Covid: in which situations should I have a check-up after infection?

More than a simple respiratory infection, Covid can have a series of repercussions on the rest of the body – and some of these complications, which affect the heart, lungs and even the brain, can happen even after the first symptoms of the infection improve.

Faced with this risk, in which situations is it indicated to have the popular check-up, that set of tests that evaluates several parameters and signals a disease in its early stages?

Doctors heard by BBC News Brasil indicate that, in general, going through this battery of laboratory tests is not recommended for everyone who has had Covid. In this sense, there is no “cake recipe”, or a general recommendation that serves the huge number of people who have had a positive diagnosis for the disease in recent months.

However, there are at least three groups of patients who may need further post-Covid evaluation: first, those who had severe infection; second, those with chronic diseases, such as hypertension or diabetes; third, individuals who are experiencing some atypical discomfort for a long time.

Understand below why these groups need special attention and which exams are most indicated in these situations.

One disease, many consequences

From the moment the coronavirus enters our body and starts using cells to create new copies of itself, it triggers a series of immune system reactions.

However, in an attempt to contain the infection, the defense cells can end up injuring the organs themselves.

This is largely because the immune system releases a series of substances that, in some patients, generate uncontrolled inflammation, as detailed in an article published in April 2021 in the scientific journal Nature Reviews Rheumatology.

This inflammation, in turn, causes injuries and disrupts the functioning of various structures of the body.

In veins and arteries, for example, this state of inflammatory crisis can destabilize fatty plaques, which are loosened and can block the flow of blood.

This leads to venous thrombosis, pulmonary embolism and even heart attack or stroke.

While all the mechanisms behind this relationship are not fully understood, the effects of Covid could also extend to the pancreas, kidneys, bladder, thyroid and brain.

It is worth remembering that, fortunately, pictures like these are rare — and they became even less common after the arrival of vaccination.

They tend to happen relatively more frequently in individuals who already have some conditions, such as chronic diseases or old age.

But is it possible to detect these complications right away, before they evolve into more complicated outcomes?

The answer is yes, through exams.

Who is the post-Covid check-up for?

The first group that would benefit from a battery of tests, such as blood or imaging tests, are precisely those who had severe Covid.

Often, in the hospital itself, during hospitalization, the team of health professionals already performs some clinical analyzes to detect early changes and avoid the most feared complications, such as a thrombosis or stroke.

In this context, specific medications are also prescribed, which help to control inflammation.

“Exams should be indicated according to individual risk”, explains infectious disease specialist Evaldo Stanislau de Araújo, from Hospital das Clínicas in São Paulo.

“In a patient who has had respiratory failure, is elderly, suffers from immune problems or has already been diagnosed with chronic diseases, such as hypertension and diabetes, it makes more sense to follow up”, adds the doctor, who is also a member of the Paulista Society of Infectious Diseases (SPI). ).

Now, in a young, healthy person who has tested positive for the virus, has only had mild symptoms and is feeling fine after a few days, having such an intense checkup doesn’t make all that much sense.

But even mild and moderate Covid may require further evaluation in people who already had chronic illnesses, such as hypertension and diabetes.

“Often, infection with the coronavirus can decompensate other diseases”, explains infectious disease specialist Valéria Paes, from Hospital Sírio-Libanês in Brasília.

“In these cases, it may be necessary to do some tests and even temporarily adjust the medication to control indices such as blood pressure and blood glucose again”, he adds.

A consultation with the general practitioner, family doctor, cardiologist or endocrinologist helps to carry out this follow-up.

In addition to patients with severe Covid and those with chronic diseases, the third group that may need additional tests are those who are experiencing some atypical discomfort after recovering from the initial infection.

“There are people who come to our offices with complaints of tiredness, as if they can no longer do things as they did before Covid”, says doctor Agnaldo Piscopo, director of the Cardiovascular Emergency Training Center of the Society of Cardiology of the State of São Paulo .

“The other day, a patient complained saying that before he ran 6 km in a good way and now he feels tired after 3 km of walking”, he exemplifies.

In these situations, imaging (such as MRI or CT) and blood tests, in addition to stress tests, help detect any problems with the heart or blood vessels.

In addition to fatigue, the UK National Health System points out that post-Covid some people also experience difficulty breathing, chest pain, memory and concentration problems, difficulty sleeping, palpitations, nausea, joint pain, depression, anxiety, earache, loss of appetite, loss of smell or taste, and redness of the skin.

This long list may (or may not) be related to the coronavirus and exacerbated inflammation.

If any of these symptoms persist for a few weeks, it is important to seek the help of a health professional who, based on the report and evaluation in the office, will indicate specific tests for each situation and prescribe the best treatment available.

– Text originally published in https://www.bbc.com/portuguese/geral-62169054