What is Long COVID?
Patients infected with the virus responsible for COVID-19 may experience prolonged effects from their infection, known as Long COVID or Post-COVID Conditions (PCC) (NCIRD, 2024). Long COVID is symptoms, signs, and conditions that persist or emerge after the initial COVID-19 infection (NCIRD, 2024).
Long COVID is referred to by various names, including post-COVID conditions, long-haul COVID, post-acute COVID-19, long-term effects of COVID, and chronic COVID (NCIRD, 2024).
Symptoms of Long COVID
Long COVID affects individuals in varied ways, with reports identifying over 100 different symptoms (PHAC, 2024). The most prevalent symptoms in adults include (PHAC, 2024):
Fatigue
Sleep disturbances
Shortness of breath
General pain and discomfort
Cognitive issues, such as memory loss, and d ifficulty thinking or concentrating
Mental health symptoms, including anxiety, and d epression
In children, the most common symptoms are (PHAC, 2024):
Fatigue
Headaches
Abdominal pain
Sleep disturbances
Shortness of breath
Cognitive issues, such as difficulty thinking or concentrating
Muscle aches and joint pains
The severity of symptoms can fluctuate, and they may disappear and reappear without another underlying diagnosis (PHAC, 2024). Some patients report that physical and mental exertion can exacerbate their condition (PHAC, 2024).
Who is more susceptible to it?
Doctors who specialize in treating long COVID have observed that individuals with a history of allergies, anxiety or depression, arthritis, autoimmune diseases, and women are among those who appear more susceptible to developing the condition (Ho, 2023). A small study conducted by Northwestern Medicine discovered that 41% of patients with long COVID never tested positive for COVID-19, yet they had antibodies indicating previous exposure to the virus (Ho, 2023). Immune dysfunction, a history of recurrent infections, or chronic sinus infections are also common among patients (Ho, 2023). Individuals with arthritis or other autoimmune diseases such as lupus also seem more susceptible, along with patients who have diabetes or are slightly overweight (Ho, 2023).
Management of long COVID
Current clinical practice for managing long COVID adopts a symptom-based approach. Comprehensive assessment through medical history and examination is essential (Koc, H.C., et al., 2022). It is recommended to conduct a complete assessment, including full blood count, renal function test, C-reactive protein, liver function test, thyroid function, hemoglobin A1c (HbA1c), vitamin D, magnesium, B12, folate, and ferritin levels (Koc, H.C., et al., 2022). The International Consensus Conference in Critical Care recommends using screening tests to predict and identify physical and mental impairments (Koc, H.C., et al., 2022). Robust clinical care also requires additional assessments for appropriate referrals to specialists. Importantly, while diagnosing long COVID, other non-COVID-19 related diagnoses should also be considered unless they can be excluded (Koc, H.C., et al., 2022).
Appropriate treatments are provided according to clinical symptoms (Koc, H.C., et al., 2022). For patients presenting with cardiopulmonary symptoms, chest imaging, electrocardiography, and pulmonary function tests should be considered (Koc, H.C., et al., 2022). Oxygen supplementation is commonly provided for patients with dyspnea and during pulmonary rehabilitation (Koc, H.C., et al., 2022). Corticosteroid treatments have been shown to resolve pneumonia and improve clinical functions (Koc, H.C., et al., 2022). Sufficient patient support and rapport building are essential for disease recovery.
Conclusion
Long COVID is a complex and multifaceted condition that continues to affect millions globally. Understanding its symptoms, risk factors, and underlying mechanisms is crucial for developing effective treatments and support systems. Ongoing research will hopefully provide clearer answers and better outcomes for those suffering from this prolonged aftermath of COVID-19.
References
National Center for Immunization and Respiratory Diseases (NCIRD), Division of Viral Diseases (Mar 14, 2024). CDC COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html#:~:text=Some%20people%20who%20have%20been,after%20acute%20COVID%2D19%20infection.
Public Health Agency of Canada (PHAC) (May 28, 2024). Government of Canada. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/symptoms/post-covid-19-condition.html
Ho, S. (Dec 27, 2023). Long COVID: New Info on Who Is Most Likely to Get It. Medscape Medical News. https://www.medscape.com/viewarticle/long-covid-new-info-who-most-likely-get-it-2023a1000wq4?ecd=ppc_google_acq_mscp_dynamic-news-pilot_englang-top8-int&gad_source=1&gclid=CjwKCAjwyJqzBhBaEiwAWDRJVDawqQrpEh9w8s0VWskhExSH229YCFbp7RPtLIxH7NmeOG64WiQtSBoCwHkQAvD_BwE&form=fpf
Koc, H.C., Xiao, J., Liu, W., Li, Y., and Chen, G. (Jul 11, 2022). Long COVID and its Management. Int J Biol Sci, 18(2), 4768-4780. doi: 10.7150/ijbs.75056. Assessed and Endorsed by the MedReport Medical Review Board