would explain the persistence of fatigue and dyspnea during this phase [7].

The post-COVID-19 neurological syndrome is one of the described phenotypes of the post-COVID syndrome, where worsening has been reported in patients with a personal history of stroke, Alzheimer's disease and other dementias, or neuroimmune disorders, which markedly increases the risk of disability and mortality [1,3]. For this reason, it is necessary to design and build post-COVID 19 rehabilitation centres [8], with the aim of trying to recover and maintain the functional capacity of those affected, especially those with chronic diseases, which require strict monitoring and control to maintain a favourable survival and quality of life [8]. Therefore, it is necessary to disseminate the impact of the post-COVID 19 syndromes on the prognosis of chronic non-communicable diseases [9,10], and to propose strategies to avoid an increase in the global burden of these diseases.