Others will develop long COVID. Long COVID is a term to describe the effects of COVID-19 that continue for weeks or months beyond the initial illness. Thousands, potentially millions of people who had seemingly recovered from COVID-19, continue to experience 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. Given the name “long haulers“, these patients have, in theory, recovered from the worst impacts of COVID-19 and have subsequently tested negative.

Long COVID is a term to describe the effects of COVID-19 that continue for weeks or months beyond the initial illness [Image: jcomp/Freepik].

More details of how many people are affected by long COVID are still emerging. However, research suggests it could be quite common, with early studies indicating that one in five people who test positive for COVID-19 have symptoms for five weeks or longer, and one in ten lasts 12 weeks or longer.

COVID-19 is not only a respiratory disease; it has been shown to damage the heart, kidneys, and even brain and expresses itself in various ways depending on what systems were involved. Long COVID is only diagnosed when a negative viral test result is reported, and the patient is no longer contagious but continues to experience COVID symptoms.

For sufferers of Long COVID, it can seem like a cycle of improving and then getting worse again. They often report many symptoms, including fever, crushing fatigue, shortness of breath, depression, anxiety, brain fog, loss of appetite, joint and muscle pain, and unexplained allergies, amongst others.

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
  • sleep issues
  • memory and concentration difficulties
  • mood changes

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.

A recognised medical condition

While it is a new disease, Long COVID is gaining recognition as a very real condition within the medical community. It has been classified as a Post Viral Fatigue Syndrome (PVFS), a disease category that has been defined for a much longer period and is more fully understood.

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

Who is more likely to become a long hauler? (Epidemiology)

Currently, we can’t accurately predict who will become a long hauler. Long COVID not only impacts those who fell seriously ill or those who needed hospitalisation but can affect anyone who contracted the virus no matter how young, fit or mild their COVID-19 symptoms were.

Interestingly, it appears to be more prevalent in the larger group of COVID patients who had mild symptoms and treated themselves at home. So it requires a high degree of suspicion.

Causation

The cause of Long COVID is still being fully understood. Like other PVFS, it appears the root cause lies in a sustained and overactive immunological response to the initial insult.

Occupational, Social & Emotional Implications

Due to its lack of understanding and diagnosis clarity, Long COVID has devastating psychological effects on patients. Many long-haulers cannot return to work nor do normal activities because of brain fog, pain or debilitating fatigue.

Long haulers cannot perform at their previous level of functioning and, as a result, need a deep sense of understanding and support from family, friends, colleagues and employers as they calibrate to new effort tolerance thresholds.

Treatment Guidelines

Most patients arriving at our practice have already been to numerous doctors and had multiple tests, still lacking a clear diagnosis, as there is no one available. Unfortunately, there is no magic pill that can fix Long COVID rapidly either.

Patients need to understand that it will require a sustained rehabilitative process to recover, but understanding and equipped practitioners are available to assist.

Ideally, a multi-disciplinary approach should be used, including but not limited to:

  • General Practice (GPs’)
  • Dietetics
  • Physiotherapy
  • Occupational Therapy
  • Psychology & Counselling

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, for up to a year. Ultimately, how long these illnesses last remains to be determined.