• VIJAYALAXMI A. SHENDE Wellness Assessment Centre, Aditya Birla Memorial Hospital, Chinchwad, Pune-411033, Maharashtra, India



Post-COVID-19, Infections, Symptomatology, Diabetes, Obesity


This comprehensive review offers a multifaceted analysis of post-COVID-19 infections, encompassing diverse aspects of this evolving health concern. In the realm of symptomatology, we explore both common and rare symptoms observed in individuals recovering from COVID-19, shedding light on the intricacies of post-acute sequelae. Moving forward, we delve into the association between COVID-19 and diabetes along with glucose intolerance, analyzing the incidence of these metabolic conditions in the post-COVID era. Another critical dimension of our analysis is the examination of the potential direct association between COVID-19 and obesity, considering the implications of this relationship on public health. Furthermore, we trace the evolution of treatment strategies across the pandemic's waves, providing a comprehensive review of approaches taken during the 1st, 2nd, and 3rd waves, along with discussions on current government-recommended treatment and management protocols. As we navigate the ongoing challenges presented by post-COVID-19 conditions, this article aims to serve as a valuable resource for healthcare professionals, researchers, and individuals seeking a deeper understanding of the multifaceted nature of these infections and their implications for healthcare and public health strategies. Concluding remarks, this comprehensive review underscores the complex landscape of post-COVID-19 infections, ranging from symptomatology to metabolic associations and treatment strategies. It serves as a vital resource for understanding the multifaceted implications of these conditions on healthcare and public health efforts.


Download data is not yet available.


Pollard CA, Morran MP, Nestor Kalinoski AL. The COVID-19 pandemic: a global health crisis. Physiol Genomics. 2020 Nov 19;52(11):549-57. doi: 10.1152/physiolgenomics.00089.2020, PMID 32991251.

Proal AD, VanElzakker MB. Long COVID or post-acute sequelae of COVID-19 (PASC): an overview of biological factors that may contribute to persistent symptoms. Front Microbiol. 2021 Jun 23;12:698169. doi: 10.3389/fmicb.2021.698169, PMID 34248921.

Kamal M, Abo Omirah M, Hussein A, Saeed H. Assessment and characterization of post‐COVID‐19 manifestations. Int J Clin Pract. 2021 Mar;75(3):e13746. doi: 10.1111/ijcp.13746, PMID 32991035.

Xie L, Zhang Z, Wang Q, Chen Y, Lu D, Wu W. COVID-19 and diabetes: a comprehensive review of angiotensin-converting enzyme 2, mutual effects and pharmacotherapy. Front Endocrinol. 2021 Nov 19;12:772865. doi: 10.3389/fendo.2021.772865, PMID 34867819.

Katsoulis M, Pasea L, Lai AG, Dobson RJB, Denaxas S, Hemingway H. Obesity during the COVID-19 pandemic: both cause of high risk and the potential effect of lockdown? A population-based electronic health record study. Public Health. 2021 Feb 1;191:41-7. doi: 10.1016/j.puhe.2020.12.003, PMID 33497994.

Organization for Economic Co-operation and Development. The territorial impact of COVID-19: managing the crisis and recovery across levels of government. OECD Publishing; 2021.

Sherif ZA, Gomez CR, Connors TJ, Henrich TJ, Reeves WB, Recover Mechanistic Pathway Task Force. Pathogenic mechanisms of post-acute sequelae of SARS-CoV-2 infection (PASC). eLife. 2023 Mar 22;12:e86002. doi: 10.7554/eLife.86002, PMID 36947108.

Joli J, Buck P, Zipfel S, Stengel A. Post-COVID-19 fatigue: a systematic review. Front Psychiatry. 2022 Aug 11;13:947973. doi: 10.3389/fpsyt.2022.947973, PMID 36032234.

Nalbandian A, Sehgal K, Gupta A, Madhavan MV, McGroder C, Stevens JS. Post-acute COVID-19 syndrome. Nat Med. 2021 Apr;27(4):601-15. doi: 10.1038/s41591-021-01283-z, PMID 33753937.

