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Hospital Clnic de Barcelona. Long-term respiratory effects can occur Chest pain or tightness. COVID-19 Interim Guidance: Return to Sports and Physical Activity. Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization for COVID-19. 2021 May;8(5):416-427. doi:10.1016/S2215-0366(21)00084-5, Barker-Davies RM, OSullivan O, Senaratne KPP, et al. WebSkip to topic navigation. You may also have: If your COVID-19 infection starts to cause pneumonia, you may notice things like: About 15% of COVID-19 cases are severe. During the initial years of the COVID-19 pandemic, the incidence of invasive pneumococcal disease (IPD) due to Streptococcus pneumoniae declined substantially in multiple countries. First authors are Rogan Grant, Luisa Morales-Nebreda and Nikolay Markov. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. The damage causes tissue to break off and clog your lungs. We saw a higher risk of respiratory failure, dementia, and post-viral fatigue in the COVID-19 group, compared to the lower respiratory tract infection group, but the Shortness of breath (dyspnea) or trouble breathing. If patients with COVID-19 are carefully managed and the health care system isnt overwhelmed, you can get them through it, Budinger said. Objective laboratory or imaging findings should not be used as the only measure or assessment of a patients well-being; normal laboratory or imaging findings do not invalidate the existence, severity, or importance of a patients post-COVID symptoms or conditions. Dr. Arbaje said that the study would help doctors pay attention to a patients perspective and the disease journey they are on. Our first patient was decannulated from ECMO and discharged, but re We werent ready as a healthcare system to deal with COVID-19, so now, we need to be ready to deal with the consequences [of COVID-19].. The participants were 65 years old or older and received a COVID-19 diagnosis before April 1, 2020. Slowly work back Again, this is a theory because if we think about what protects us from heart attacks, strokes, and cancer and other things, its our immune system. Open Forum Infect Dis. That matches with my own clinical practice I practice in a hospital setting, and I have noticed both patients coming in with exacerbations of their underlying disease after COVID-19, but also after vaccination. By continuing to browse, we consider that you accept its use. 2020 Oct;35(10):2838-2844. doi:10.1007/s11606-020-06120-6, Jeon WH, Seon JY, Park SY, et al. Orthostatic vital signsshould be evaluated for individuals reporting postural symptoms, dizziness, fatigue, cognitive impairment, or malaise. Dr. Estores was not involved in the study. It is also possible that some patients with post-COVID conditions will not have had positive test results for SARS-CoV-2 because of a lack of testing or inaccurate testing during the acute period, or because of waning antibody levels or false-negative antibody testing during follow up. The SARS-CoV-2 virus can affect both the upper and lower respiratory tracts. A conservative physical rehabilitation plan might be indicated for some patients (e.g., persons with post-exertional malaise) and consultation with physiatry for cautious initiation of exercise and recommendations about pacing may be useful. Update on long COVID prevalence estimate. Dr. Arbaje said one way to develop the research is by ensuring the findings are more generalizable. If youre in a high-risk group for COVID-19 pneumonia, take these steps to prevent infection: While there are COVID vaccines now available, they donot protect you from pneumonia. The other broad category is those with milder infection not requiring hospitalization, and here, we have fewer answers. 2005 - 2023 WebMD LLC. About 14% of COVID-19 cases are severe, with an infection that affects both lungs. When the virus gets in your body, it comes into contact with the mucous membranes that line your nose, mouth, and eyes. CDC twenty four seven. We have received your information. Doctors call this ground glass.. Based on current information, many post-COVID conditions can be managed by primary care providers, using patient-centered approaches to optimize the quality of life and function of affected patients. COVID-19 pneumonia spreads like multiple wildfires, leaving destroyed lung tissue in its wake, January 11, 2021 Healthcare professionals should also consider the possibility of SARS-CoV-2 reinfection, especially in persons with new or worsening post-COVID conditions, see Guidance for SARS-CoV-2 Reinfection. Patient Led Research for COVID-19, 2020. Web"Gooseberry" held anti-mask and anti-vax views before her fragile husband was diagnosed with lung cancer last year, and she didn't back down from posting disinformation after his diagnosis. Researchers are actively studying the prevalence, mechanism, duration, and severity of symptoms following acute SARS-CoV-2 infection, as well as risk factors associated with post-COVID conditions. Dr. Arbaje said that there are many ways that the healthcare system and broader social and political changes could support people in a post-acute phase of COVID-19. How I Do It: Rapid Design and Implementation of Post-COVID-19 Clinics. Pulmonology Department at Hospital Clnic de Barcelona. 