Long COVID And Its Ongoing Effects
The SARS-CoV-2 virus that caused the COVID-19 pandemic has badly impacted global health since late 2019. Though many people recovered from the infection within weeks, many continue to experience persistent symptoms to date. This phenomenon is often referred to as Long COVID. It is characterized by several symptoms that persist in people for weeks, months, or even years after the initial COVID-19 attack. The sad part is that Long COVID affects multiple organs and deeply impacts the quality of life. Therefore, the challenges faced by modern healthcare systems in this regard are many.
Prevalence and Risk Factors
According to an estimate, nearly 20%-30% of all people who have contracted COVID-19 are dealing with Long COVID. Some experts in the medical and research field also believe the number could be as high as 43%. Given these figures, it is easy to figure out how Long COVID is playing its part and changing the way people are leading their lives.
A look at the demographic point of view is enough to understand that middle-aged people have been hit the hardest. Also, more women than men are likely to contract Long COVID. It has also been found that people who have had a bad experience with COVID earlier are more likely to get the longest form of this disease than others.
Chances of developing Long COVID are high if you have some pre-existing medical conditions, like:
- Asthma
- Obesity
- Autoimmune disorders
- Type 2 diabetes
- Certain respiratory conditions
- Chronic cardiovascular conditions
Other factors are believed to equally contribute to Long COVID. These include high viral load during initial infection, absence of initial treatment, and the presence of certain inflammatory markers.
Knowing all these factors is important to identifying vulnerable sections of people and developing targeted interventions that will help mitigate the risks associated with Long COVID.
Common Symptoms of Long COVID
Symptoms of Long COVID can be diverse and may continue to persist for several months after the initial infection.
A] Physical Symptoms
- One of the most common symptoms of Long COVID is fatigue. People often complain about extreme tiredness even after taking adequate rest. This situation is usually referred to as ‘hitting a wall’. When fatigue creeps in, it can vastly impact an individual’s work performance and daily activities.
- People dealing with this medical condition also complain about chest pain. This pain may range from sharp and stabbing sensations. Though cardiac-related most of the time, it could also be musculoskeletal or related to lung inflammation.
- Another common symptom among people is dyspnea or shortness of breath. People suffering from Long COVID are often seen grasping for air after mild exertion. Sometimes, people can also be seen experiencing breathlessness even while taking rest. This condition can be particularly distressing for those who otherwise were leading a healthy and active lifestyle.
- People may also experience myalgia or muscle pain at times. While in some cases, the pain may be localized or restricted to some muscle groups or specific joints, in other cases it can transform to a more generalized body pain.
B] Psychological Symptoms
Long COVID patients also may have to deal with anxiety-related issues that often arise out of the unpredictable nature of the disease’s symptoms and their long-term implications.
In some patients, PTSD (Post-traumatic stress disorder) has also been observed, especially among those who have experienced ICU stays or acute COVID-19. Some of the symptoms include nightmares, flashbacks, and intense bouts of anxiety related to the illness.
Another major psychological symptom seen in people is depression. Major lifestyle changes, persistent COVID symptoms, and uncertainty regarding recovery often lead to low mood and feelings of hopelessness.
C] Cognitive Symptoms
Long COVID sufferers often complain of going through a condition called ‘Brain Fog’. This is a state of lack of clarity, mental confusion, and difficulty in thinking. When individuals go through this state, it can be disorienting and frustrating.
To make matters even worse, patients also report memory issues. This state can range from mild forgetfulness to severe short-term memory loss.
Another hallmark of Long COVID’s symptoms is difficulty in concentration. People dealing with this medical condition often find it hard to focus on tasks, absorb new information, and follow conversations. All this can significantly impact work and study.
Organ Systems Affected
Multiple organ systems can be affected when people get infected with Long COVID. And when this happens, a wide range of persistent symptoms and complications arise. Given below are some major organ systems that can be affected by this medical condition:
A] Cardiovascular System
An individual’s heart health is badly impacted by Long COVID. It has been seen that patients experience palpitations and continued chest pain. That’s not all, there is also evidence of more risks of conditions like inflammation of the heart’s outer lining and heart inflammation. POTS (Postural orthostatic tachycardia syndrome) have also been reported in some patients; causing rapid heartbeat and dizziness upon standing.
B] Respiratory System
Lungs are amongst the worst hit organs when individuals experience long-term effects of COVID-19. It is common to see patients complaining about reduced lung capacity and persistent shortness of breath. In severe cases, pulmonary fibrosis or scarring of lung tissues occurs which makes it difficult for an individual to breathe.
