Table 2.

Post–COVID-19 Sequelae

System	Sequelae
•Persistent presenting symptoms	•At least one persistent symptom (particularly fatigue and dyspnea) evident at 60.3 ± 13.6 days from the onset of first SARS-CoV-2 symptoms in patients recovering from moderate-to-severe SARS-CoV-220 •Fatigue or muscle weakness,14 , 21 sleep difficulties, anxiety, depression,14 loss of sense of smell or taste21 •Negative impact on at least one activity of daily living including performance of household chores at 31-to-300 days after the symptom onset21 •A small proportion of recovering healthcare workers reported long-term moderate to marked disruption of their work life for a minimum of two months after infection22
•Respiratory	•Persistent radiologic abnormalities consistent with pulmonary dysfunction such as interstitial thickening and evidence of fibrosis at three months after discharge23 •Decreased diffusion capacity for carbon monoxide at three months after discharge24 •Median six-minute walking distance lower than the lower limit of the normal range at 175-to-199 days after the onset of symptoms14 •Pulmonary diffusion impairment at 175-to- 199 days after the onset of symptoms14 •Severe diaphragmatic myopathy that may lead to diaphragm weakness and might contribute to ventilator weaning failure25
•Cardiovascular	•Abnormal screening results in athletes 19 ± 17 days after the onset of symptoms including26: •Elevated cardiac troponin defined as a level greater than the 99th percentile of the reference laboratory value •Abnormal ECG findings •Abnormal echocardiography findings •Cardiac magnetic resonance imaging findings suggesting inflammatory heart disease (eg, myocarditis, pericarditis) •Elevated troponin values on admission were associated with higher mortality and a greater risk of cardiovascular and noncardiovascular complications27 •Supraventricular and ventricular arrhythmias28 •A high burden of neutrophil extracellular traps in the coronary thrombi of patients with ST-elevated myocardial infarction29 •SARS-CoV-2 may cause heart failure with preserved ejection fraction (HFpEF), may unmask subclinical HFpEF, or may exacerbate existing HFpEF30 •Right ventricular dysfunction, dilatation, or pulmonary hypertension31 •Acute cor pulmonale with altered two-dimensional speckle-tracking echocardiography (2D-STE)-derived parameters, especially right ventricular longitudinal shortening fraction (RV-LSF) in patients with moderate-to-severe COVID-19 infection receiving mechanical ventilation32
•Thromboembolism	•Increased risks for •A venous thromboembolism33 •Pulmonary embolism33 •Arterial thromboembolism (eg, ischemic stroke, myocardial infarction, and systemic thromboembolism)33
•Neurologic	•Headache, vertigo, and chemosensory dysfunction (eg, anosmia and ageusia) are the commonest prolonged symptoms.34 •Stroke, encephalitis, seizures, major mood swings, and “brain fog” at 2 to 3 months after initial illness onset are reported commonly.21 , 35 •Delirium including increased risks for impaired consciousness, disorientation, hypoactive delirium symptoms, and agitation or hyperactive delirium symptoms.36
•Mental	•Increased risks for •Serious distress symptoms37 •Major depressive disorder more in women than men at 4.2 ± 2.7 months after the onset of symptoms38 •Suicidal ideation39 •Increased substance use39
•Renal	•Acute kidney injury (AKI) with an accelerated decrease in estimated glomerular filtration rate40
•Gastrointestinal	•A higher rate of gastrointestinal complications, including mesenteric ischemia, in critically ill patients with SARS-CoV-2 disease41

Abbreviations: COVID-19, coronavirus disease 2019; ECGtb1fn1, electrocardiogram; SARS-COV-2, severe acute respiratory syndrome coronavirus 2.