Persistierende Beschwerden nach akuter COVID-19-Erkrankung: „Long-COVID“?

Was ist neu?

Prävalenz und Risikofaktoren Die Gesamthäufigkeit von Langzeitbeschwerden ist unklar. Als Risikofaktoren konnten bisher der Schweregrad der Akuterkrankung, weibliches Geschlecht und Grunderkrankungen identifiziert werden.

Klinik und Pathogenese Die Pathogenese ist nicht geklärt. Ebenso unbekannt ist die Prognose über den Verlauf der Beschwerden. Wichtig erscheint ein symptomgeleiteter Ausschluss von behandlungsbedürftigen Alternativdiagnosen. Für den Beschwerdekomplex gibt es bislang weder einen einheitlichen Begriff („Long-COVID“) noch eine einheitliche Definition. Häufig wird die Definition des NICE verwendet, das zwischen anhaltendem COVID-19 bei Beschwerden 4–12 Wochen bzw. einem Post-COVID-19-Syndrom mehr als 12 Wochen nach Akuterkrankung unterscheidet.

Eine verzögerte Rekonvaleszenz oder persistierende Beschwerden scheinen nach COVID-19 häufiger als nach anderen akuten Infektionskrankheiten aufzutreten und beinhalten vor allem ein Erschöpfungssyndrom mit Belastungsintoleranz, Brustschmerzen/Belastungsdyspnoe und verschiedene neurologische bzw. neuropsychiatrische Symptome.

Diagnostik und Therapie Diagnostik und Therapie sollten interdisziplinär erfolgen. Physiotherapie, psychologische/psychosomatische Anbindung und Möglichkeiten der Rehabilitation sollten erwogen werden. Insbesondere bei persistierender pulmonaler Symptomatik können Patienten von einer Rehabilitationsmaßnahme profitieren. Daten zur Effektivität einer Impfung im Sinne eine Beschwerdelinderung bei Long- COVID fehlen.

Persisting symptoms after COVID-19: „Long COVID“?

Some patients complain of persisting symptoms after acute COVID-19. There is no universal definition yet for these post-acute sequelae, also termed Long COVID. Although their prevalence remains to be established, a delayed recovery seems to be more common than after other acute infectious diseases. Common complaints include fatigue with exercise intolerance, dyspnea on exertion, chest pain, and neuropsychiatric symptoms. Female sex, comorbidities, and severity of the acute disease have been identified as risk factors for persisting symptoms. It is, however, important to highlight that they are not limited to patients after severe COVID-19. Whilst their pathogenesis and prognosis is largely unknown, diagnostic evaluation should focus on exclusion of objective organ dysfunctions. Due to the variable presentation, management is interdisciplinary and may include physiotherapy, rehabilitation programmes, and psychological support. This article aims to summarize the current – limited – evidence on persisting symptoms after COVID-19.

Schlüsselwörter

Long-COVID - COVID-19 - SARS-CoV-2 - Post-COVID Syndrom

Key words

Long-COVID - COVID-19 - SARS-CoV-2 - Post-COVID syndrome

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