Long Covid – Let’s Learn and Be Prepared

After a Covid patient is discharged from the hospital, does it mean he/she is done with the virus? Unfortunately the  answer may be not yet. He/she is not done with Covid-19 yet. It is now known that the symptoms of post-Covid linger around for some more weeks or months after the infection is no longer detectable. Such people are said to suffer from post-Covid syndromes – often referred to “Long Covid”.

The website of The Office for National Statistics, UK  said:

The website of the World Economic Forum said:

  • For millions of people around the world, the health impact of catching coronavirus extends well beyond the initial infection period.
  • A recent study led by Imperial College London suggests that 2 million people in England alone may have had long Covid, that’s about 3.5% of the population.

How does long Covid affect people’s lives?

  • Many are unable to return to work or have a social life.
  • Because long Covid affects people’s ability to work, it has “important economic consequences” for them, their families and for society.
  • Many have described how it affected their mental health.                                              https://www.weforum.org/agenda/2021/07/long-covid-symptoms-research/

Chaoling Huang et al. of the Jin Yin-ta Hospital, Wuhan, China studied patients after they were discharged from the hospital. These patients suffered from the follow problems:

  1. 63% – fatigue or muscle weakness.
  2. 26% – sleep difficulties.
  3. 23%  – anxiety or depression.
  4. 22% –  hair loss.
  • At 6 months after acute infection, Covid-19 survivors were mainly troubled by at least one symptom such as fatigue or muscle weakness, sleep difficulties, and anxiety or depression.
  • More severely ill patients had increased risk of pulmonary diffusion abnormality, fatigue or muscle weakness, and anxiety or depression. 
  • Long-term extrapulmonary organ manifestations – for example, persistent renal dysfunctions were observed, some participants were newly diagnosed with diabetes, and venous thromboembolic diseases, (including cardiovascular and cerebrovascular events).      
  • The long-term health consequences of Covid-19 remain largely unclear.                         https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext#%20

Bjorn Blomberg of the Department of Clinical Science, University of Bergen, Norway carried out a long-term study of  home-isolated and  hospitalized patients after being diagnosed with Covid-19.

At 6 months, 61%  of all patients had persistent symptoms such as:

  • fatigue (37%)
  • difficulty concentrating (26%)
  • disturbed smell and/or taste (25%)
  • memory problems (24%)
  • dyspnea –  shortness of breath / breathlessness (21%)

Among the 247 home-isolated patients, 55% (136/247) experienced persistent symptoms at 6 months, most commonly

The website of University College London said:

The following are some symptoms of Long Covid:

  • Anxiety – feeling uneasy, nervous
  • Appetite loss
  • Blurred vision
  • Changes to the menstrual cycle
  • Chest pain or tightness in the chest
  • Cough – persistent
  • Depression – sadness and loss of interest
  • Diarrhoea
  • Difficult to concentrate or think clearly
  • Difficult to control bladder
  • Difficulty breathing or shortness of breath
  • Dizziness when standing
  • Ear ringing or ear ache
  • Feeling light-headed
  • Feeling sick
  • Fever, temperature comes and goes
  • Hair loss
  • Hallucination – seeing or hearing things that are not there. Only in the mind.
  • Headache
  • Heart beat – fast or pounding
  • Itchy skin or rashes
  • Memory loss or memory problem
  • Mood changes
  • Muscle aches / pain
  • Numbness
  • Pain in the joints
  • Pins and needles – hands or feet or body
  • Sense of smell or taste – change or loss
  • Severe kidney injury
  • Sexual dysfunction
  • Shingles
  • Sleep problems
  • Sore throat
  • Stomach aches
  • Tiredness (fatigue)
  • Tremor – shaking movement of body

Problems To Come

An article in the Mayo Clinic website, Covid-19 symptoms can sometimes persist for months. The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems said.

  • Older people and people with many serious medical conditions are the most likely to experience lingering Covid-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection.

Organ damage.

Although Covid-19  is seen as a disease that primarily affects the lungs, it can damage many other organs such as:

  • Heart. Imaging tests taken months after recovery from Covid-19  have shown lasting damage to the heart muscle, even in people who experienced only mild Covid-19 symptoms. This may increase the risk of heart failure or other heart complications in the future.
  • Lungs. The type of pneumonia often associated with Covid-19  can cause long-standing damage to the tiny air sacs (alveoli) in the lungs. The resulting scar tissue can lead to long-term breathing problems.
  • Brain. Even in young people, Covid-19  can cause strokes, seizures and Guillain-Barre syndrome — a condition that causes temporary paralysis. Covid-19  may also increase the risk of developing Parkinson’s disease and Alzheimer’s disease.

Blood clots and blood vessel problems.

Covid-19 can make blood cells more likely to clump up and form clots. While large clots can cause heart attacks and strokes, much of the heart damage caused by Covid-19 is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle.

Other parts of the body affected by blood clots include the lungs, legs, liver and kidneys. 

Covid-19 can also weaken blood vessels and cause them to leak, which contributes to potentially long-lasting problems with the liver and kidneys.

Problems with mood and fatigue.

People who have severe symptoms of Covid-19 often have to be treated in a hospital’s intensive care unit, with mechanical assistance such as ventilators to breathe. Simply surviving this experience can make a person more likely to later develop post-traumatic stress syndrome, depression and anxiety.

Much is still unknown about how Covid-19 will affect people over time.

https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-long-term-effects/art-20490351

A news article, WHO warns of ‘long term’ Covid -19 impact on mental health reported:

  • The mental health impact of the pandemic will be “long-term and far-reaching”, the World Health Organization said Thursday (Jul 22). Everyone is affected in one way or another.
  • Anxieties around virus transmission, the psychological impact of lockdowns and self-isolation had contributed to a mental health crisis, along with stresses linked to unemployment, financial worries and social alienation.
  • The pandemic has shaken the world. More than four million lives lost globally, livelihoods ruined, families and communities forced apart, businesses bankrupted, and people deprived of opportunities.
  • The WHO called for the strengthening of mental health services in general – it also urged better psychological support services in schools, universities, workplaces and for people on the front line of the fight against Covid -19.                                                                                https://www.channelnewsasia.com/news/world/covid-19-impact-on-mental-health-who-15271306

Let me close by referring you to the website of the American Psychological Association.

  • The stress brought on by the Covid -19 pandemic has taken a toll on almost everyone.
  • About 10% of patients develop long Covid (JAMA, Vol. 225, No. 19, 2021; The BMJ, Vol. 370, No. 8258, 2020).
  • With 32 million cases and counting of Covid -19 in the United States alone, that means 3.2 million Americans may be facing long-term illnesses that could reshape their relationships, jobs, and futures and take a significant toll on their mental health.
  • A May 2021 study found that a third of Covid -19 patients had been diagnosed with neurological or psychological symptoms, including anxiety, depression, post-traumatic stress disorder (PTSD), and psychosis, in the 6 months after they contracted Covid -19 (The Lancet Psychiatry, Vol. 8, No. 5, 2021).
  • “If we only focus on recovery from the virus, and not recovery from a holistic, whole-person perspective, people’s recovery is going to be incomplete,” said Megan Hosey, an assistant professor of rehabilitation psychology and neuropsychology in the Johns Hopkins Department of Physical Medicine and Rehabilitation.
  • In Hopkins’s intensive care unit (ICU) and hospital, she sees patients who are experiencing long Covid symptoms—like brain fog, fatigue, breathlessness, sleep disturbance, anxiety, and depression — they frequently need help with feelings of isolation, worries over lost jobs and income, and adjusting to their new lives. https://www.apa.org/monitor/2021/07/treating-long-covid