Long covid symptoms are:
• Fatigue
• Difficulty breathing.
• Cognitive dysfunction.
• Others, which generally have an impact on everyday functioning.
• And lowers, quality of life.
Difficulty breathing. is one of the most common and prominent symptom, in patients with Long Covid.
Breathing difficulty is huge problem for patients because: its really difficult to live with breathlessness.
Breathing is difficult on minor exertion;
unable to walk upstairs without becoming short of breath,
moderate physical activity, (walking up 4 or 5 floors), leads to a period of extreme breathlessness and exhaustion. unable to walk further.
And Constant feeling of fatigue.
Sometimes, when person has difficulty breathing, it accompanies fear of death.
Medically.. Difficulty breathing is called dyspnea.
Dyspnea is an uncomfortable abnormal awareness of breathing.
Every person has her own definition, of what is dyspnea, because they experiening it subjectively.
But, it most frequently described as shortness of breath.
Inability to take a deep breath.
Or chest tightness.
Uncomfortable breathing comprised of various sensations of varying intensity.
Dyspnea frequently accompanied by cough.
When Patient has dyspnea, first step is to identify, what is underlying cause of difficulty breathing.
There are three main potential mechanisms by which covid 19 could modulate breathlessness:
• Inflammation in the alveoli and lung tissue,
• Thrombosis and associated microclots,
• Neuroinvasion.
Lets discuss each of them.
Coronavirus infection invades and causes inflammation in lung tissue.
Inflammation in the alveoli causes, impaired gas exchange in the lungs.
resulted damage of alveoli and edema in the lungs. It means less oxygen in the blood.
At this case breathing rate can be normal or decreased.
Second possible mechanism of breathlessness.
Infection with Covid 19 causes, activation of the coagulation cascade and subsequent endothelial cell damage.
When clots and microthrombi forming in the lungs, it increases area which is not participate in breathing. It is called physiological dead space.
Patient tries to compensate this deficiency with fast breathing,
which is called hypercapnia.
And third mechanism.
Coronavirus damages cranial nerves. for example: olfactory nerve, which is responsible on sense of smell.
Many patients infected with covid 19 have reported loss of smell, which is called anosmia.
Damaging of cranial nerves may alter the function of the respiratory centers which can cause in neurogenic breathlessness.
Difficulty breathing can be symptom of several undiagnosed conditions.
For example: Asthma; Chronic obstructive pulmonary disease; or Idiopathic pulmonary fibrosis.
Chronic obstructive pulmonary disease , which comprises emphysema and chronic bronchitis, generally present with a long history of cigarette smoking, and gradually progressive dyspnea over a number of years. This condition can be worsened by Covid 19 infection.
A productive cough is a frequent associated symptom, and the sputum may become purulent during exacerbations.
Asthma; - periods of dyspnea frequently alternate with periods of normal breathing. Seasonal and diurnal variations in symptoms are common.
The patient usually perceives wheezing. A productive cough is frequent, particularly during recovery from an acute attack.
Asthma or can be temporary or permanent sequelae of covid infection.
Pulmonary fibrosis.
Patients with pulmonary fibrosis generally present with progressive and relentless dyspnea with a variable time course. Frequently the only associated symptom is a non-productive cough.
Pulmonary fibroses was observed in some patients with post covid conditions.
Treatment:
is dependent on underlying cause of dyspnea but General principles are:
If a patient is a tobacco smoker, this should be discontinued.
Various inhaler therapies may be used in respiratory disease, including short-acting or long-acting bronchodilators, inhaled antimuscarinics, and inhaled corticosteroids.
• Patients with persistent symptoms may benefit from enrollment into a pulmonary rehabilitation program which is key for faster clinical recovery and vaccination against influenza and Streptococcus pneumoniae.
• Controlled breathing exercises and techniques, such as an upright leaning forward position and pursed lip breathing are also beneficial.
• Negative emotions have a major impact on breathlessness perception, while positive emotions reduce the intensity of perception of breathlessness
