Latest on Long COVID

9th January 2021

Fatigue, post-exercise malaise and cognitive dysfunction (brain function or brain fog) are the most common symptoms reported by long term COVID sufferers 6 months after contracting the coronavirus. People are considered to have ongoing symptomatic COVID-19 if they present with symptoms 4 to 12 weeks after the start of acute symptoms, the National Institute for Health and Care Excellence (NICE) has said.
Some people have experienced relapses, which were triggered by stress or exercise, and many were still unable to work at full capacity. “We believe it’s vital at this time to collect and present  dataset that reflects multifaceted long-COVID experiences reported by patients,” Athena Akrami, the senior study author and a neuroscientist at University College London ( @AthenaAkrami Twitter).

Most COVID-19 patients recover within a few weeks, but an increasing number of people have reported months-long symptoms that affect a number of organs. This study hasn’t yet been peer reviewed, but is one of the largest studies so far that captures the range of issues affecting  some who face a longer recovery from COVID-19.

Published by a group of Long COVID patients who are also researchers, the study surveyed more than 3,700 people from 56 countries who contracted COVID-19 between December 2019 and May 2020. Overall, they recorded 205 symptoms across 10 organ systems and traced 66 symptoms over 7 months. On average, the survey respondents experienced symptoms from nine different organ symptoms. About 45% of people said they still required a reduced work schedule, and 22% weren’t working at all due to their ongoing health issues.

This study presents a glimpse into the ongoing struggles that COVID-19 patients may face should some symptoms continue after recovery. “This is a chapter that has not yet been written in the medical textbooks, and barely any major research papers yet published. Part of the progress here is simply inputting large numbers and stats to the existing anecdotal sense of what’s been happening. Nobody can address the condition until we’re better able to tell what’s happening,” Danny Altmann, a professor of immunology at Imperial College London.

Latest research in the UK found that 1 in 5 people with COVID-19 may develop longer term symptoms. Around 186,000 people experience health problems for up to 12 weeks, according the the Office for National Statistics (ONS),

The ONS estimated that 9.9% of people who had COVID-19 remained symptomatic after 12 weeks ( now called Long Covid)  The most common symptoms were

  1. fatigue,
  2. cough
  3. headache.

The NICE  (National Institute for Health and Care Excellence) guidance covers the care of people who have signs and symptoms that develop during or after an infection consistent with COVID-19, that continues for more than 4 weeks, and are not explained by an alternative diagnosis. It provides recommendations based on current evidence (which is thin at the moment)  and expert consensus.

The guideline makes recommendations in a number of other key areas, including:

  • Assessing people with new or ongoing symptoms after acute COVID-19
  • Investigations and referral
  • Planning care
  • Management, including self-management, supported self-management, and rehabilitation
  • Follow-up and monitoring
  • Service organisation

Paul Chrisp, director of the Centre for Guidelines at NICE, said: “This guideline highlights the importance of providing people with good information after they’ve had acute COVID-19, so they know what to expect and when they should ask for more medical advice.

“This could help to relieve anxiety when people do not recover in the way they expect, particularly because symptoms can fluctuate and there are so many different symptoms reported.”

Not everyone will develop Long Covid but we must be aware that some people could, and we need to recognise the symptoms and point them in the right direction.