Covid19 infection is a major process that affects multiple organs and systems simultaneously and profoundly. This leads to significant biological wear and tear and consequences that must be managed to avoid sequelae and minimize possible further damage as much as possible.
- Most frequent symptoms:
It is very common to perceive different discomforts after overcoming the acute infection. One of the most important symptoms is dyspnea (shortness of breath), more frequent in relation to physical exertion. A check-up is mandatory in this case.
Other common symptoms are severe fatigue (asthenia), joint pain, chest pain, headache (cephalalalgia) and taste and smell disorders.
- When a check-up is advisable:
If the case has been controlled at home, it is advisable to have a check-up no earlier than 4 weeks after the onset of symptoms. It is important to go to appropriate and labeled centers for this pathology and always communicate at the time of the appointment the reason for the consultation. In this way, the safety of the patients is ensured in circuits established in the centers to avoid risky contacts and to limit the safe dates for a physical presence visit.
It happens that patients make appointments without taking these aspects into account, coming to consultations in the acute phase of the disease when contagion is possible, a situation that both patients and healthcare professionals should avoid.
In case of having been hospitalized at discharge, the date of review will be set, which is marked by medical order, according to the evolution of each case.
- Physical exercise:
After Covid infection, the convalescence period should adapt the care to the capacity of the organism, which will normalize in the following weeks. A complete and correct diet, rich in proteins and fresh vegetables and fruits (vitamins), is of vital importance.
Physical exercise should be gradual but never forcing the individual’s capacity, it should be consulted when to do sport again. It is important to observe if there are alterations in muscle power, sensitivity and respiratory distress on exertion to rule out complications.
- Advice:
The ideal after overcoming Covid19 infection, is to undergo a review in Internal Medicine. Especially in non-hospitalized cases (where medical control is being more limited). This review will include a medical evaluation and complementary tests to assess the status of the organism, paying attention to the main target organs of the infection. Depending on the results of this medical examination and tests, the life regimen and pharmacological treatment will be adjusted. For example, pulmonary involvement with reduced ventilatory capacity is very frequent, sometimes even requiring physiotherapy. Coagulation alterations often occur without symptoms and are only evident if they are studied in the analysis, and require specific treatment to avoid complications (thrombosis).
- Negative tests:
There are different diagnostic tests for Covid19. The indication for each of them is different depending on the time of symptoms, exposure, the patient’s risk situation and the time of evolution of the disease.
The cost-effectiveness and diagnostic reliability of the tests also depend on whether they are correctly indicated.
In the first phase of the disease, the first 7 days, PCR is very reliable, but after this time its diagnostic yield decreases. Antibodies require an average of 14 days from the onset of the disease to appear in the blood.
Therefore, a specialist in Internal Medicine should be the one to prescribe what type of test should be done in each clinical case and at each moment of the clinical evolution. Only by correctly calculating the number of days and the patient’s risk, will the most appropriate test be chosen. Otherwise, we may encounter false negative tests, for example if we perform PCR in a patient who has been evolving for more than 9 days. It is a problem that people perform tests on their own without having been evaluated by professionals. If a false negative is suspected, the physician will indicate a 14-day quarantine period in order to obtain antibodies in the blood and avoid contagion. After this period, the diagnosis is confirmed with a serology that also informs of the individual’s potential for contagion.
Therefore, it is necessary that an expert assesses the test result and the patient’s context to indicate the isolation measures, preventive quarantine and its duration, and possible subsequent control or confirmation tests.
In recent times, a lot of confusing and varied information has been spread and it may have been transmitted to the population that it is apparently a simple issue, but this is not so. It is a complex subject from a technical point of view that must be handled by experts for patient safety.