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Dr. Hina Ansar
Mar 235 min read

Long COVID: Myth or Reality?

Editor: Isabello Io


Did you have COVID? Did you get it treated? But there is still something wrong, and you are unable to determine what it is. Worldwide, many people have reported similar experiences. Let's determine the root cause of your health issues and offer you a solution to address them.


What is Long-term COVID?

Long-term COVID-19 refers to a variety of symptoms that last or recur for over 12 weeks following the initial COVID infection. These symptoms may be either persistent or intermittent. This definition is provided by the WHO. Long-haul COVID, post-COVID conditions (PCC), and chronic COVID are other terms used to refer to this illness. Even though many COVID-19 patients may recover without any problems, a significant percentage continue to have health problems that negatively impact their quality of life.


Causes

The exact causes of long COVID occurring in some people, while others heal completely, are unknown. It is still being studied by medical professionals. Here are the factors that may contribute to the development of long-term COVID:

Organ Damage

The immune response of the body against the SARS-CoV-2 virus may also damage healthy tissues in the body, leading to prolonged symptoms and long-term complications.

Autoimmune Response

Autoantibodies might be produced during acute COVID infections. These autoantibodies can damage various organs and tissues in the body. COVID-19 may also increase the risk of autoimmune diseases like systemic lupus erythematosus and rheumatoid arthritis.

Viral Remnants

After the initial treatment of COVID-19, some viral remnants may remain in the body. Reactivation of these remnants initiates an inflammatory response, damaging the tissues and leading to prolonged symptoms.

Latent Viral Reactivation

Some viruses, like the Epstein-Barr virus (the virus that causes infectious mononucleosis), can remain dormant in the body for years before reactivating. This reactivation can occur during times of stress or a weakened immune system. In some case studies, reactivation of these viruses has been shown to be associated with symptoms of long-term COVID.


Signs and Symptoms 

There are varieties of symptoms experienced by different patients throughout the world. Symptoms not only vary from person to person but also in severity. Some people have such mild symptoms that they don't even notice they are still affected. Others have such severe symptoms that they need to be hospitalised.

Some of the most common symptoms include fatigue, shortness of breath, joint pain, and chest pain. It is important to note that the symptoms of long-term COVID can persist for weeks or even months after the initial infection. Seeking timely medical care is very important to ease the symptoms and reduce the severity of the disease.


Neurologic Symptoms

  • Brain fog (difficulty concentrating)

  • Memory problems

  • Headache

  • Sleep problems

  • Alteration in sense of smell and taste

  • Feeling dizzy on standing up

  • Depression and anxiety

Respiratory Symptoms

  • Difficulty breathing or shortness of breath

  • Persistent cough

Heart Symptoms

  • Chest pain

  • Fast beating heart (palpitation)

Digestive Symptoms

  • Nausea

  • Diarrhoea

  • Stomach pain

  • Loss of appetite or changes in appetite

Reproductive Symptoms

  • Changes in the menstrual cycle 

  • Interference with menopause

  • Changes in fertility

Other Symptoms

  • Joint pain

  • Muscle pain

  • Hair loss

  • Skin rash


Complications

Increased risk of:

  • Type I and type II diabetes

  • Stroke

  • Pulmonary embolism

  • Myocardial infarction


Risk Factors

The exact pathophysiology of long COVID is still under investigation, but these risk factors will increase likelihood of contracting:

  • Female sex

  • Old age

  • ICU hospitalisation due to COVID-19

  • Pre-existing medical diseases, including asthma, diabetes, or obesity

  • Old age

  • Smoking

  • Not being vaccinated against COVID-19


Diagnosis

Currently, there is no specific test to definitively diagnose long-term COVID. It's sometimes challenging to establish a precise diagnosis since individuals appear with a broad array of symptoms. Because of this, numerous cases remain undetected.

Having a prior positive COVID-19 PCR is not essential since many people don't get themselves tested and may never have known they have COVID-19. Similarly, there are risks of a misleading negative report. Diagnosing long-term COVID involves the doctor inquiring about your COVID-19 infection history, symptoms, and the course of the illness.

Based on the severity of your symptoms, the doctor may request several tests, such as:

  • Heart rate and blood pressure measurements

  • Complete blood count (blood tests)

  • Chest x-ray

  • ECG

  • Pulse oximetry

  • Exercise tolerance test

Diagnosis often involves eliminating other possible conditions that may share the same symptoms as to identify long-term COVID.


Prevention

These are some measures to lower the chance of having COVID-19, and hence developing Long COVID:

Avoiding Infection

The best way to prevent long-term COVID is to avoid getting COVID-19 in the first place. Avoid close interactions, use masks, wash hands often, and maintain excellent hygiene to limit the chance of acquiring COVID-19.

Vaccination 

After mass vaccination against COVID-19, the incidence of the disease has markedly decreased. Even those getting infected have very mild symptoms with nearly no long-term complications. Being vaccinated lowers the likelihood of developing long-term COVID.

Effective therapy

Treating COVID-19 effectively reduces the likelihood of needing prolonged treatment for long-term COVID.


Treatment

There isn't any particular therapy. Treatment depends on the patient's symptoms, their severity, and any accompanying conditions. It is important for patients to follow a comprehensive treatment plan that addresses both symptomatic relief and the underlying causes of their condition for optimal outcomes.

Symptomatic Treatment:

  • Painkillers such as nonsteroidal anti-inflammatory drugs (NSAIDs) or analgesics for pain

  • Paracetamol for fever

  • Montelukast for respiratory symptoms

  • Melatonin for sleep problems

  • Antidiarrheals for diarrhoea

  • Antiemetics to stop nausea and vomiting

Respiratory Support 

  • Hyperbaric oxygen treatment for low oxygen saturation

  • Corticosteroids to relieve inflammation

  • Bronchodilators to relieve difficulty in breathing

Counselling and Supportive Treatment

Providing mental and emotional support to patients aims to prevent and alleviate depression linked to the illness. For numerous neurologic symptoms (brain fog and sleeplessness), cognitive-behavioural therapy is administered.

Rehabilitation 

Rehabilitation is also an important aspect of treatment to improve overall functioning and quality of life. Rest, physiotherapy, massage, and exercise are employed to reduce joint and muscle pain in long-term COVID treatment, facilitate movement, and improve overall physical function.

Nutritional Support

Dietary modifications and nutritional supplements may be recommended to support the body's healing process and improve energy levels.


Conclusion

While long-term COVID poses substantial problems, a comprehensive treatment strategy that targets both symptoms and underlying causes may assist patients in managing their disease and improving their overall health. Ongoing research and medical developments will help us better understand and treat this complicated disorder.


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