What are we discovering about Long Covid symptoms, which is growing as a health crisis inside a health crisis? Jamie Morton, a science reporter, explains.
Long Covid symptoms has a greater impact on individuals than we realize
Two years after a UK archaeologist coined the term “Long Covid” to describe the chronic, post-viral sickness that afflicted her, scientists are still uncovering worrisome details about this set of symptoms.
A significant UK research published this week found some of the best proof yet that Covid-19 infections can affect our brains in the long run, particularly in regions related to scent and memory.
A month earlier, a US research of 153,000 veterans revealed that the risk of heart disease increased significantly in the year after an infection, even in mild instances.
These are only two instances of the long-term effects of Covid-19 on our bodies.
Long Covid symptoms may damage practically every organ system, according to scientists, who have connected post-infection difficulties to respiratory, metabolic, neurocognitive, gastrointestinal, cardiovascular, and mental health diseases.
Given this diversity, it’s no surprise that symptoms range from weariness to headaches to muscular weakness to shortness of breath to loss of smell and cognitive problems.
Although the causes of Long Covid symptoms remain unknown, senior professor Dr Anna Brooks of the University of Auckland believes it was caused by a mix of direct impacts from infection and indirect consequences from the defensive immunological response.
“What we do know is that it is a complex, multi-system illness largely driven by dysfunction of the immune, nervous and circulatory systems leading to a spectrum of debilitating symptoms.”
Dysautonomia – or a disturbance of “autopilot” activities of our neurological system such as heart rate, respiration, and digestion – was one of the most prevalent, she claimed.
Long Covid symptoms may still follow even minor viral infections, affecting individuals of different ages, including healthy young individuals.
A team of researchers, including Brooks, highlighted to the possibility of Long Covid symptoms, as well as the uncommon but severe multisystem inflammatory syndrome peculiar to the virus, in a recent round-up of data of post-acute effects of Covid-19 in children.
Dr Amanda Kvalsvig, an epidemiologist at Otago University, said there was still a lot of uncertainty about how unusual or prevalent these effects might be in New Zealand.
“We can expect impacts to be less severe for children than for adults, but we can also expect that the risk will be spread unevenly in our populations.”
Omicron does not imply that anything is getting better
It was impossible to determine exactly what the variation meant for Long Covid symptoms risk because cases were only beginning to surface in the first places Omicron raced across three to four months ago.
Even yet, the sheer magnitude of Omicron’s infections was significant.
Dr. Mona Jeffreys, a researcher from Victoria University who is co-leading a large investigation looking into Covid-19’s influence in this country, quantified the danger.
“If, say, 10 per cent of people have Covid symptoms that persist beyond one month, we would expect about 1000 people in Aotearoa New Zealand to be in this group, based on pre-Omicron data,” she said.
“Based on current numbers – over 260,000 currently – we will be looking at a huge case-load of people.”
While previous research revealed that immunization lowered the incidence of Long Covid symptoms, Brooks said there was no evidence to suggest that the same was true for Omicron.
“Although vaccination, especially when recently boosted, has proven protective against hospitalisation and severe illness, we know that Omicron is able to partially evade our immune defence, which means there are much higher rates of symptomatic, or breakthrough infections,” she added.
“In fact, we don’t often hear the term ‘breakthrough’ like we did for Delta, given it is now relatively common following exposure to Omicron.”
The danger maintained as long as Omicron was prevalent in our communities, with symptomatic infections widespread, she added.
“We need widespread awareness: the narrative that Omicron is ‘mild’ is dangerous and misleading.”
She noted that the descriptor “mild” implied fewer fatalities and hospitalizations from major diseases, which she attributed to high vaccination rates.
“Vaccinations are critical but are just one layer of protection, and an imperfect one at that,” she said, pointing to waning vaccine immunity and the likelihood of new variants.
“So, emphasis on infection prevention should be maintained to reduce infection transmission through vaccination, mask-wearing and adequate indoor ventilation,” she said.
“Even a small per cent of widespread infection is going to lead to a significant health and economic burden.”
The best therapy is prevention
Brooks’ view was reinforced by Professor Harvey White, a cardiologist who runs Auckland City Hospital’s Green Lane Cardiovascular Research Unit.
“It is real and anybody can get it. The best way to avoid it is to not get Covid in the first place,” he said.
“Don’t trivialise getting it, you could have heart attacks or strokes in the future, or brain fog affecting your memory and thinking, or fatigue affecting your ability to work or take part in recreation.”
Experts advised patients who did get Covid-19 not to try to fight the virus.
“If we look at the people that are affected by Long Covid, it includes those who have quite mild symptoms with the initial infection, as well as young people and those who are very high-functioning physically and cognitively – like athletes or those who hold down high-powered and stressful jobs,” Otago University cardio-respiratory physiotherapist Dr Sarah Rhodes said.
“We think that, if you try to push through with an acute infection, that possibly increases your propensity to develop the persistent symptoms.
“That means resting when you have an infection – even if you’re only mildly symptomatic – is a really important thing to take on board.”
There were no particular therapies available at the time for individuals who did develop Long Covid symptoms.
“Obviously, there are a massive amount of symptoms – more than 200 – but a big one is fatigue,” Rhodes said.
“Here, what we really encourage people to do is think about managing their energy levels: that means learning about their energy reserve and recognising how much they’ve got, so they’re not depleting it by doing certain things.
“It also means planning out your day, pacing yourself, and not trying to do more and push through, as this is likely to tip the balance and lead to a crash.”
Dr. Bronwyn Lennox Thompson, a pain management expert at Otago University, recommends that patients start their days with a low level of activity and gradually increase it, interspersed with regular planned pauses throughout the day.
“At first you may need to rest before you think you need to, but avoiding a ‘boom and bust’ cycle of overdoing then having to rest is crucial.”
Long Covid symptoms sufferers should also eat a balanced, nutritious diet and seek aid from friends and family when necessary.
“They may question your motivation because your recovery is slow, and you may question your own motivation,” Lennox Thompson said.
“Be prepared to say what it’s like for you, but most of all, tell people what you think they can do to help.”
She said that because healing can be lengthy and discouraging, some people may begin to doubt their mental health and experience low mood.
“Cultivate some time for yourself, connection with at least one good friend, and consider using a form of meditation or relaxation practice,” she said.
“Reach out for counselling or talk therapy if you need it.”
According to Brooks, there are currently no recognized support routes for Long Covid patients.
“Access to medical care has been challenging, whereby people with Long Covid regularly report a lack of understanding of the condition or knowledge to assist,” she said.
“Notwithstanding, medical management guidelines are still emerging, and we hope that in due course dedicated Long Covid services will be implemented.”