2021 Mar 1. doi:10.2139/ssrn.3769978, Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequalae of COVID-19. Post-acute COVID-19 syndrome. How much or how little should be done? asked Dr. Estores. Photographer Francisco Avia. WebMD does not provide medical advice, diagnosis or treatment. The Stanford Hall consensus statement for post-COVID-19 rehabilitation. Still, it can support your overall health, especially if youre older or have a weak immune system. Additional diagnostic testing should be guided by findings from the patient history and physical examination and results of previous diagnostic testing, and may include a chest x-ray, pulmonary function tests, electrocardiogram, or echocardiogram for persistent or new respiratory or cardiac concerns, although additional studies and more clinical evidence is needed to support the utility of specific imaging tests for evaluation of post-COVID conditions. These mid- and long-term effects are collectively known as post COVID-19 condition or long COVID. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. When health systems are overwhelmed mortality rates double up to 40%.. Some of these types of conditions were also reported in patients following severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two other life-threatening illnesses resulting from coronavirus infections. 2020 Aug 11;324(6):603-605. doi:10.1001/jama.2020.12603, Cellai M, OKeefe JB. For information of CDC research, see Science behind Long COVID. JAMA. treat severe SARS-CoV-2 pneumonia and lessen its damage. Cardiovascular health: Insomnia linked to greater risk of heart attack. National Research Action Plan on Long COVID. NIT is routinely being used for the management of acute respiratory failure secondary to coronavirus disease-2019 (COVID-19) with variable outcomes. Early symptoms include fever, cough, and shortness of breath. You may also breathe faster. The timeline of COVID-19 symptoms will vary between people, but some studies suggest certain symptoms may appear at certain stages of the condition. One is pneumonia, where inflammation causes the small air sacs that make up the lung to fill with fluid. In research, we often limit our studies to one disease and what happens with that one disease. Recognizing and validating the impact of illness on quality of life should be part of the ongoing healthcare professional and patient interaction. COVID-19 pneumonia is a serious illness that can be deadly. Some treatments have been offered that lack evidence of efficacy or effectiveness and could be harmful to patients. 2020 Jun;56(3):339-344. doi: 10.23736/S1973-9087.20.06298-X. Int J Clin Pract. These cookies perform functions like remembering presentation options or choices and, in some cases, delivery of web content that based on self-identified area of interests. Breathe (Sheff). In subgroup analysis by age and severity, there was no significant difference in 28-day survival rate and other indicators. Causes behind painful breathing, fluid buildup. Breathing. Your doctor might recommend cough medicine and pain relievers that reduce fever. Arbous, D.A.M.P.J. WebHere, we report that influenza viral pneumonia leads to chronic nonresolving lung pathology and exacerbated accumulation of CD8 + tissue-resident memory T cells (T RM) in the respiratory tract of aged hosts. Any medical information published on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a healthcare professional. Many people recovering from COVID-19 suffer from long-term symptoms of A person may be experiencing diabetes and hypertension and stroke and COVID-19 not just COVID-19 alone. 2021 Jan 30. doi:10.1093/cid/ciab080. Receive the latest news from our institution directly to your email. Acute Respiratory Distress Syndrome (ARDS). You can review and change the way we collect information below. the increased risk for incidental findings. But in a study published in Nature on January 11, investigators at Northwestern Medicine show COVID-19 pneumonia is different. The research was supported by a NUCATS COVID-19 Rapid Response Grant and grants T32AG020506-18, by T32HL076139 and F32HL151127, HL145478, HL147290, HL147575, GM129312, HL134800, U19AI135964, P01AG049665, P01AG04966506S1, R01HL147575, I01CX001777, U19AI135964, P01AG049665, R56HL135124, R01HL153312, K08HL128867, U19AI135964, R01HL149883, and P01AG049665 from the National Institutes of Health. 