Browsing by Author "Virtanen, Kaisa"

Abstract Long-lasting symptoms potentially related to Covid-19 have been recognized by medical practitioners and through peer support groups on social media platforms. Currently there is no consensus on detailed clinical picture or prevalence of these symptoms and their underlying pathophysiologies remain largely unexplored. This is a literature review exploring firstly what kind of research has been conducted thus far on post Covid-19 symptoms and medical findings. Secondly, we portray, what is known about the symptom prevalence and medical findings based on the current literature. This thesis includes a structured search on Pubmed looking for three kinds of studies: 1. Symptom prevalence, 2. Medical examination findings and 3. Case studies on rare manifestations. Only studies with PCR/antibody confirmed subjects were included and the symptomatology or medical findings was set only to comprise reports covering the time period at least three weeks after biological confirmation of acute Covid-19. Symptom prevalence across the studies was found very heterogenous. In order to get a deeper insight into this notion, we grouped the studies according to acute illness severity and time point of inquiry/questionnaire after initial illness. However, also this grouping resulted in great variations in the findings within groups, further confirming the initial impression of great variability across study results. In many studies, the inclusion criteria were set only to prior Covid-19 illness and cohort characteristics were poorly described. For these reasons, comparisons across the studies were impaired and it became clear that controlled, more stratified research is warranted in the future. Studies on symptoms lacked control groups further hindering the analysis. Fatigue and dyspnea were most prevalent symptoms in our review. Prevalence of some symptoms such as anosmia and hair loss appeared to be increased compared to our clinical experience on prevalence in population. However, as control groups were lacking, even these observations remained unreliable. With regards to medical examinations, various kinds of abnormal findings were reported. However, control groups were mostly lacking. The impression was that the rate of abnormal findings appeared to be increased. They included e.g. the following: There were signs of pulmonary impairment in a large proportion of chest CT’s with ground glass opacity being the most common finding. In pulmonary function tests, a decreased diffusion capacity was common. Vascular pathologies were explored through large vessel PET, brain PET exploring metabolic rate as an indirect measure of vascular function, nailfold videocapillaroscopy and retinal angiography. Results were suggestive of large vessel vasculitis and brain hypometabolism with varying findings on microvasculature. Cardiac MRIs and echocardiography showed high prevalence of abnormal findings. There were observations of long-lasting dermatologic symptoms. Lowered cognition and psychiatric symptoms were also observed post-acute Covid-19. The key finding was that the disease entity calls for more stratified and defined cohort studies with controls. Organ dysfunction findings seem prevalent and are a good starting point for studies looking into pathophysiologies of post Covid-19 disease entities.