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The disease caused by the new coronavirus detected in 2019 (COVID-19), which arose in the Asian continent and later spread worldwide, has generated more than 3.5 million deaths, in America, 1.6 million have been registered, and in Mexico, around 223,000, in the latter, it is equivalent to 10% of the population that suffered from COVID-19.
With the above, we must take the next step and ask ourselves: do we have to worry about the 90% who survived the acute infection? The answer is yes. The symptoms caused by COVID-19 can continue more than 4 weeks after the onset of the disease and are known as a post-COVID-19 syndrome.
The syndrome has a persistent cough, dyspnea, chest pain, and fatigue, and it may be present in one-third of survivors regardless of the severity of the initial infection1. The cause has not yet been founded; however, we know that the transforming growth factor-beta is involved. This cytokine promotes cell repair through fibrosis, which may explain the persistence of the symptoms2. It can also present with neurological disorders characterized by post-traumatic stress syndrome, neuropathy, and critically ill myopathy, especially in patients who required invasive mechanical ventilation support in intensive care units and general care wards3.
Regarding treatment, there is nothing specific but general recommendations such as identifying the syndrome and documentation of the present symptoms, leaving as a cornerstone the follow-up of patients after hospital discharge without forgetting those who kept at home.
Who can follow up? It can be done by family or general practitioner, with interventions of a pulmonary rehabilitator, and last the pulmonologist and cardiologist if there is an exacerbation of the symptoms4. It should be noted that people who have post-COVID-19 syndrome are predisposed to develop depression, anxiety, and obsessive-compulsive disorder5. Therefore, the purposeful search and evaluation by psychology and psychiatry are essential.
Finally, the post-COVID-19 syndrome can be considered as a chronic disease, which generates the need to implement strategies that include continuing education for health personnel and, above all, the dissemination of information to the general public. It is probably not enough in the months to follow, but no strategy has better results than the one that does not start with a vision for the future since this will be a large percentage of the consultation in general for a long time.