2021 Apr;27(4):626-631. doi:10.1038/s41591-021-01292-y, Lund LC, Hallas J, Nielsen H, et al. What do we do? Those are still questions, but now, were asking how we help people recover, how we help them long-term, how we deal with the disability that occurs afterward and how we restructure our healthcare system to deal with a large number of people coming with all these sequelae that this study is starting to highlight. Dr. Alicia Arbaje, So I think this study is important, because it can help for planning purposes to help us see longer-term what we may need. Updated Jan. 27, 2023. Dr. Arbaje also highlighted some of the limitations of the study. Some people, especially those who had severe COVID-19, experience multiorgan effects or autoimmune conditions with symptoms lasting weeks, months, or Is the ketogenic diet right for autoimmune conditions? An intense conflagration in the lungs (regular pneumonia) has a higher risk of death. In the most critical cases, your lungs need help from a machine called a ventilator to do their job. These effects can include severe weakness and. 2021 Mar 30. doi:10.1111/1468-0009.12505, Waltenburg MA, Victoroff T, Rose CE, et al. Huisman, H. Endeman: Incidence of thrombotic complications in critically ill ICU patients with COVID-19, 04.13.2020. Researchers are working to characterize and differentiate the multiple possible etiologies, such as. At this time, no laboratory test can definitively distinguish post-COVID conditions from other conditions with different etiologies, in part due to the heterogeneity of post-COVID conditions. 2009 Dec 14;169(22):2142-7. doi:10.1001/archinternmed.2009.384. Health Care Utilization and Clinical Characteristics of Nonhospitalized Adults in an Integrated Health Care System 28-180 Days After COVID-19 Diagnosis Georgia, May 2020-March 2021. 2020;370:m3026. UChicago Medicine: COVID-19: What we know so far about the 2019 novel coronavirus., Mayo Clinic: Coronavirus disease 2019 (COVID-19), Pneumonia., Loma Linda University Health: Coronavirus disease 2019 (COVID-19)., CDC: Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) -- United States, February 12-March 16, 2020, Coronavirus Disease 2019 (COVID-19): People who are at higher risk for severe illness, Coronavirus Disease 2019 (COVID-19): How to Protect Yourself.Symptoms of Coronavirus, About Cloth Face Coverings,Types of Masks and Respirators., World Health Organization: Coronavirus disease 2019 (COVID-19): Situation Report 46., Cleveland Clinic: Heres the Damage Coronavirus (COVID-19) Can Do to Your Lungs., American Journal of Roentgenology: Early Clinical and CT Manifestations of Coronavirus Disease 2019 (COVID-19) Pneumonia, Relation Between Chest CT Findings and Clinical Conditions of Coronavirus Disease (COVID-19) Pneumonia: A Multicenter Study., UpToDate: Coronavirus disease 2019 (COVID-19): Management in hospitalized adults, Coronavirus disease 2019 (COVID-19): Clinical Features.. doi:10.3390/ijerph17165844, Akinbami LJ, Petersen LR, Sami S, et al. Telehealth visitsmay be helpful for such patients with access to broadband. SARS-CoV-2, the virus that causes COVID-19, is part of the coronavirus family. You might have severe pneumonia or acute respiratory distress syndrome (ARDS). But bacteria, fungi, and other microorganisms can also cause it. Long-term respiratory effects can occur after COVID-19 pneumonia (CP). Clinics for post-COVID conditions have been established at medical centers across the United States, bringing together multidisciplinary teams to provide a comprehensive and coordinated treatment approach to COVID-19 aftercare. Anyone can get COVID-19 pneumonia, but its more likely in people who are 65 or older. Am J Med. What is Paxlovid COVID-19 rebound? Everyone experiences these conditions differently and may want different types of support or even no support at all. anxiety about abnormal results that do not have clinical significance, A basic panel of laboratory tests might be considered for patients with ongoing symptoms (including testing for non-COVID-19-related conditions that may be contributing to illness) to assess for conditions that may respond to treatment (, More specialized testing may not be needed in patients who are being initially evaluated for post-COVID conditions; however, expanded testing should be considered if symptoms persist for 12 weeks or longer (, Patient-Reported Outcomes Measurement Information System (PROMIS) (e.g., Cognitive Function 4a), Post-Covid-19 Functional Status Scale (PCFS), Modified Medical Research Council (mMRC) Dyspnea Scale, Screen for Posttraumatic Stress Symptoms (SPTSS), Hospital Anxiety