Text / Chen Jieyu (attending physician of the Cardiovascular Center of Cathay General Hospital)
32-year-old Mr. Huang, with no known past medical history, was infected with COVID-19 and SARS-CoV2 in mid-May this year. In addition to common respiratory symptoms, he also suffered from chest tightness, palpitations, asthma and other symptoms. In severe cases, he almost fainted. Symptoms worsened, and he went to the Cardiology Outpatient Clinic.
After examination, it was found that severe arrhythmia was complicated, and the duration of ventricular tachycardia (VT) attack lasted for nearly 20 seconds. After medical treatment and drug control, it has gradually stabilized, and the cardiopulmonary symptoms have gradually improved.
Now the variant virus strain Omicron has a low mortality rate in severe cases. According to current statistics, the overall mortality rate is regarding 2 to 10 per 10,000. However, its transmission is stronger than that of the previous virus strains, and there is a more obvious immune escape phenomenon. There is still a risk of infection following vaccination, but vaccine protection can reduce the mortality rate of moderate and severe cases, because the mortality rate increases once the patient enters the moderate and severe cases. Therefore, the Central Epidemic Command Center of Taiwan recommends early antiviral administration for high-risk patients. Drug treatment to reduce the risk of subsequent cases of severe death.
At present, the vast majority of infections are mostly mild. Even if they do not enter the moderate and severe cases, there are still some infected people who may have residual sequelae. Therefore, the World Health Organization defines: New crown confirmed patients develop persistent symptoms or symptoms within 3 months following infection. The sequelae of more than 2 months are called “Long COVID syndrome”. At present, it is estimated that regarding 1 to 20% of infected people in the world will have this phenomenon following recovery from acute virus infection. It covers a variety of symptoms, including various organs, systems or sensory disorders. Common Have:
(1) Respiratory system: persistent dyspnea, asthma, pulmonary fibrosis, increased respiratory sputum, chronic cough.
(2) Cardiovascular system: palpitations, chest tightness, chest pain, myocarditis, arrhythmia, thrombosis.
(3) Cranial nervous system: anxiety, depression, mood disorders, insomnia, fatigue, brain fog, inattention, cognitive dysfunction.
(4) Bone and joint system: muscle and joint pain, abnormal bone metabolism.
(5) Endocrine system: abnormal thyroid function, changes in the menstrual cycle.
(6) Renal and urinary system: deterioration of renal function, acute kidney injury, changes in urination.
(7) Gastrointestinal and digestive system: abdominal distension, abdominal pain, diarrhea, nausea, nausea, loss of appetite, gastroesophageal reflux.
(8) Skin system: skin rash, ulcer, hair loss. multisystem
(9) Multisystem inflammatory syndrome (MIS), including MIS-C (MIS in children) in children and MIS-A (MIS in adults) in adults.
Regarding the cardiovascular system, a recent US study found that patients infected with COVID-19 had an increased incidence of the following complications following 12 months compared with the control group:
Cardiovascular complications are regarding 4.5%, major adverse cardiovascular events (including myocardial infarction, stroke, total mortality) are regarding 2.3%, and arrhythmia is regarding 2.0% (more than half of which are atrial fibrillation).
Other cardiovascular disorders (including heart failure and non-ischemic cardiomyopathy) are regarding 1.3%, thromboembolic disorders are regarding 1.0%, and ischemic heart disease is regarding 0.7% (70% of them are acute coronary heart disease, And 4 is myocardial infarction), cerebrovascular disease is regarding 0.5% (7 of them are stroke), 0.1% is heart or pericardium inflammatory disease (including pericarditis and myocarditis).
Recent studies have also analyzed the risk factors for Omicron variant virus to develop into severe disease: including unvaccinated individuals, especially males aged 40-64 with two or more comorbidities, or patients over 65 years old with multiple comorbidities. However, Vaccinated patients under the age of 65 have a lower risk of developing severe disease following contracting COVID-19.
In the current post-epidemic period when the world is gradually unblocking and opening up, it is necessary to do personal epidemic prevention, enhance self-immunity, and give high-risk patients oral antiviral drugs in advance, and give necessary injection antiviral drugs, immunomodulatory drugs, etc. Supportive care and breathing assistance are the most important topics today. Do not listen to the Internet or rumors, and accept treatment or remedies without scientific evidence, so as to avoid harming your health.
