With vaccination rates increasing and new infections declining, we all hope the worst of the COVID-19 pandemic is over (fingers crossed really tight). Regardless, the post–COVID-19 syndrome pandemic has already begun. What is post–COVID-19 syndrome (or long-haulers or long-COVID)? Is it standard postviral fatigue? Prolonged deconditioning following debilitating illness? Permanent lung or vascular injury? Common sense and past experience say it's all of these.
In theory, the burden of actual lung injury post-COVID-19 should be the easiest to quantify, so let's discuss what we think we know. I've heard experts break post–COVID-19 lung injury into three broad categories:
Pre-existing lung disease that is exacerbated by acute COVID-19 infection
Acute COVID-19 infection that causes acute respiratory distress syndrome (ARDS) or other acute lung injury (ALI)
Non–critically ill acute COVID-19 with residual lung damage and abnormal repair
These categories are necessarily imprecise, making it challenging to fit some patients neatly into a single definition.
For patients in the first category, management will largely be dictated by the nature of the pre-existing lung disease. For those in category two, we already know a lot about what their recovery from ARDS will look like. There's no longer reason to believe that COVID-19–related ARDS is particularly unique