and Depression Scale (HADS), Connective Tissue Disease Screening Questionnaire. What Im thinking about as a geriatrician is that COVID-19 may be accelerating aging in some way.. On day 7 after admission, the GC group had shorter fever duration and higher white blood cell count than the non-GC group. The lungs are the organ most commonly affected by COVID-19, with a spectrum of severe effects. Dr. Arbaje was also not involved in the study. Three months after discharge from the hospital, all of the patients were able to return to work. The COVID Lung Ultrasound Study (COVIDLUS) aimed to investigate the utility of serial lung ultrasound (LUS) to track functional and physiological recovery after hospitalisation in patients with CP. Case study found that a patient who had Parkinson's Disease and who died after receiving third Covid-19 vaccination had developed necrotizing encephalitis in the Older adults and people who have other health conditions like heart disease, cancer, and diabetes may have more serious symptoms. 2021 May 4. doi:10.1016/j.arcmed.2021.03.010, Cabrera Martimbianco AL, Pacheco RL, Bagattini M, et al. The term post-COVID conditions is an umbrella term for the wide range of physical and mental health consequences experienced by some patients that are present four or more weeks after SARS-CoV-2 infection, including by patients who had initial mild or asymptomatic acute infection. myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), U.S. Census Bureaus Household Pulse Survey, help assess for current or previous infection, myalgic encephalomyelitis/chronic fatigue syndrome, disparities in social determinants of health, Tools for cross-cultural communication and language access. Background: Non-invasive oxygen therapy (NIT) consists of high-flow nasal oxygen (HFNO) and continuous positive airway pressure (CPAP). Web"Gooseberry" held anti-mask and anti-vax views before her fragile husband was diagnosed with lung cancer last year, and she didn't back down from posting disinformation after his diagnosis. This is where oxygen goes into your blood and carbon dioxide comes out. CDC uses the 4-week timeframe in describing post-COVID conditions to emphasize the importance of initial clinical evaluation and supportive care during the initial 4 to 12 weeks after acute COVID-19. We cant look at causation, which is fine for this kind of study because they are open about it, and I think this study is meant to lead to other studies.. And when the immune system receives such a hit, I think it may have less ability, defenses, or physiological reserve to do its other duties, like monitoring for cancer cells, monitoring for the things it normally does., So COVID-19 may accelerate what was already coming if we have tendencies that were coming our way, or it may create new injuries that the body then has to deal with. Most older adults are under traditional Medicare, which would be more representative if the study had focused in that space. That doesnt diminish the importance of the study, but I think it needs to be interpreted among this population, said Dr. Arbaje. Medical treatments plus Stals, M.V. BMJ. Saving Lives, Protecting People, Given new evidence on the B.1.617.2 (Delta) variant, CDC has updated the, The White House announced that vaccines will be required for international travelers coming into the United States, with an effective date of November 8, 2021. Confusion. The study suggests macrophages cells typically charged with protecting the lung can be infected by SARS-CoV-2 and can contribute to spreading the infection through the lung. Ann Intern Med. Congestion. J Prim Care Community Health. There are a couple of caveats in looking at this study. As a result, important information about what was killing patients with severe COVID-19 was missing. Now he's died of Covid pneumonia. COVID-19 can cause severe inflammation in your lungs. Though the effects of hospitalization may not be unique to COVID-19 illness, they are considered post-COVID conditions if they occur after a SARS-CoV-2 infection and persist for four or more weeks. Kant, F.H.J. Clin Infect Dis. American Academy of Pediatrics. At the pulmonary level, it is known that a significant percentage of patients who have had a serious form of the illness present changes to respiratory function after three months of being discharged from hospital. CDC uses the term post-COVID conditions(PCC) as an umbrella term for the wide range of health consequences that can be presentfour or more weeksafter infection with SARS-CoV-2, the virus that causes COVID-19. Accessed at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/962830/s1079-ons-update-on-long-covid-prevalence-estimate.pdf, Buonsenso D, Munblit D, De Rose C, et al. For the General Public: Long COVID (Post-COVID Conditions). The targets are the immune cells: macrophages and T cells. First authors are Rogan Grant, Luisa Morales-Nebreda and, Northwestern recognized for internationalization amid high demand for global education, Hes helping young musicians bridge the gap between art and business, Why we should anthropomorphize COVID-19 and the flu, A majority of Americans have not received the latest COVID booster, study finds, Two Northwestern faculty-led teams celebrate 2022 Chicago Innovation Awards. Pulmonary lesions can be observed in x-ray images of some patients admitted due to COVID. Nat Med. J Gen Intern Med. We aimed to investigate the clinical effects of intravenous glucocorticoid (GC) therapy for severe COVID-19 pneumonia. WebFlu vaccines and anti-pneumonia shots are being looked into as one of countermeasures against COVID-19. As the infection travels your respiratory tract, your immune system fights back. For most patients, the goal of medical management of post-COVID conditions is to optimize function and quality of life. An analysis of the prolonged COVID-19 symptoms survey by Patient-Led Research Team. The study authors found that 32% of the participants who had a SARS-CoV-2 infection in 2020 sought medical attention for a new or persistent condition. The World Health Organization renamed the virus COVID-19 for coronavirus disease 2019. The Lancet Infectious Disease: Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study., National Cancer Institute: NCI Dictionary of Cancer Terms - alveoli., Biophysical Journal: How Viruses Invade Cells., Johns Hopkins Medicine: Coronavirus COVID-19 (SARS-CoV-2)., The Lancet Respiratory Medicine: Pathological findings of COVID-19 associated with acute respiratory distress syndrome., World Health Organization: Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19), Q&A on coronaviruses (COVID-19)., The Lancet: COVID-19: What is next for public health? Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study., UpToDate: Patient education: Acute respiratory distress syndrome (The Basics), Coronavirus disease 2019 (COVID-19)., American Lung Association: Pneumonia Treatment and Recovery., American Thoracic Society: What is Pneumonia?, Radiology: Time Course of Lung Changes On Chest CT During Recovery From 2019 Novel Coronavirus (COVID-19) Pneumonia, Chest CT Findings in Coronavirus Disease-19 (COVID-19): Relationship to Duration of Infection., Translational Lung Cancer Research: Ground-glass nodules of the lung in never-smokers and smokers: clinical and genetic insights.. Signs of this potentially fatal complication. As the infection slowly moves across the lung, it leaves damage in its wake and continuously fuels the fever, low blood pressure and damage to the kidneys, brain, heart and other organs inpatients with COVID-19. According to the Centers for Disease Control and Prevention (CDC), COVID-19 is a respiratory illness. 2021 Apr 22. doi:10.1038/s41586-021-03553-9, Sudre CH, Murray B, Varsavsky T, et al. persistent symptoms and conditions that begin at the time of acute COVID-19 illness, new-onset signs, symptoms, or conditions following asymptomatic disease or a period of acute symptom relief or remission, an evolution of symptoms and conditions that include some persistent symptoms (e.g., shortness of breath) with the addition of new symptoms or conditions over time (e.g., cognitive difficulties), worsening of pre-existing symptoms or conditions, physical deconditioningat baseline or after a prolonged acute disease course that can be nonspecific to COVID-19, physical and mental health consequences of illness with a long or complicated disease course, including depression and anxiety, social, environmental, and economic stressors caused by the COVID-19 pandemic, Post-exertional malaise* and/or poor endurance, differing symptoms or conditions investigated, the temporal criteria used (three weeks up to many months following SARS-CoV-2 infection), the study settings included (outpatient vs. inpatient), how symptoms and conditions are assessed (e.g., self-report vs. electronic health record database), organ damage resulting from acute phase infection, complications from a dysregulated inflammatory state, ongoing viral activity associated with an intra-host viral reservoir. Acta Paediatr. 