Battle to fully recover from effects of Covid-19

FOURTEEN days after testing positive for Covid-19, you’re supposed to have recovered, ready to resume normal life.

But for some survivors, the weeks turn into months, the Covid-19 tests come back negative, but excruciating symptoms continue to linger.

Migraines, intense body pains, unexplained shortness of breath, cognitive impairment, coughing and exhaustion are all part of the unpredictable array of symptoms becoming known as post-Covid syndrome.

Desperate for answers, these Covid survivors around the world have formed online support communities in a bid to understand why they can’t seem to get better.

They call themselves “Covid long-haulers”.

Local human rights and environmental activist Catherine Constantinides said it felt like she was losing her mind when her Covid symptoms refused to clear up long after her isolation period had ended, despite being previously fit and healthy.

“I thought I was going crazy, but I just didn’t feel better,” she said.

Tests showed that Constantinides had inflammation in her lungs, heart and in the fluid around her brain as a residual effect of the virus.

“Everyone talks about the 14 day period. It’s now eight weeks later,” she said.

“Life has to carry on, I just don’t know how. I’m huffing and puffing. I’m sitting still now, and I feel like I’ve run a marathon.”

Physical isolation has given way to emotional isolation as the long term effects of the virus profoundly changed Constantinides’ energetic lifestyle.

“I feel very angry and very anxious a lot of the time because my body doesn’t want to do what I need it to do. Emotionally, it becomes extremely draining,” she said. Constantinides said it was a huge comfort to find a community of people online suffering from the same after-effects.

“I was so shocked, and almost relieved,” she said. “I spoke to people overseas; they’ve been sick for 35 weeks.”

Very little is known about postCovid syndrome yet, but what we do know is that it affects different organ systems differently, said Dr Ismail Kalla, a senior consultant in the division of pulmonology and critical care at Charlotte Maxeke Johannesburg Academic Hospital.

There appear to be four main symptom clusters: pulmonary (from lung damage), cardiac (from heart damage), neuropsychiatric and musculoskeletal.

“About 10% of all Covid survivors will have some residual effects in these four major domains,” Kalla said.

“With the more severe patients, those that end up in hospital, my estimate is 80% of those will have persistent symptomatology at least three months post resolution (of Covid infection).”

Most of his Covid long-hauler patients have symptoms related to scar tissue in the lungs.

“The majority of patients have one of two symptoms: persistent unexplained shortness of breath, or a chronic nagging cough,” Kalla said.

“There’s an abundance of literature to support what we call post-Covid lung fibrotic syndrome. What we don’t know is how to treat it.”

Kalla said studies from the United Kingdom and Italy show dysfunction in the heart muscles up to three months after the Covid-19 inflammatory process has subsided, resulting in lingering cardiac symptoms.

“We don’t know how long this will persist for, and what the eventual residual effect to the heart may be.”

The musculoskeletal manifestation involves body pains and significant loss of stamina, while the neuropsychiatric manifestation includes persistent headaches or migraine attacks, as well as severe sleep disturbance.

“Whether this is a result of illness itself, or because of post traumatic stress and anxiety, is debatable,” Kalla said.