What is a persistent misdemeanor

Corona: consequential damage if the disease progresses slightly

Status: 08/17/2020 11:25 a.m.
Every second Covid 19 sufferer suffers from a cough.

Most of the sick survive an infection with the Sars-CoV-2 coronavirus apparently unscathed. But after a mild course of the disease from Covid-19, those affected are often not completely recovered even after weeks.

VIDEO: Corona: consequential damage even if the disease progresses slightly? (5 min)

Mild course without hospitalization

According to estimates by the World Health Organization, around 80 percent of all Sars-CoV-2 infections are mild. Around every second person affected by symptoms suffers from a cough, 40 percent from a fever - similar to a flu-like infection, but often much more violent and persistent.

After a mild course, many sick people feel fit and fully resilient again very quickly. The course of recovery can, however, be very different from person to person and also depends on possible concomitant illnesses. Even in those affected with a mild course, it is not uncommon for brain involvement with changes in the sense of taste and smell, which usually regress within two to three weeks. In some cases the disorder persists longer.

Possible consequences in the event of a mild course of the disease

After a mild corona illness, some sufferers complain about symptoms for weeks or months, even if the virus is no longer detectable:

  • Disorders of the sense of smell and taste
  • persistent exhaustion and fatigue
  • Difficulty breathing
  • Joint pain

It is not yet known why this is and how long the consequences can last with a mild course of the disease.

Causes of severe courses of Covid-19

Doctors do not know why the disease affects infected people differently. Your assumptions range from genetic disposition to physical fitness to viral load, i.e. the number of viruses. There is even evidence that people with blood group A + could have a higher risk of a severe course than those with other blood groups.

17 percent of the reported patients treated in clinics

According to the Robert Koch Institute, 17 percent of the reported Covid 19 sufferers in Germany are admitted to hospitals.

In the best case, they can be treated in a normal ward and only need a little oxygen to relieve the shortness of breath. Other sufferers need more oxygen, which is supplied through a plastic tube under the nose. Several weeks pass before these sick people feel fit and productive again.

A study from Italy has shown that of 142 people who were in hospital with a corona infection, 87 percent still suffered from symptoms such as exhaustion, shortness of breath and joint pain two months after recovery.

Severe course of the disease with ventilation in the intensive care unit

If a simple dose of oxygen is no longer sufficient, those affected are transferred to the intensive care unit, put into an artificial coma and mechanically ventilated through a tube in the trachea. However, invasive ventilation, which is often required for many days or even weeks with Covid-19, carries risks.

  • The longer the ventilation lasts, the more difficult and tedious it is to wean from machine support, as the body quickly breaks down the muscles needed to breathe. Especially with older people, it is difficult to build up the muscles again.
  • The lungs are sensitive to the excess pressure and the oxygen added to the ventilation air, so that lung tissue can be irreparably damaged. Artificial respiration can also damage other organs.
  • Bacteria can get into the lungs through the tubes and lead to bacterial pneumonia in addition to viral pneumonia.

In general, seriously ill Covid 19 patients need significantly more time to recover than those with other types of pneumonia.

over Long-term consequences is also still little known. Experts expect long-term consequences such as reduced lung volume in the event of severe disease progression and long ventilation. For these people, even light movements are often as stressful as competitive sports.

Researchers in China have observed that people suffer from chronic damage to the lung tissue (pulmonary fibrosis) after severe disease. Damage to the kidneys, liver, brain and nerve cells are also possible consequences. And there is a risk of thrombosis with heart attack, stroke and pulmonary embolism.

Watch recovery carefully

Since no one knows for sure what long-term consequences a coronavirus infection can lead to, doctors should continue to monitor Covid-19 sufferers after they have recovered. Because it is now known that Sars-CoV-2 can affect practically any organ. Sometimes new symptoms appear during the rehabilitation period, which require an individual adjustment of the rehabilitation measures.

As the pandemic progresses, doctors are learning more and more about the course of the disease and the consequential damage caused by Covid-19.

Experts on the subject

Prof. Dr. Tobias Welte, specialist in pulmonology
Acting Vice President and Medical Director of the Hannover Medical School
Carl-Neuberg-Str. 1
30625 Hanover

Prof. Dr. Stefan Schreiber
Director of the Clinic for Internal Medicine I
University Medical Center Schleswig-Holstein, Campus Kiel
24105 Kiel
(0431) 500 222 02

Prof. Dr. Stefan Kluge, Director Clinic for Intensive Care Medicine
Deputy Head of the Center for Anaesthesiology and Intensive Care Medicine
University Medical Center Hamburg Eppendorf
Martinistrasse 52
20251 Hamburg

Dr. Sven-Christian Birkholz, specialist in internal medicine
Lung Center Stade
Pneumological-allergological group practice
Harsefelder Str. 6
21680 Stade
(04141) 797690

Prof. Dr. Carmen disc arch
Specialist in hematology, oncology and specialist immunologist
Head of Immunodeficiency Outpatient Clinic
Institute for Medical Immunology
Charité - University Medicine Berlin

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08/18/2020 | 8:15 pm