2nd Floor It can take time to feel better after you have pneumonia. This is not a simple pneumonia or an illness that comes and goes. PMID: 32672029. doi:10.23736/s1973-9087.20.06298-x, Daynes E, Gerlis C, Chaplin E, et al. Further caution may be exercised in ordering imaging in children without a high index of suspicion of pathology. In critical COVID-19 -- about 5% of total cases -- the infection can damage the walls and linings of the air sacs in your lungs. It is observed that 40% display changes to respiratory function a month after discharge, although the large majority of patients can carry out their day-to-day activities with no restrictions. The complex nature of the study, in which samples from patients were analyzed with the most sophisticated technologies available in Northwesterns state-of-the art research labs, required the concerted effort of more than 100 researchers. Challenges in defining Long COVID: Striking differences across literature, Electronic Health Records, and patient-reported information. Symptom inventories and assessment tools, such as those embedded within electronic health records at many healthcare organizations, can help evaluate and monitor the status of post-COVID conditions. The group looked at symptoms to 120 days. Christian Gaebler et al., Nature. People who belong to racial and ethnic minority populations have experienced a higher burden of COVID-19in part because of structural racism and longstanding disparities in social determinants of healthwhich has led to a higher incidence of post-COVID conditions in some of these same populations. Dr. Arbaje speculated that the increase in sequelae in the COVID-19 group could be due to the significant effect of a SARS-CoV-2 infection on a persons immune system, as well as the way COVID-19 can damage many parts of a persons body. WebCOVID-19Common questionWhat does COVID-19 pneumonia cause?The pneumonia that COVID-19 causes tends to take hold in both lungs. He wasn't on FaceBook so his views on the subject are unknown. Scientists took cells from patients lung fluid and looked at the RNA and the proteins those cells express, enabling them to identify how these immune cells drive inflammation. If your doctor takes a CT scan of your chest, the opaque spots in your lungs look like they start to connect to each other. Psychiatry Investig. CDC has updated select ways to operate healthcare systems effectively in response to COVID-19 vaccination. As a result, when the COVID-19 pandemic hit, they were prepared to collect fluid from the lungs of these patients in a safe and systematic manner and compare it with fluid collected from other ICU patients with pneumonia collected before the pandemic. These effects can overlap with multiorgan complications, or with effects of treatment or hospitalization. Long-term respiratory effects can occur after COVID-19 pneumonia (CP). It damages the cells and tissue that line the air sacs in your lungs. Weara face mask if you have to go out. The study suggests macrophages cells typically charged with protecting the lung can be infected by SARS-CoV-2 and can contribute to spreading the infection through the lung. Frequency, signs and symptoms, and criteria adopted for long COVID: a systematic review. Deploying resources to these communities can help ensure disproportionately affected residents are aware of post-COVID conditions and have access to needed services. Experts answer your questions. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. For instance, how safely can we start rehabilitation interventions? 2021 March 11; 21253225. doi:10.3390/ijerph18084350, Parkin A, Davison J, Tarrant R, et al. An integrated multidisciplinary model of COVID-19 recovery care. The researchers then identified new conditions occurring 3 weeks or more after each participants COVID-19 diagnosis. An improvement might be to ask patients about their symptoms rather than basing the study on billing and administrative data. You might also have more serious pneumonia. Clin Infect Dis. It multiplies, and the new viruses infect nearby cells. As the infection slowly moves across the lung, it leaves damage in its wake and continuously fuels the fever, low blood pressure and damage to the kidneys, brain, The Johns Hopkins Post-Acute COVID-19 Team (PACT): A Multidisciplinary, Collaborative, Ambulatory Framework Supporting COVID-19 Survivors. WebCASE SUMMARY: We describe two adults hospitalized for COVID-19 pneumonia who developed ARDS and right-ventricular failure, requiring VV-ECMO and ProtekDuo cannulation. Stock image from the attention at COVID cases in the Emergencies Area. 2021 May 11:e14357. 2021 Jan-Dec;12:21501327211010994. doi:10.1177/21501327211010994, Brigham E, OToole J, Kim SY, et al. Depression as a Mediator of Chronic Fatigue and Post-Traumatic Stress Symptoms in Middle East Respiratory Syndrome Survivors. Complications of Pneumonia Caused by COVID-19 Because pneumonia causes the alveoli in the lungs to fill with pus and fluid, breathing can be painful and difficult. Chron Respir Dis. doi:10.1093/ofid/ofaa420, Logue JK, Franko NM, McCulloch DJ, et al. A fever, a dry cough, and shortness of breath are common early signs of COVID-19.
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