POST-COVID Conditions 


COVID-19, the renowned celebrity virus, with multiple symptoms, is an infectious disease caused by a virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initially, most people infected with the COVID-19 virus experienced mild to moderate respiratory illness and recovered without requiring special treatment. It spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. 

As time passed, with new variants of the virus, new symptoms have flourished affecting various parts of the human body. Talking in this context, Multiorgan effects can affect most, if not all, body systems including heart, lung, kidney, skin, and brain functions. Multiorgan effects can also include conditions that occur after COVID-19, like multisystem inflammatory syndrome (MIS) and autoimmune conditions. MIS is a condition where different body parts can become swollen. Autoimmune conditions happen when your immune system attacks healthy cells in your body by mistake, causing painful swelling in the affected parts of the body. It is unknown how long multiorgan system effects might last and whether the effects could lead to chronic health conditions.

Nepal, a landlocked country aspiring to graduate from a Least Developed Country status, stands highly vulnerable to the unfolding COVID-19 pandemic. Heedful of its vulnerabilities, the Government of Nepal has enforced a nationwide lockdown and activated its federal, provincial and local level mechanisms to respond to the crisis. Nepal Government has reported over 620K COVID-19 cases and total deaths of 9500 as of 20 June 2021. 


 Approved Vaccines:


  1. The Pfizer/BioNTech Comirnaty immunization (created by an American pharmaceutical company, Pfizer, a German biotechnology company, Biotech) was recorded for WHO Emergency Use Listing (EUL) on 31 December 2020. 

  2. The SII/Covishield and AstraZeneca/AZD1222 immunizations (created by AstraZeneca/Oxford and made by the State Institute of India and SK Bio separately) were given EUL on 16 February. 

  3. The Janssen/Ad26.COV 2.S created by Johnson and Johnson was recorded for EUL on 12 March 2021. 

  4. The Modena COVID-19 antibody (mRNA 1273) was recorded for EUL on 30 April 2021 The Sino pharm COVID-19 immunization was recorded for EUL on 7 May 2021. 

  5. The Sinopharm antibody is delivered by Beijing Bio-Institute of Biological Products Co Ltd, auxiliary of China National Biotec Group (CNBG). 

  6. The Sinovac-CoronaVac was recorded for EUL on 1 June 2021. (World Health Organization, 2020).



New or Ongoing Symptoms:


  • Difficulty breathing or shortness of breath

  • Tiredness or fatigue

  • Symptoms that get worse after physical or mental activities

  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”)

  • Cough

  • Chest or stomach pain

  • Headache

  • Fast-beating or pounding heart (also known as heart palpitations)

  • Joint or muscle pain

  • Pins-and-needles feeling

  • Diarrhea

  • Sleep problems

  • Fever

  • Dizziness on standing (lightheadedness)

  • Rash

  • Mood changes

  • Change in smell or taste

  • Changes in period cycles

  • Excessive sweating 

  • Throat pain and irritation


The basic Preventive Measures:


  • Clean your hands often

  • Cough or sneeze in your bent elbow - not your hands!

  • Avoid touching your eyes, nose, and mouth

  • Limit social gatherings and time spent in crowded places

  • Avoid close contact with someone who is sick

  • Clean and disinfect frequently touched objects and surfaces


POST-COVID Conditions 


The term “Post-COVID Conditions” is an umbrella term for the wide range of physical and mental health consequences experienced by some patients that are present four or more weeks after SARS-CoV-2 infection, including by patients who had the initial mild or asymptomatic acute infection. These consequences include both general complications of prolonged illness as well as hospitalization and post-acute sequelae of SARS-CoV-2 infection (PASC), which are more specific to the effects of SARS-CoV-2 infection 


Multiple possible onset patterns for post-COVID conditions have been identified that further exemplify their heterogeneity, including, but not limited to:  


(A) persistent symptoms and conditions that begin at the time of acute COVID-19 illness;  


(B) new-onset late sequelae following asymptomatic disease or a period of acute symptom relief or remission; or  


(C) evolution of symptoms and conditions that include some persistent symptoms (e.g., shortness of breath) with the addition of new symptoms or conditions over time (e.g., cognitive difficulties). 


Some presentations may share similarities with other postviral syndromes, such as myalgia encephalomyelitis/chronic fatigue syndrome (ME/CFS), dysautonomia (e.g., postural 1 orthostatic tachycardia syndrome [POTS]), or mast cell activation syndrome (MCAS 


Types of Post-COVID Condition 


Long COVID  

Long COVID is a range of symptoms that can last weeks or months after first being infected with the virus that causes COVID-19 or can appear weeks after infection. Long COVID can happen to anyone who has had COVID-19, even if the illness was mild, or had no symptoms. People with long COVID report experiencing different combinations of the following symptoms:  


  • Tiredness or fatigue  

  • Difficulty thinking or concentrating (sometimes referred to as “brain fog”) 

  • Headache  

  • Loss of smell or taste  

  • Dizziness on standing  

  • Fast-beating or pounding heart (also known as heart palpitations) 

  • Chest pain  

  • Difficulty breathing or shortness of breath 

  • Cough Joint or muscle pain  

  • Depression or anxiety  

  • Fever 


Effects of COVID-19 Treatment or Hospitalization  

Post-COVID conditions also can include the longer-term effects of COVID-19 treatment or hospitalization. 


  • Some of these longer-term effects are similar to those related to hospitalization for other respiratory infections or other conditions. 


  • Effects of COVID-19 treatment and hospitalization can also include post-intensive care syndrome (PICS), which refers to health effects that remain after a critical illness. These effects can include severe weakness and post-traumatic stress disorder (PTSD). PTSD involves long-term reactions to a very stressful event 



Before ordering laboratory testing for post-COVID conditions, the goals of testing should be clear to the healthcare professional and to the patient. Laboratory testing should be guided by the patient’s history, physical examination, and clinical findings.