Everything You Need to Learn About Long COVID-19

Are your patients complaining about long-term symptoms after contracting SARS-CoV-2 infection?

Every human will have their own experience of COVID-19. Many people suffer from persistent symptoms even after weeks of contracting this infection. Some of them may go through new, recurring, or various symptoms even after four weeks. Hence, some term these people’ ‘long haulers.’

Long-haul COVID mainly occurs in patients with underlying conditions before contracting acute COVID-19.

Many names can be given to this condition.

• Long COVID
• Post-acute COVID-19
• Long-term effects of COVID-19
• Post-acute COVID-19 syndrome
• Chronic COVID
• Long-haul COVID
• Late sequelae
• Post-acute sequelae of SARS-COV-2 infection (PASC)

In this article, we’ll refer to it as long COVID.

What Is Long COVID?

Long COVID is a state when ongoing symptoms of COVID-19 infections take weeks and months to last. It is non-transmissible.

Ask your patient to consult you if they are unable to recover from the initial COVID-19 infection within four weeks. Provide them guidance about post-COVID symptoms.

Long COVID vs Post-COVID Syndrome

Patients typically take four weeks or less to recover from a COVID-19 infection. Anything beyond that is either long COVID or post-COVID syndrome.

Research published in October 2021 splits these two on temporal grounds:

• Long COVID (referred to as ongoing symptomatic COVID) — four to 12 weeks after initial infection
• Post-COVID-19 syndrome — 12 weeks or more from initial infection

The symptoms for both are similar and multi-organ (due to COVID-19’s entry point into cells being present in many areas of the body).

Additionally, despite the technical differentiation, many patients are now familiar with the term long COVID, so it may be appropriate to continue to use this term even after 12 weeks have passed.

NICE’s guide, developed with the Scottish Intercollegiate Guidelines Network (SIGN) and the Royal College of General Practitioners (RCGP), is available here and covers everything from diagnosis to an ongoing duty of care.

The WHO’s clinical case definition of long COVID, published in October 2021, is available here.

What are the symptoms of Long COVID?

Chest pain is a usual manifestation of COVID-19 infection. But do ask your patient to consult you if the pain persists for weeks or feels new, as it can be a sign of a serious lung or heart problem. Patients battling severe illness may report some other types of symptoms.

As said above, symptoms can vary. Long COVID symptoms are typically multiorgan and patients can experience between 25 and 85 over the course of the illness. Here are a few commonly reported signs and symptoms according to the Center for Disease Control and Prevention:

• Difficulty in breathing
• Shortness of breath
• Tiredness and fatigue
• Post-exertional malaise
• Difficulty thinking or concentrating (sometimes referred to as “brain fog”)
• Cough
• Chest or stomach pain
• Headache
• Joint or muscle pain
• Pins-and-needles feeling
• Heart palpitations and/or tachycardia
• Joint pain (arthralgia)
• Muscle pain (myalgia)
• Unexplained itching or crawling sensation on the skin (paresthesia)
• Diarrhea
• Sleep problems
• Fever
• Dizziness on standing, lightheadedness
• Rash
• Mood changes
• Change in smell or taste
• Changes in menstrual cycles

What Is the Cause Behind Long COVID?

A March 2022 study found four main risk factors for patients to develop long COVID:

• A high viral load
• Diabetes (Type 2)
• High autoantibodies level
• A prior instance of glandular fever/mono, leading to dormant Epstein-Barr virus in the body that can be reactivated by COVID-19

Some of the study’s patients had all four risk factors, while others only had one, and it is currently uncertain whether having more of them increases the severity of long COVID or just the likelihood someone will develop it.

Treating Long COVID

You should inform your patients that there are no specific medicines to treat long COVID because different conditions and symptoms are treated accordingly. Many patients feel symptoms in their hearts, brain, and lungs. Therefore, a customized treatment plan is prepared to help them.

Antiviral medications, especially when taken during the initial four-week infection of COVID, have been shown to reduce long COVID symptoms. This ties into a high viral load being a risk factor for long COVID. Antiviral medication may not help relieve the patient’s symptoms directly but will aid the body in fighting off the virus.

Some people develop severe effects from this infection. In these cases, you may need to refer them to a rehabilitation center or other supporting channels as relevant for their symptoms.

Otherwise, lifestyle changes, a healthy diet, indoor air purification, and managing common symptoms can help. In addition, the introduction of immunity-boosting supplements and food can decrease the recovery time.

Recovery time from long COVID varies for each individual; the duration also depends on the severity of the patient’s symptoms.

You can suggest your patients monitor their cough using the Hyfe app. The Hyfe App uses artificial intelligence to track coughs to recognize an outbreak early. Additionally, it gives users tips to adjust their daily routines for better health.