Ahmed I, Mustafaoglu R, Yeldan I, Yasaci Z, Erhan B. Effect of pulmonary rehabilitation approaches on dyspnea, exercise capacity, fatigue, lung functions, and quality of life in patients with COVID-19: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2022 Jul 29;103(10):2051-62. doi: 10.1016/j.apmr.2022.06.007, PMID 35908659.

Melendez Oliva E, Martinez Pozas O, Cuenca Zaldivar JN, Villafane JH, Jimenez Ortega L, Sanchez Romero EA. Efficacy of pulmonary rehabilitation in post-COVID-19: a systematic review and meta-analysis. Biomedicines. 2023 Aug 7;11(8):2213. doi: 10.3390/biomedicines11082213, PMID 37626710.

Taquet M, Dercon Q, Luciano S, Geddes JR, Husain M, Harrison PJ. Incidence, co-occurrence, and evolution of long-COVID features: a 6 mo retrospective cohort study of 273,618 survivors of COVID-19. PLOS Med. 2021 Sep 28;18(9):e1003773. doi: 10.1371/journal.pmed.1003773, PMID 34582441.

Ceban F, Ling S, Lui LMW, Lee Y, Gill H, Teopiz KM. Fatigue and cognitive impairment in post-COVID-19 syndrome: a systematic review and meta-analysis. Brain Behav Immun. 2022 Mar 1;101:93-135. doi: 10.1016/j.bbi.2021.12.020, PMID 34973396.

Rabaiotti P, Ciraci C, Donelli D, Oggioni C, Rizzi B, Savi F. Effects of multidisciplinary rehabilitation enhanced with neuropsychological treatment on post-acute SARS-CoV-2 cognitive impairment (brain fog): an observational study. Brain Sci. 2023 May 12;13(5):791. doi: 10.3390/brainsci13050791, PMID 37239263.

Raman B, Bluemke DA, Luscher TF, Neubauer S. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J. 2022 Mar 14;43(11):1157-72. doi: 10.1093/eurheartj/ehac031, PMID 35176758.

Hasan LK, Deadwiler B, Haratian A, Bolia IK, Weber AE, Petrigliano FA. Effects of COVID-19 on the musculoskeletal system: clinician’s guide. Orthop Res Rev. 2021 Sep 21;13:141-50. doi: 10.2147/ORR.S321884, PMID 34584465.

Groff A, Kavanaugh M, Ramgobin D, McClafferty B, Aggarwal CS, Golamari R. Gastrointestinal manifestations of COVID-19: a review of what we know. Ochsner J. 2021 Jun 20;21(2):177-80. doi: 10.31486/toj.20.0086, PMID 34239378.

Davis HE, McCorkell L, Vogel JM, Topol EJ. Long COVID: major findings, mechanisms and recommendations. Nat Rev Microbiol. 2023 Mar;21(3):133-46. doi: 10.1038/s41579-022-00846-2, PMID 36639608.

Sequeria Rodriguez P, Santana Ortiz R, Ortiz Hernandez E. Late onset and persistent parosmia and dysgeusia as a neurosensorial complication by the SARS virus COV 2. Otolaryngol Case Rep. 2023 Mar 1;26:100510. doi: 10.1016/j.xocr.2023.100510, PMID 36691459.

Pedrosa AL, Bitencourt L, Froes ACF, Cazumba MLB, Campos RGB, de Brito SBCS. Emotional, behavioral, and psychological impact of the COVID-19 pandemic. Front Psychol. 2020 Oct 2;11:566212. doi: 10.3389/fpsyg.2020.566212, PMID 33117234.

Coronavirus disease (COVID-19): post COVID-19 condition. Who. Int. Available from: [Last accessed on 29 Sep 2023]

Levine RL. Addressing the long-term effects of COVID-19. JAMA. 2022 Sep 6;328(9):823-4. doi: 10.1001/jama.2022.14089, PMID 35921084.

