- Andre Biernath
- bbc brazil
Beyond a simple respiratory infection, covid can have repercussions throughout the body. Some of these complications (affecting the heart, lungs, and even the brain) can occur after the first symptoms of the infection improve.
Faced with this risk,when is it recommended to do the increasingly popular general check-upto evaluate various parameters and indicate the presence of a disease in its early stages?
Doctors consulted by BBC Brazil pointed out that, in general, this compendium of lab tests is not recommended for anyone with covid. In this sense, there is no recipe or recommendation that works for everyone who have had a positive diagnosis in the last few months.
However, there is at least three groups of patients who might need a post-covid evaluation: first, those who have had a severe infection; second, those with chronic diseases such as hypertension or diabetes; and third, individuals who are experiencing some type of prolonged discomfort.
At the BBC, we explain why these groups require special attention and what types of tests are required in these situations.
One disease, different consequences
From the moment the coronavirus enters our body and begins to use cells to create copies of itself, it triggers a series of infections.
Many times, the defense cells of the immune system can end up doing damage to the organs themselves in their attempt to protect the body from invasion.
This mainly occurs because the immune system releases a series of substances that, in some patients, generate uncontrolled inflammation, as detailed in an article published in the journal Nature Reviews Rheumatology in April 2021.
This inflammation, in turn, causes injuries and affects the functioning of various structures in our body.
In veins and arteries, for example, this state of inflammatory crisis can destabilize and block blood flow.
This leads to venous thrombosis, pulmonary embolism, and even heart attacks and strokes.
While the mechanisms involved in this process are not yet fully understood, the effects of covid can also extend to the pancreas, kidneys, bladder, thyroid, and brain.
It is also worth noting that, fortunately, such cases are not common, and have become even less frequent after the arrival of vaccinations.
They also tend to occur more frequently in individuals who have some type of chronic disease or in old age.
But can these complications be detected immediately before they evolve into more complicated conditions?
The answer is yes, through testing.
Who should have a post-covid check-up?
The first group that would benefit from a series of tests such as blood tests or magnetic images are precisely those who had severe covid.
Many times, the team of health professionals perform clinical tests to detect early changes, in addition to avoiding more severe complications, such as thrombosis or stroke.
In this situation, medications are also prescribed to help control inflammation.
“The tests should be indicated according to individual risks,” explains infection expert Evaldo Stanislau de Araújo, from the Hospital das Clínicas in São Paulo, Brazil.
“In a patient who has had respiratory failure, who is an older adult, who suffers from immune problems or who has been diagnosed with chronic diseases, such as hypertension and diabetes, it makes sense to have more follow-up,” adds the doctor, who also is a member of the São Paulo Society of Infectious Diseases.
Now, in a young and healthy person who has tested positive for covid, who has only had mild symptoms and who feels well after a few days, it does not make as much sense to do such an intensive check-up.
What is clear is that even in mild and moderate cases of covid, a more in-depth evaluation may be required if the person suffers from chronic conditions such as hypertension and diabetes.
“Many times, getting infected with the coronavirus can decompensate other diseases,” explains the infectious disease specialist Valeria Paes, from the Sirio Libanés Hospital in Brasilia.
“In these cases, it may be necessary to do some tests and even temporarily adjust medications to get things like blood pressure and glucose under control again.”
A consultation with the general practitioner, family doctor, cardiologist or endocrinologist helps to achieve these check-ups.
In addition to patients who have had severe covid and those with chronic illnesses, the third group that may also require additional testing is those who are experiencing some type of atypical discomfort after recovering from the initial infection.
“There are many people who come to our office complaining of fatigue, as if they could not do the things they did before covid,” says Dr. Agnaldo Piscopo, director of the Emergency Training Center of the São Paulo Society of Cardiology.
“The other day, a patient was complaining that before he could run 6 km at a good pace, and now he gets tired with 3 km walking,” he says to illustrate his point.
In these types of situations, imaging (such as MRIs or CAT scans) and blood tests can help find problems with your heart or blood vessels.
In addition to fatigue, the UK health system, the NHS, warns that after covid, many people may also experience shortness of breath, chest pain, memory and concentration problems, palpitations, nausea, joints, depression and anxiety, ear pain, loss of appetite, loss of smell or taste, and skin redness.
This long list may (or may not) be related to the inflammation caused by the coronavirus.
If any of these symptoms persist for more than a few weeks, it is important to seek help from a health professional who will order specific tests for each situation and will be able to prescribe the best available treatment.
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