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It has been reported that various symptoms such as fatigue and dysgeusia continue for a long period of time even after recovery from the new coronavirus infection. In addition, symptoms such as hair loss that were not seen immediately after the onset may appear several months later, and it is said that there are many cases in which it interferes with daily life. Such patients are called "long cobits" and are a major problem with new coronavirus infections.

Lancet.2021 Jan 16; 397 (10270): Drawing from 220-232.

It is said that many patients with coronavirus infection suffer from severe fatigue, sleep disorders, and hair loss even after recovery. According to data from a research group in Wuhan, China, which was reported to Lancet in January this year, about 1,700 patients discharged from a hospital in Wuhan City were interviewed 6 months after discharge, and 76% of the patients complained of some aftereffects. There was also. The breakdown is 63% for fatigue / muscle weakness, 26% for sleep disorders, 22% for hair loss, 11% for sensory disorders, 9% for palpitation, 9% for joint pain, 8% for loss of appetite, and taste disorders. 7%, dizziness 6%, diarrhea / vomiting 5%, chest pain 5%, etc., and the symptoms were diverse.

Corona sequelae are found not only in severely ill patients but also in mildly ill patients. According to data from a research group at the University of Washington in the United States, which was reported in JAMA (American Medical Association) in February this year, 177 patients with new coronavirus infection were followed up for 9 months after the onset, and nearly 90% of the subjects were followed. Approximately 33% of mild outpatients were found to have some aftereffects. In addition, about 6% of mildly ill outpatients had problems with activities of daily living such as housework.

The sequelae of the new corona extend to the mind and nerves. According to data from a research group at the University of Oxford, UK, reported to Lanctt Psychiatry in May this year, about 236,000 cases infected with the new coronavirus infection were analyzed, and about 34% were psychiatric within half a year after diagnosis. I was diagnosed with a neurological disorder. The most common were anxiety disorders (about 17%) and mood disorders (about 14%). Neurological disorders such as stroke and dementia had a low incidence, but were found in a significant proportion of severely ill patients.

On the other hand, according to the data of the research group of the National Center for Global Health and Medical Sciences reported to 0pen Forum Infectious Diseases in October last year, patients who were admitted to the hospital due to a new type of coronavirus infection and were discharged from February to June 2020 63. For example, an interview survey conducted from July to August revealed that hair loss as a sequela was seen in about 24%, and that hair loss did not occur immediately after the onset, and that hair loss often occurred 2 months after the onset. It took more than two months for the hair loss to heal.

It is said that there are many unclear points about the reason for the aftereffects, but it is thought that multiple factors are intertwined. One of them is damage to the organ itself. The new coronavirus has the property of binding to a protein called the human angiotensin converting enzyme (ACE) 2 receptor and invading the cell. ACE2 receptors are present in the lungs, mucous membranes of the nose and tongue, heart, brain, and intestines. Therefore, when the coronavirus proliferates in the cells of the lungs and the cells are damaged, lung function declines and respiratory symptoms such as coughing and shortness of breath appear. Damage to the cells of the mucous membranes of the nose and tongue can lead to dysgeusia and dysgeusia. It is thought that inflammation, which is one of the reactions of cell damage in the heart, leads to palpitation, and inflammation in the brain leads to brain fog (such as deterioration of concentration and memory).

It has also been pointed out that coronavirus can infect cells throughout the body and cause excessive inflammation called cytokine storms, which can damage organs. In addition, even if the coronavirus itself disappears from the body, some immune responses may remain, suggesting that autoantibodies may cause inflammation of various organs and induce symptoms.

There is no radical treatment for corona sequelae, and symptomatic treatment is performed to relieve the symptoms, but when a person with corona sequelae was vaccinated, it became clear that symptoms such as fatigue, suffocation, and sleeplessness improved. I did. According to data from a research group at the University of Bristol in the UK reported to medRxiv in March this year, the improvement rate of aftereffects in the unvaccinated group (22 people) was 15.4%, while that in the vaccinated group (44 people) was 23.2%. It was significantly higher. It is hypothesized that the immune cells activated by vaccination may have eliminated the trace amount of coronavirus that remained in the body even after recovery.

It is hoped that the mechanism of corona sequelae will be elucidated and that effective treatment methods will be developed.