Overview of how to diagnose long covid.
An initial medical examination should be done 4 weeks after infection if symptoms persist to rule out organ dysfunction after Covid-19 and other causes of fatigue. If symptoms persist, targeted symptoms-based examinations should be carried out involving respiratory specialists, cardiologists, neurologists, rheumatologists, dermatologists, psychologists or sleep physicians, depending on the symptom.
The primary entry point for the virus is the respiratory tract and the lungs. Many patients complain of shortness of breath not only during acute infection, but also weeks after the initial symptoms have subsided.
The following diagnostic tests are recommended to assess the extent of lung function impairment:
The following laboratory diagnostics can be performed if Long Covid is suspected:
The following cardiological diagnostics are recommended for Long Covid:
Following internal medical diagnostics are recommended for Long Covid:
X-ray of the thoracic organs
sonography and vascular duplex examinations
Post-infectious fatigue symptoms often occur following viral diseases (e.g. Epstein-Barr virus, SARS-CoV-1 virus, Coxsackie viruses). Besides physical and mental exhaustion, patients with fatigue often suffer from the following:
Overall, women are affected more often than men with Long Covid, and younger people (20-50 years) with internal conditions are affected more often than older people. Post-viral fatigue symptoms are often harmless and subside spontaneously within a matter of days or weeks after infection. The persistence of symptoms over several months, especially beyond 6 months, is referred to as chronic fatigue syndrome (CFS). The symptoms and severity of the acute infection have no influence on the development of chronic fatigue.
Various sets of criteria exist for making a diagnosis (e.g. Canadian criteria for the diagnosis of CFS). The Bell score can be used to classify the severity of the disease. Measurement of hand strength and heart rate variability are also important for the diagnosis of CFS.
Serious mental disorders can occur as a direct consequence of a coronavirus infection. We use a variety of health questionnaires in our clinics to systematically diagnose mental comorbidities:
Questionnaire to identify patients with an anxiety disorder:
Questionnaire for the diagnosis of depression
Questionnaire for screening trauma
Depending on the specific damage to the central or peripheral nervous system, neuro-rehabilitation has the task of diagnosing the underlying organ damage (e.g. by means of electrophysiology, imaging) and objectifying damage and activity limitations (standardised assessments).
Smell or taste samples can be used to determine the degree of an impairment to smell or taste.
Neurocognitive impairment is one of the most common long-term symptoms following Covid-19 infection. These can be analysed using standardised and normed test procedures for brain performance diagnostics (paper and pencil, computer tests, computer-assisted test procedures). Neuropsychological procedures provide information on the following areas of performance:
Neuropsychological diagnostics objectifies and quantifies feared, suspected or already known damage- and disease-related disorders of cerebral organic performance, emotional processing, behavioural regulation and control.
There are other specific assessments that can be used for Long Covid: