What is Post-Viral Syndrome?

Post-viral syndrome is a spectrum of symptoms that stay on after infection with a virus. It can affect various body systems such as the nervous, musculoskeletal, and even the respiratory system.

Sometimes, people suffer psychological symptoms. Post-viral syndrome can last for a few weeks to months or years and its severity varies among different people.

However, it seems to be more common among women. It is unclear whether this is due to differences in reporting.

Over the years, scientists have tried to understand the mechanism of post-viral syndrome through clinical research with limited success.

The emergence of COVID-19 has put a spotlight on post-viral syndrome, many people infected during the pandemic have lingering symptoms even years later.

How do I know if I have post-viral syndrome?

The symptoms of post-viral syndrome are broad, with chronic fatigue and aches and pains most often reported. Other symptoms include:

• Sleep disturbances
• Loss of ability to think clearly
• Neurological abnormalities
• Weakness
• Impaired memory
• Headaches
• Muscle pains
• Joint aches
• Depression
• Rashes

A recent NIH study of Long COVID symptoms has identified several more potential post-viral symptoms.

Chronic Fatigue

Many studies have been done to try and understand fatigue as a feature of post-viral syndromes.

A significant number of people affected by the COVID-19 virus and those who recovered from the SARS of 2003 have lingering fatigue. For some, the symptoms are so severe that they haven’t been able to resume their jobs.

This fatigue is typically not relieved by rest or sleep.

Which Viruses Can Cause Post-Viral Syndrome?

Post Viral syndrome can follow different kinds of viral infections. Viruses most commonly associated with Post-Viral syndrome include:

• Epstein Barr Virus
• Cytomegalovirus
• Ross River Virus
• Enterovirus
• Rubella
• Bornavirus
• Human herpes virus 6

Many other viruses have the potential to cause lingering symptoms. An example is post-polio syndrome which occurs many years after the primary polio infection and mainly affects the muscular system.

How Post Viral Syndrome Occurs

It is not clear how Post-Viral syndrome occurs. However, scientists have proposed several ideas that might explain the condition.

Inflammation appears to be a common mechanism underlying many of the symptoms affecting diverse organs. It has been posited that in responding to the initial infection, the immune system becomes disregulated, leading to chronic inflammation.

A second proposition is the possibility of the viruses reactivating and causing symptoms after the initial immune response wanes.

Experts have also shown the psychological lasting effects of a viral infection originate from the stresses that come with the disease condition. Some people suffer from post-traumatic stress disorder following a severe viral illness.

Who Gets Affected?

Anyone who gets infected with a viral infection can develop post-viral syndrome, but some predisposing factors also exist.

For instance, it has been demonstrated that people infected with COVID-19 are more likely to experience long-term symptoms compared to those affected with the other viruses listed previously.

The CDC states that people who have been vaccinated against COVID-19 are less likely to suffer from Post-Viral syndrome compared to those who are unvaccinated.

Getting recurrent infections also adds to the risk that you could develop Post-Viral syndrome.

People who had more symptoms during the initial infection are more likely to suffer from chronic symptoms.

Other factors contributing to Post-Viral syndrome include old age and the presence of underlying health conditions.

Diagnosis

Currently, there are no specific laboratory markers that can be used to diagnose the condition. It is a diagnosis of exclusion where the doctor has to rule out any other possible causes of the symptoms.

Examples of Post Viral Syndrome

Long COVID

Following the COVID-19 pandemic, researchers have been studying the long-term effects of the virus. The post-viral syndrome associated with COVID-19 is now referred to as Long COVID or post-acute sequelae of SARS-CoV-2.

The definition of Long COVID according to the CDC is the presence of symptoms four weeks or more after the initial COVID infection. The symptoms vary in severity and they can have a progressive pattern or they can be intermittent.

Myalgic Encephalitis/Chronic Fatigue Syndrome

Chronic fatigue syndrome is a condition characterized by extreme fatigue that is not relieved by rest. The origin of the condition is not clear but available data shows some association with some viral infections.

Most affected people report flu-like symptoms prior to chronic fatigue and even relapses in the long term.

Post-Polio Syndrome

Post-polio syndrome is a little different to the other post-viral syndromes listed. In this case, it refers to the phenomenon whereby 15 to 40 years after an initial exposure to Polio, patients begin to experience symptoms such as muscle weakness, fatigue, muscular atrophy (shrinking), and skeletal problems related to points of mobility. These symptoms are thought to be caused by damage to the motor neurones that operate those muscles and joints during the original infection. Over many years the damage becomes more significant and difficult for the body to compensate for, leading to deterioration. Sadly there are no treatment options cutrently available but mobility aids can be useful in aiding daily life. More information on clinical trials and support is available through Post-Polio Health International.

Is There a Treatment?

There is no single treatment for post-viral syndrome. This is largely because it is yet to be understood well and as many roads lead to Rome, it might also have numererous underlying causes.

However, coping mechanisms have been devised to help maintain a quality of life and prevent the progression of symptoms.

Most of the approaches to managing these conditions are aimed at symptomatic relief. Because the condition can last for a long time, you may need to make lifestyle adjustments in order to cope.

Experts recommend exercising regularly and within tolerable limits to manage fatigue.

Improving sleep hygiene and setting up a routine can relieve sleep disturbances. If symptoms persist, your doctor may prescribe some pills or even refer you to a sleep specialist.

Behavioral therapy helps to relieve symptoms of anxiety and post-traumatic stress. Lastly, people who experience chronic pain can be enrolled in physical therapy and trained in coping mechanisms.

Make sure to see a doctor if you need a recommendation and prescription to deal with pain.

Conclusion

Post-viral syndrome is a condition where one experiences symptoms following a viral infection. The symptoms might recur or the individual might have new symptoms altogether. The exact mechanism of how the symptoms occur is not clear.

The symptoms of post-viral syndrome vary between people and they can be mild or severe and disabling. Long COVID is one of the post-viral conditions that have been researched widely.

The remedies for the post-viral syndrome include both medical and non-medical approaches. Psychological stresses can be relieved by behavioral therapy.

References

Long COVID or post-COVID conditions. Centers for Disease Control and Prevention. Accessed August 27, 2023. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html.
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Centers for Disease Control and Prevention. May 18, 2023. Accessed August 27, 2023. https://www.cdc.gov/me-cfs/index.html.
Perrin R, Riste L, Hann M, Walther A, Mukherjee A, Heald A. Into the looking glass: Post-viral syndrome post COVID-19. Med Hypotheses. 2020;144:110055. doi:10.1016/j.mehy.2020.110055
Pervan Z. Postviral syndrome. Med J Aust. 1987 Nov 16;147 (10):524. doi: 10.5694/j.1326-5377.1987.tb133446.x. PMID: 3683273.
Yamato M, Kataoka Y. Fatigue sensation following peripheral viral infection is triggered by neuroinflammation: who will answer these questions?. Neural Regen Res. 2015;10(2):203–204. doi:10.4103/1673-5374.152369

US National Institute of Health. National Institute of Neurological Disorders and Stroke. Health Information: Post- Polio Syndrome. Accessed September 18 2023.