Kaafarani HM, Weiser M, Chen W. COVID-19: gastrointestinal symptoms and complications; 2023.

Kariyawasam JC, Jayarajah U, Riza R, Abeysuriya V, Seneviratne SL. Gastrointestinal manifestations in COVID-19. Trans R Soc Trop Med Hyg. 2021 Dec;115(12):1362-88. doi: 10.1093/trstmh/trab042, PMID 33728439.

Moghimi N, Di Napoli M, Biller J, Siegler JE, Shekhar R, McCullough LD. The neurological manifestations of post-acute sequelae of SARS-CoV-2 infection. Curr Neurol Neurosci Rep. 2021 Sep;21(9):44. doi: 10.1007/s11910-021-01130-1, PMID 34181102.

Korchut A, Rejdak K. Late neurological consequences of SARS-CoV-2 infection: new challenges for the neurologist. Front Neurosci. 2023 Feb 9;17:1004957. doi: 10.3389/fnins.2023.1004957, PMID 36845421.

Panda M, Dash S, Behera B, Sil A. Dermatological manifestations associated with COVID-19 infection. Indian J Dermatol. 2021 May;66(3):237-45. doi: 10.4103/ijd.ijd_464_21, PMID 34446946.

Hadeler E, Morrison BW, Tosti A. A review of nail findings associated with COVID‐19 infection. J Eur Acad Dermatol Venereol. 2021 Nov;35(11):e699-709. doi: 10.1111/jdv.17448, PMID 34131957.

Tomidokoro D, Hiroi Y. Cardiovascular implications of the COVID-19 pandemic. J Cardiol. 2022 Apr 1;79(4):460-7. doi: 10.1016/j.jjcc.2021.09.010, PMID 34563439.

Fu Y, Zhang TQ, Dong CJ, Xu YS, Dong HQ, Ning J. Clinical characteristics of 14 pediatric mycoplasma pneumoniae pneumonia associated thrombosis: a retrospective study. BMC Cardiovasc Disord. 2023;23(1):1. doi: 10.1186/s12872-022-03030-9, PMID 36600223.

Xiong J, Lipsitz O, Nasri F, Lui LMW, Gill H, Phan L. Impact of COVID-19 pandemic on mental health in the general population: a systematic review. J Affect Disord. 2020 Dec 1;277:55-64. doi: 10.1016/j.jad.2020.08.001, PMID 32799105.

Aluganti Narasimhulu C, Singla DK. Mechanisms of COVID-19 pathogenesis in diabetes. Am J Physiol Heart Circ Physiol. 2022 Sep 1;323(3):H403-20. doi: 10.1152/ajpheart.00204.2022, PMID 35776683.

Chourasia P, Goyal L, Kansal D, Roy S, Singh R, Mahata I. Risk of new-onset diabetes mellitus as a post-COVID-19 condition and possible mechanisms: a scoping review. J Clin Med. 2023 Feb 1;12(3):1159. doi: 10.3390/jcm12031159, PMID 36769807.

Rizvi AA, Kathuria A, Al Mahmeed W, Al-Rasadi K, Al-Alawi K, Banach M. Post-COVID syndrome, inflammation, and diabetes. J Diabetes Complications. 2022 Oct 6;36(11):108336. doi: 10.1016/j.jdiacomp.2022.108336, PMID 36228563.

Malik VS, Ravindra K, Attri SV, Bhadada SK, Singh M. Higher body mass index is an important risk factor in COVID-19 patients: a systematic review and meta-analysis. Environ Sci Pollut Res Int. 2020 Nov;27(33):42115-23. doi: 10.1007/s11356-020-10132-4, PMID 32710359.

Abumayyaleh M, Nunez Gil IJ, Viana LLamas MC, Raposeiras Roubin S, Romero R, Alfonso Rodriguez E, Uribarri A, Feltes G, Becerra Munoz VM, Santoro F, Pepe M. Post-COVID-19 syndrome and diabetes mellitus: a propensity-matched analysis of the international HOPE-II COVID-19 registry. Frontiers in Endocrinology. 2023 May 16;14:1167087.

