Luke O’Neill

The lasting symptoms of ‘Long Covid’

WHEN it comes to Covid-19, please remember one thing: it’s still early days. I know that’s hard to hear, as you just want your old life back right? You’d like to go on holiday where you like. Have as many friends over to your house as you please. Go into a pub and talk loudly. Not worry about schools or case numbers or possible future lockdowns. You might even be shouting for these things. You might be saying, ‘Hardly anybody is dying anymore and anyway we’ll have a vaccine soon.’ If you’re not in a vulnerable group, you might even be thinking it would be no harm if you got infected. You might then be protected.

If you are thinking this way, think again. Listen to someone like Peter Piot. He is a world-famous virologist who did pioneering work on Aids and Ebola. Ironically, earlier this year he became infected with Covid-19. His immune system fought the virus, but then he noticed that symptoms were persisting. He had trouble breathing when he exercised. He felt exhausted. And he couldn’t think straight.

He talked about how frustrating it all was and how for a long time all he could do was “be a patient and rest”. This went on for two months, and in that time he received many emails from people saying they had the same long-term symptoms.

There are now so many people reporting prolonged symptoms that they have been named ‘long-haulers’ and the condition they have has been dubbed ‘Long Covid’. It is worrying doctors everywhere. They still don’t know exactly how common it is, what’s causing it, how severe it might get and whether any damage that happens might last for years. Another reason to be very wary of Covid-19. It might mean many people not being able to work, damaging their lives long-term, perhaps giving rise to health consequences for years. We just don’t know enough about it.

How many people have Long Covid? A recent report has concluded that up to 60,000 people in the UK may have been suffering from it for more than three months. At least 300,000 people have reported symptoms lasting for more than a month. That’s an awful lot of people who are still ill.

In studies on Long Covid elsewhere, a similar picture is emerging. In a German study, 80pc of people had heart abnormalities several months after infection. An Italian study found that 87pc of hospitalised patients had symptoms after two months. A similar trend was observed in a UK study.

In Bergamo, Italy, epicentre of the first worrying European outbreak of Covid-19, doctors are bringing the survivors back six months on. The doctors have said they feel a moral obligation to bring their former patients back in. They are taking their blood, examining their hearts, and scanning their lungs. They are also asking them how they feel. A 54-year-old woman who still can’t walk up a flight of stairs without becoming breathless said, “I feel like I’m 80 years old”.

The Bergamo study has revealed that 30pc still have lung scarring and breathing problems. Another 30pc have heart abnormalities. But the list of symptoms goes on: short-term memory loss; leg pain; tingling in the extremities; hair loss; depression; and, most of all, severe fatigue.

Bergamo frightened all doctors six months ago with the number of fatalities, but it is now sending another message to the world about Covid-19. Recovery might be incomplete, especially in those who were very sick. The virus is gone, but the pain still lingers.

Overall, half of the people there who had the virus say they are still sick, with various symptoms. One person has said it’s a bit like you wake up, throw a set of symptoms in the air, and see which ones land. Those symptoms will be with you all day.

Doctors are still unsure as to what is causing Long Covid. Might the virus still be lingering? What makes this virus somewhat unique is it might start in your lungs but then it can go anywhere in your body, causing damage as it goes. That damage might persist even after the virus is gone. Is it possible that being infected somehow resets your immune system, which continues to cause symptoms? This might resemble an autoimmune disease, where your immune system starts to attack you own body. Some even suggest that the virus damages nerves in the body, leading to the pain, fatigue and brain fog.

Some of these things can happen with other viruses, but some doctors are convinced that they are seeing something new. Previous viruses haven’t been reported to have such a profound effect with such a range of symptoms. It is also not clear what course the disease might take when comparing different people. Doctors are currently effectively in the dark when it comes to long-haulers.

However, a lot of research is happening. Long Covid is clearly an important aspect of Covid-19. In July, the UK allocated £8.4m for research into the long-term consequences of Covid-19, but a lot more is needed internationally. And anyone with Covid-19 can turn to support groups, for example Body Politic, which had doubled in size since June, with participants from over 25 countries. Membership goes up in regions or countries where there are spikes in the numbers of those infected. It provides information and support, including ‘tips for those who aren’t listening’.

Sufferers of Long Covid are reporting that their symptoms are often dismissed by family members and work colleagues. The NHS has a website called ‘Your Covid Recovery’, and there is also an Irish support group: https://www.internalconnections.ie/covidcasesireland.

There is, however some good news. Many people with Long Covid start to feel better in their fourth or fifth month out. Breathing gradually improves, although there are reports indicating that lung scarring might be permanent.

Recovery can be tentative and is not guaranteed. And as people age, we don’t know if symptoms might come back as their hearts and lungs age and have suffered earlier damage. Prevention will as ever be better than cure. This means a vaccine — but, in the meantime, prevention means trying to get the viral numbers right back down. The upward trend in Dublin and Limerick might well lead to more people in hospital and may even lead to more deaths. But it will also give rise to more people with Long Covid.

We must remember, we can’t relax the fight against Covid-19. It might be on the back foot when it comes to the death rate, and let’s hope that continues to go down. But don’t forget about Long Covid, which may well turn out to be one of the more insidious features of the virus.

‘It’s like you wake up, throw a set of symptoms in the air and see which ones land. They will be with you all day’