Long-COVID: An evolving problem with an extensive impact

Most people recover from COVID-19 within two weeks. However, thousands of people who had seemingly recovered from COVID-19 are now reporting persistent and even debilitating symptoms lasting for several weeks or months after initially contracting the virus. “Long COVID” is the term to describe this condition.

The National Institute for Health and Care Excellence (NICE) defines long COVID as COVID-19 symptoms lasting for more than 12 weeks; up until this point, it is considered Ongoing symptomatic COVID-19.

Long COVID is not contagious. The prolonged symptoms are caused by the body’s response to the virus continuing beyond the initial illness.

More details of how many people are affected by long COVID are still emerging. However, research suggests it could be quite common. Around one in five people who tested positive for COVID-19 had symptoms that lasted for five weeks or longer, and one in ten people had symptoms that lasted 12 weeks or longer.

Danny Altmann, an immunologist at London’s Imperial College, said that his “guesstimate is that we probably have way more than five million people on the planet with long COVID.”

Diagnosing long COVID

Long COVID does not only impact those who fell seriously ill or had to be hospitalised but can affect anyone who contracted the virus.

The precise explanation for what causes Long COVID remains uncertain. Research has suggested that some people have an overactive immune response to the virus, known as a cytokines storm. One reason people have fatigue, loss of energy, muscular aches and pains, and generally feel unwell when they have an acute infection is the production of chemicals called cytokines by the body’s immune system. These immune system chemicals form part of the front line response to any viral infection. When fatigue and flu-like symptoms persist for a longer period once the acute infection is over, as they do in Long COVID and ME, there is growing evidence to indicate that what is a perfectly normal immune system response to the acute infection has not returned to normal and there is on-going immune system activation.

Since many people do not get tested for COVID-19 and false-negative tests occur, a positive test for COVID-19 is not a prerequisite for a long COVID diagnosis.

Currently, researchers may define ongoing symptomatic COVID-19 as symptoms extending beyond three weeks since onset and long COVID-19 (Post-COVID-19 syndrome) as symptoms extending beyond 12 weeks since onset.

For sufferers of Long COVID, it can seem like a cycle of improving and then getting worse again.

Lasting symptoms can include:

  • fatigue

  • breathlessness

  • headaches

  • anxiety and depression

  • palpitations

  • chest pains

  • fever which may come and go

  • joint or muscle pain

  • brain fog, not being able to think straight or focus (‘brain fog’)

People may also develop long-term complications that affect the organs. These complications are less common but may include:

  • inflammation of the heart muscle

  • abnormal lung function

  • severe kidney injury

  • a rash

  • hair loss

  • problems with smell and taste

  • sleep issues

  • memory and concentration difficulties

  • anxiety

  • mood changes

Currently, there is no way to predict how long recovery from long COVID will take. Research reports that people may experience symptoms 60–90 days after the initial infection, and some people may experience symptoms for longer than this.

Providing the support patients need

It was just a couple of months into the pandemic when patients began describing the phenomenon of Long COVID. Up until recently, patients exhibiting symptoms of long COVID described difficulty in getting GPs to “believe” their condition, a lack of awareness and knowledge of the condition, and challenges in accessing the right care.

The good news is that the condition is now widely recognised by medical communities. Multidisciplinary medical teams dedicated to the treatment of Long COVID now exist, harnessing general practitioners (GPs), physiotherapists, and other specialists who offer physical and psychological assessments to refer patients to the right treatment and rehabilitation services.

People who suspect they may have Long COVID can reach out to their GP for a diagnosis and referral for a treatment plan. Taking steps to look after their health and well-being. Medical treatment may be necessary to treat any secondary infections or complications.

At the Ingress Medical Centre Rondebosch, we have a dedicated Long COVID medical team. After a medical diagnosis from our general practitioner, our team will put together a tailored treatment plan which could include medication, therapy, physiotherapy, dietary plans and other relevant rehabilitation techniques.