What is long COVID and how it makes life difficult for patients even after recovery

People recovering from COVID-19, the infection caused by the novel coronavirus, have reported persisting symptoms such as fatigue or suffering other health complications. Here’s taking a look at long COVID and its symptoms.

What is long COVID

According to the US Centers for Disease Control and Prevention, post-COVID conditions, also known as long COVID or long-haul COVID, are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. It is also known as post-acute COVID-19, long-term effects of COVID, or chronic COVID. According to the UK’s NHS, the recovery time for COVID-19 differs for everybody but most make a full recovery within 12 weeks. For some, however, symptoms can last longer and this does not appear to be linked to the severity of the symptoms during the first COVID-19 infection. In other words, people who had mild symptoms or no symptoms can still experience symptoms later on or have long-term problems.

What are the symptoms?

The CDC and NHS list the following as common symptoms, some of which may also overlap:

• extreme tiredness (fatigue)
• shortness of breath
• chest pain or tightness, stomach
• problems with memory and concentration (sometimes referred to as brain fog)
• difficulty sleeping (insomnia)
• heart palpitations
• dizziness
• pins and needles
• joint pain
• depression and anxiety
• tinnitus, earaches
• feeling sick, diarrhoea, stomach aches, loss of appetite
• a high temperature, cough, headaches, sore throat, changes to sense of smell or taste
• rashes
• mood changes
• Changes in period cycles
• Symptoms that get worse after physical activity

The American Psychological Association, citing studies in JAMA and the BMJ, states that around 10 percent of patients develop long COVID.  According to the World Health Organisation’s policy brief, “In the wake of the pandemic:” Preparing for Long COVID," it can affect anyone, but women and health care workers seem to be at greater risk. Meanwhile, the REACT-2 study from Imperial College London, published as a preprint, found that around a third of people in England who developed COVID-19 went on to experience long-term symptoms. The researchers found that long COVID was more common among women than men (1.5 times as likely) and in people who were overweight or obese, who smoked, lived in deprived areas, or had been admitted to hospital. In contrast, persistent COVID-19 symptoms were lower in people of Asian ethnicity. “Increasing age was also linked with having persistent symptoms, with the risk rising by 3.5 percent with each decade of life,” the Imperial College adds. In India, a follow-up study on a cohort of patients with acute coronavirus infection across three facilities of the Max healthcare group has found that 40 percent of them had 'long-Covid' symptoms. Dr Sandeep Budhiraja, Group Medical Director of Max Super Specialty Hospital, who led the study titled “Long term health consequences of COVID-19 in hospitalised patients from north India: A follow-up study of up to 12 months”, said that “no correlation”  was found between developing post-Covid symptoms and age, gender, comorbidities or the severity of disease; however the duration of post-Covid symptoms had significant correlations to the disease severity at the time of admission but not to age, gender and comorbidities. Fatigue, which was most commonly reported, showed a significant association with age. Only 1 of 44 (2.3 percent) in the age group of less than 30 years had fatigue, which increased to 21.5 percent in the age-group of 60 years or more, the doctor said.

What are the Multiorgan or Autoimmune conditions?

According to the CDC, some who have had severe COVID-19 can also “experience multiorgan effects or autoimmune conditions over a longer time with symptoms lasting weeks or months after COVID-19 illness.” Multiorgan effects can affect most, if not all, body systems, including heart, lung, kidney, skin, and brain functions. Some people, mostly children , may also experience a rare condition known as multisystem inflammatory syndrome (MIS) during or immediately after a COVID-19 infection.

What are the effects of hospitalisation and COVID-19 illness

The CDC further states that hospitalisations and severe illnesses for lung-related diseases, including COVID-19, can cause health effects like severe weakness and exhaustion during the recovery period. Those who receive treatment in hospitals can also go through effects such as post-intensive care syndrome (PICS). PICS refers to health effects that begin when a person is in an intensive care unit (ICU) and can remain after a person returns home. These effects can include severe weakness, problems with thinking and judgment, and post-traumatic stress disorder (PTSD). Some symptoms after hospitalisation can be similar to the ones listed above as common symptoms and it can be difficult to know whether they are caused by the effects of hospitalisation, the long-term effects of the virus, or a combination of both. They also may be complicated by other effects related to the COVID-19 pandemic, including mental health effects from isolation, negative economic situations, and lack of access to healthcare for managing underlying conditions.

What are the impacts?

In a statement on 25 February 2021, Professor Martin McKee, European Observatory on Health Systems and Policies notes that long COVID can be extremely debilitating and can have a huge impact on people’s lives. “Many are unable to return to work or have a social life. Many have described how it affects their mental health, especially as the course of the condition is often fluctuating; just as they feel they are getting better the symptoms return. And of course, it has important economic consequences for them, their families and for society,” he says.