{"id":9804,"date":"2021-05-24T06:00:13","date_gmt":"2021-05-24T05:00:13","guid":{"rendered":"https:\/\/blogs.bmj.com\/bjsm\/?p=9804"},"modified":"2021-05-24T09:04:38","modified_gmt":"2021-05-24T08:04:38","slug":"long-covid-on-a-long-leash-lets-embrace-the-multidisciplinary-approach","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bjsm\/2021\/05\/24\/long-covid-on-a-long-leash-lets-embrace-the-multidisciplinary-approach\/","title":{"rendered":"Long COVID on a long leash &#8211; let\u2019s embrace the multidisciplinary approach"},"content":{"rendered":"<p><em>Athletes and Post-COVID-19 condition<\/em><\/p>\n<p>For more than a year now the whole world has been fighting the COVID-19 crisis. WHO declared a pandemic on March 11 and it is still ongoing. The great hope is in massive vaccination but the real end is still not clear. What seemed a \u201csimple\u201d respiratory infection at the beginning soon revealed its complex and diverse nature. COVID 19 is a multi-system disease with common prolonged forms.[1]<img loading=\"lazy\" decoding=\"async\" class=\" wp-image-9811 alignright\" src=\"https:\/\/blogs.bmj.com\/bjsm\/files\/2021\/05\/SEM_Doc_Corona.png\" alt=\"\" width=\"730\" height=\"439\" \/><\/p>\n<p><u>Long COVID \u2013 patient-made disease<\/u><\/p>\n<p>Several months after the coronavirus outbreak, patients, which connected through social media, came up with &#8216;Long COVID&#8217;, so their lasting and various symptoms could be acknowledged.[2] The literature now recognises more than 200 different symptoms in 10 organ systems associated with, what WHO calls post-COVID-19 condition. [3,4] The proposed aetiology is a dysfunctional immune-inflammatory response. [5]<\/p>\n<p>While some authors define Long COVID as a syndrome due to its multisystem affection, Prof. Greenhalgh et al. focus their terminology on the time that takes for symptoms to resolve:<\/p>\n<ul>\n<li>3-12 weeks \u2013 post-acute<\/li>\n<li>more than 12 weeks \u2013 chronic.[6]<\/li>\n<\/ul>\n<p>The precise terminology is yet to come as the science needs to answer more important questions.<\/p>\n<p>The World Health Organization has recently highlighted the importance of adequate Long COVID rehabilitation and suggested more systematic research on COVID 19 health consequences.[4] In this global effort the sport community should not be excluded.<\/p>\n<p><u>Athletes and Long COVID<\/u><\/p>\n<p>Many athletes were infected during the coronavirus pandemic, but the extent of Long COVID symptoms among them are not known. The sports and exercise medicine professionals should be able to recognize possible \u201clong haulers\u201d among athletes. Approximately 20% of non-hospitalized COVID-19 patients had long-COVID symptoms &#8211; indicating that healthy individuals with mild clinical presentation can develop long-lasting symptoms.[3,4] Many patients fight persistent symptoms for more than 7 months.[3] Some of the most commonly reported are fatigue, post-extensional malaise, depression, sleep disorders, autonomic dysfunction and they shouldn\u2019t be mistaken for overtraining or relative energy deficiency syndrom in athletes. RTP should be adjusted, re-evaluated and individualized with a multidisciplinary decision making model.<\/p>\n<p>Preliminary data and available guidelines suggest that the general practitioners (GP) are the doctors of choice for \u201clong haulers\u201d.[5,7]\u00a0 This growing group of patients requires holistic approach with accessible multidisciplinary care.[8] Sports and exercise doctors like their GP colleges are capable to understand and offer individualised multidisciplinary rehabilitation model.<\/p>\n<p>WHO\u2019s director general, Tedros Ghebreyesus, stated that the post-COVID 19 condition should be challenged with \u201cthree Rs\u201d\u2014recognition, research, and rehabilitation.[4] Athletes, professional and recreational, after being rehabilitated also need appropriate RTP that is individualised, sport specific and now adapted to experienced post COVID symptoms.<\/p>\n<p><u>Conclusion<\/u><\/p>\n<ul>\n<li>Long COVID can affect athletes and the sports medicine community should prepare for it.<\/li>\n<li>\u201cFour Rs\u201d of sports and exercise medicine facing Long COVID: recognition, research, rehabilitation, and RTP.<\/li>\n<\/ul>\n<p><strong>Authors and Affiliations:<\/strong><\/p>\n<p>Milena Tomovic <a href=\"https:\/\/twitter.com\/MilenaTomovic\">@MilenaTomovic<\/a>, Laboratory of Sports Medicine Aristotle University of Thessaloniki<\/p>\n<p>Lana Krzman @<a href=\"https:\/\/twitter.com\/LKrzman\">LKrzman<\/a>, Faculty of Medicine University of Belgrade<\/p>\n<p>Ivan Stankovic <a href=\"https:\/\/twitter.com\/StankovicID\">@StankovicID<\/a>, Aspetar Orthopaedic and Sports Medicine Hospital<\/p>\n<p>We declare no conflict of interest.<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li>Altmann D M, Boyton R J. Decoding the unknowns in long covid. <em>BMJ<\/em> 2021;372:132.<\/li>\n<li>Callard F, Perego E. How and why patients made Long Covid. <em>Soc Sci Med<\/em> 2021;268:113426.<\/li>\n<li>Davis H, Assaf G, Corkell L, et al. Characterizing long covid in an international cohort: 7 months of symptoms and their impact.\u00a0MedRxiv 20248802 [Preprint]. December 27, 2020. [cited 2021 March 20]https:\/\/doi:1101\/2020.12.24.20248802.<\/li>\n<li>Wise J. Long covid: WHO calls on countries to offer patients more rehabilitation. <em>BMJ<\/em> 2021;372:405.<\/li>\n<li>Greenhalgh T, Knight M. Long COVID: A Primer for Family Physicians. <em>Am Fam Physician<\/em> 2020;102(12):716-717.<\/li>\n<li>Greenhalgh T, Knight M, A&#8217;Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. <em>BMJ<\/em> 2020;370:3026.<\/li>\n<li>Venkatesan P. NICE guideline on long COVID. <em>Lancet Respir Med<\/em> 2021;9(2):129.<\/li>\n<li>The Lancet. Facing up to long COVID. <em>Lancet<\/em> 2020;396(10266):1861.<\/li>\n<\/ol>\n<p><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Athletes and Post-COVID-19 condition For more than a year now the whole world has been fighting the COVID-19 crisis. WHO declared a pandemic on March 11 and it is still ongoing. The great hope is in massive vaccination but the real end is still not clear. What seemed a \u201csimple\u201d respiratory infection at the beginning [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2021\/05\/24\/long-covid-on-a-long-leash-lets-embrace-the-multidisciplinary-approach\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":404,"featured_media":9805,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[16114,16068],"class_list":["post-9804","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-covid-19","tag-featured"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Long COVID on a long leash - let\u2019s embrace the multidisciplinary approach - BJSM blog - social media&#039;s leading SEM voice<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bjsm\/2021\/05\/24\/long-covid-on-a-long-leash-lets-embrace-the-multidisciplinary-approach\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Long COVID on a long leash - let\u2019s embrace the multidisciplinary approach - BJSM blog - social media&#039;s leading SEM voice\" \/>\n<meta property=\"og:description\" content=\"Athletes and Post-COVID-19 condition For more than a year now the whole world has been fighting the COVID-19 crisis. 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