‘Long Covid’: Why Some People Don’t Recover

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For most people, Covid-19 is a brief, mild illness, but some struggle with symptoms that include long-lasting fatigue, persistent pain, and shortness of breath for months.

The condition known as “Long Covid” is having a debilitating effect on people’s lives, and stories of exhaustion even after a short walk are now common.

Until now, the focus has been on saving lives during the pandemic, but it is now increasingly recognized that people are facing the long-term consequences of a Covid infection.

However, even basic questions – like why do people get a long Covid or if everyone will make a full recovery – are fraught with uncertainty.

What is Long Covid?

There is no medical definition or list of symptoms that all patients share: two people with long-term Covid can have very different experiences.

However, the most common feature is crippling fatigue.

Other symptoms include: shortness of breath, cough that does not go away, joint pain, muscle aches, hearing and vision problems, headaches, loss of smell and taste, as well as damage to the heart, lungs, kidneys, and intestines.

Mental health problems including depression, anxiety, and difficulty thinking clearly have been reported.

It can completely destroy people’s quality of life. “My fatigue was unlike anything I’d ever experienced before,” said one of the victims, Jade Gray-Christie,

Long Covid is not just people taking the time to recover from an intensive care stay. Even people with relatively mild infections can suffer from serious and long-lasting health problems.

“We have no doubt that Covid has been around for a long time,” Professor David Strain from the University of Exeter, who is already treating Covid patients for a long time at his chronic fatigue syndrome clinic, told the BBC.

How many people are receiving it?

A study of 143 people at Rome’s largest hospital, published in the Journal of the American Medical Association, followed patients from the hospital after they were discharged.

It showed that 87% had at least one symptom almost two months later and more than half still had fatigue.

However, these studies focus only on the minority of people who end up needing hospital treatment.

The Covid Symptom Tracker app, used by around 4 million people in the UK, found that 12% of people still had symptoms after 30 days. Their most recent, unpublished data suggests that up to one in 50 (2%) of all infected people have prolonged Covid symptoms after 90 days.

Do you need severe Covid to get long Covid?

It seems not.

Half of the people in a study in Dublin still had fatigue 10 weeks after being infected with coronavirus. A third were unable to physically return to work.

Crucially, the doctors found no link between the severity of the infection and fatigue.

However, extreme exhaustion is just a prolonged Covid symptom.

Professor Chris Brightling of the University of Leicester and principal investigator for the PHOSP-Covid project, which tracks people’s recovery, believes that people who developed pneumonia may have more problems due to damage to their lungs.

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How is it causing the prolonged Covid virus?

There are many ideas, but there are no definitive answers.

The virus may have been shed from most of the body, but it remains in a few small pockets.

“If there is prolonged diarrhea, the virus is in the gut, if there is loss of smell, it is in the nerves, so it could be what is causing the problem,” says Professor Tim Spector of King’s College London.

The coronavirus can directly infect a wide variety of cells in the body and trigger an overactive immune response that also causes damage throughout the body.

One thought is that the immune system does not return to normal after Covid and this causes health problems.

The infection can also alter the function of people’s organs. This is most obvious with the lungs if they are scarred: long-term problems have been observed after infection with Sars or Mers, which are both types of coronavirus.

But Covid can also alter people’s metabolism. There have been cases of people struggling to control their blood sugar levels after developing diabetes as a result of Covid, and Sars caused changes in the way the body processes fats for at least 12 years.

There are early signs of changes in the structure of the brain, but they are still being investigated. And Covid-19 also does strange things to the blood, including abnormal clotting, and damages the network of tubes that carry blood through the body.

• Inside Health: Sticky Blood and Covid 19

Professor Strain told the BBC: “The theory I am working on is a premature aging of the small blood vessels that carry oxygen and nutrients to the tissues.” But he cautioned that until we find out what’s causing prolonged Covid “it’s hard to figure out the treatments.”

Is this unusual?

Post-viral fatigue or post-viral cough is well documented and common; we’ve probably all had an infection that has taken us years to fully recover.

About one in 10 people with glandular fever has fatigue that lasts for months. And there have even been suggestions that the flu, especially after the 1918 pandemic, may be linked to Parkinson’s-like symptoms.

“With Covid there seem to be more far-reaching symptoms and the number of people seems to be much higher,” says Professor Brightling.

However, the emphasis is on the word “seems,” because until we have a real picture of how many people have been infected we won’t know exactly how common these symptoms are, he says.

He told the BBC: “The uniqueness of the way the virus attacks the host and the different ways it then alters the way cells behave seem to be giving people a more serious infection than other viruses and symptoms. persistent “.

Will people fully recover?

The number of people with prolonged Covid appears to be decreasing over time.

However, the virus emerged only in late 2019 before going global earlier this year, so long-term data is lacking.

“We have deliberately asked to follow people for 25 years. I certainly hope that only a very small number will have problems beyond a year, but I could be wrong,” said Professor Brightling.

However, there is concern that even if people appear to recover now, they could face lifetime risks.

People who have had chronic fatigue syndrome are more likely to have it again, and the concern is that future infections could cause more flare-ups.

“If Covid follows the same pattern for a long time, I would expect some recovery, but if it just takes another coronavirus infection to react, this could be every winter,” said Professor Strain.

More problems are still possible in the future.

The World Health Organization has warned that the widespread inflammation caused by the coronavirus could cause people to have heart problems at a much younger age.

What should I do if I think I have long Covid?

The NHS has a “Recovery Plan for your Covid” that offers advice, especially for those who need hospital treatment.

Recommend the “three Ps” to conserve energy:

• Control your pace so you don’t overexert yourself and make sure you get enough rest
• Plan your days so that your most strenuous activities are spread throughout the week
• Prioritize: think about what to do and what can be postponed

He advises talking to the hospital team or your GP if you are not recovering as quickly as you might expect.

Some have expressed concern that there is not enough support for people with prolonged Covid.

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