C] Endocrine System
The endocrine system that regulates hormones can also get badly affected due to Long COVID. When this happens, patients often complain about thyroid dysfunction. Several cases continue to be reported worldwide of patients developing diabetes or worsening pre-existing diabetic conditions. Several people have also reported changes in reproductive health or menstrual cycles.
D] Gastrointestinal System
Persistent digestive issues may also arise in people suffering due to Long COVID. Some of the symptoms include loss of appetite, abdominal pain, diarrhoea, and nausea. It is also common to see aggravated pre-existing gastrointestinal conditions or develop new food intolerances in people dealing with long-term COVID implications. There are also problems arising due to alteration of the gut microbiome that can further contribute to ongoing symptoms.
E] Nervous System
Neurological complications are also common in Long COVID. While in mild cases, individuals may experience mild cognitive impairment, in more severe cases, people may experience other symptoms like persistent headaches, seizures, and neuropathy. Patients may also experience loss of taste and smell in some cases.
Diagnosis and Testing
It is not easy to diagnose Long COVID because of its nonspecific and varied symptoms. Therefore, there isn’t a definitive test for this medical condition. Healthcare professionals need to rule out potential causes before attaching them to Long COVID.
Some of the most popular and commonly employed diagnostic approaches include:
- Physical examination
- Comprehensive medical history
- CT scans or chest X-rays to assess lung damage
- Blood tests to check on organ function, inflammation markers, and nutritional deficiencies
- Neurological tests for cognitive symptoms
- Pulmonary function tests for evaluating lung capacity
- Mental health screenings for checking psychological effects
- Electrocardiograms and echocardiograms for accessing heart functions
Treatment Approaches
The focus of various treatment approaches for Long COVID will be on managing symptoms, improving function, and supporting overall recovery. The treatment plans are personalized as the condition may vary from person to person.
The cornerstone of any Long COVID treatment lies in effectively managing its symptoms and this may include the following:
- Dietary modifications for managing gastrointestinal issues
- Breathing exercises to alleviate respiratory symptoms
- Cognitive exercises to tackle brain fog and memory issues
- Physical therapies for addressing muscle and joint pains
- Pacing strategies for managing fatigue
B] Rehabilitation programs
Specialized Long COVID rehabilitation programs have been developed by many healthcare systems. These include:
- Cardiac rehabilitation programs for heart-related symptoms
- Pulmonary rehabilitation programs for improving lung function
- Speech and language therapies for cognitive issues
- Occupational therapies to help with daily activities
- Gradual exercise programs for building stamina
C] Medications
Though specific cure is not available for Long COVID, some commonly prescribed medications include:
- Antihistamines for alleviating allergic-type symptoms
- Over-the-counter pain relievers to address body aches and headaches
- Anti-inflammatory drugs for reducing systemic inflammation
- Anti-anxiety medications or antidepressants for mental health symptoms
D] Mental health support
It is critical to address the psychological impact of Long COVID. Therefore, mental health support features include:
- Mindfulness and relaxation techniques for managing stress
- Creation of support groups for connecting with others experiencing similar challenges
- Providing counselling sessions to cope with the emotional impact of illness
- Cognitive behavioural therapy for managing anxiety and depression
Impact on Daily Life
Different aspects of life are badly affected by Long COVID. Therefore, it is common to see major changes in work, social interactions, and overall quality of life.
Long COVID patients often have to deal with reduced work capacity because of physical symptoms, cognitive difficulties, and persistent fatigue. The sad part is that many of them are forced to change their roles, reduce work hours, or even leave their jobs.
Some patients are also forced to limit their social engagements owing to their ongoing symptoms. The fatigue factor prompts many of them to stop engaging in activities they once enjoyed.
The overall quality of life of individuals also gets impacted because of the chronic and unpredictable nature of the condition. For example, exercise routines and hobbies are affected. Also, the psychological impact of not being able to fully understand the situation can lead to depression, anxiety and frustration.
Ongoing Research
A lot of research is ongoing to fully understand Long COVID and the challenges posed by it.
Researchers are trying to figure out various underlying mechanisms of Long COVID, including persistent viral reservoirs and potential autoimmune responses. Additionally, there are many large-scale studies taking place to understand the outcomes across diverse populations.
Many areas of research are promising, including immunomodulatory drugs for addressing dysregulated immune responses, antiviral therapies for targeting possible viral persistence, and treatments that will target specific symptoms like cognitive issues or fatigue. Efforts are also being made to develop personalized treatments for individual patient profiles.
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