Yang J, Ma Z, Lei Y. A meta-analysis of the association between obesity and COVID-19. Epidemiol Infect. 2020;149:e11. doi: 10.1017/S0950268820003027, PMID 33349290.

Obesity. Who. Int. Available from: [Last accessed on 29 Sep 2023]

World Obesity Day. Africa Health Organisation; 2020. Available from: [Last accessed on 29 Sep 2023]

Khanna D, Khanna S, Khanna P, Kahar P, Patel BM. Obesity: a chronic low-grade inflammation and its markers. Cureus. 2022 Feb 28;14(2):e22711. doi: 10.7759/cureus.22711, PMID 35386146.

De Heredia FP, Gomez Martinez S, Marcos A. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012 May;71(2):332-8. doi: 10.1017/S0029665112000092, PMID 22429824.

Subbarao K, Mahanty S. Respiratory virus infections: understanding COVID-19. Immunity. 2020 Jun 16;52(6):905-9. doi: 10.1016/j.immuni.2020.05.004, PMID 32497522.

Hu B, Huang S, Yin L. The cytokine storm and COVID‐19. J Med Virol. 2021 Jan;93(1):250-6. doi: 10.1002/jmv.26232, PMID 32592501.

Sharma JR, Yadav UCS. COVID-19 severity in obese patients: potential mechanisms and molecular targets for clinical intervention. Obes Res Clin Pract. 2021 Mar 1;15(2):163-71. doi: 10.1016/j.orcp.2021.01.004, PMID 33509701.

Gao M, Piernas C, Astbury NM, Hippisley Cox J, O’Rahilly S, Aveyard P. Associations between body-mass index and COVID-19 severity in 6•9 million people in England: a prospective, community-based, cohort study. Lancet Diabetes Endocrinol. 2021 Jun 1;9(6):350-9. doi: 10.1016/S2213-8587(21)00089-9, PMID 33932335.

Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW. Presenting characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City Area. JAMA. 2020 May 26;323(20):2052-9. doi: 10.1001/jama.2020.6775, PMID 32320003.

Feuillet V, Canard B, Trautmann A. Combining antivirals and immunomodulators to fight COVID-19. Trends Immunol. 2021 Jan 1;42(1):31-44. doi: 10.1016/, PMID 33281063.

Gibson PG, Qin L, Puah SH. COVID‐19 acute respiratory distress syndrome (ARDS): clinical features and differences from typical pre‐COVID‐19 ARDS. Med J Aust. 2020 Jul;213(2):54-56.e1. doi: 10.5694/mja2.50674, PMID 32572965.

Tendulkar P, Pandey P, Panda PK, Bhadoria AS, Kulshreshtha P, Mishra M. Comparative study between the first and second wave of COVID-19 deaths in India: A Single Center Study. Cureus. 2023 Apr 12;15(4):e37472. doi: 10.7759/cureus.37472, PMID 37187656.

Baig R, Mateen MA, Aborode AT, Novman S, Abdul Matheen IA, Siddiqui OS. Third wave in India and an update on vaccination: a short communication. Ann Med Surg (Lond). 2022 Mar 1;75:103414. doi: 10.1016/j.amsu.2022.103414, PMID 35261767.

Haleem A, Javaid M, Singh RP, Suman R. Telemedicine for healthcare: capabilities, features, barriers, and applications. Sens Int. 2021 Jan 1;2:100117. doi: 10.1016/j.sintl.2021.100117, PMID 34806053.

Mohfw G. Clinical management protocol for COVID-19 (in adults). Version 6. 2023;24:21.



How to Cite

SHENDE, V. A. “COMPREHENSIVE REVIEW OF POST-COVID-19 INFECTIONS: A MULTIFACETED ANALYSIS”. International Journal of Current Pharmaceutical Research, vol. 15, no. 6, Nov. 2023, pp. 43-49, doi:10.22159/ijcpr.2023v15i6.4000.



Review Article(s)