Long Covid

What is Long COVID? 

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is a term used to describe a range of persistent and often debilitating symptoms that some individuals experience after recovering from the acute phase of COVID-19. These symptoms can last weeks or months and affect various body parts, including the respiratory, cardiovascular, nervous, and more. Long COVID-19 can significantly impact a person's quality of life and ability to perform daily activities.

Risk Factors for Long COVID

Long COVID can affect individuals of any age, including those with mild or asymptomatic initial COVID-19 infections. However, research has shown that certain groups may be at a higher risk of developing Long COVID:

• Age: Older individuals are more likely to experience Long COVID, but it can affect people of all ages.
• The severity of initial infection: Those with a more severe acute COVID-19 illness are more likely to develop Long COVID, but it can also occur in individuals with mild or asymptomatic cases.
• Gender: Some studies suggest that women may be more likely to experience Long COVID than men, but more research is needed to confirm this.
• Underlying health conditions: Individuals with pre-existing health conditions, such as diabetes, obesity, or autoimmune disorders, may be at an increased risk of developing Long COVID.

Causes of Long COVID

The exact cause of Long COVID is not fully understood, but several factors may contribute to its development:

• Viral persistence: The SARS-CoV-2 virus may persist in some individuals after the acute infection has resolved, leading to ongoing symptoms.
• Immune dysregulation: Long COVID may involve an abnormal immune response to the initial infection, causing inflammation and damage to various organs and systems.
• Autoimmunity: Some researchers speculate that Long COVID could be related to autoimmune responses triggered by the initial infection, where the immune system mistakenly attacks the body's tissues.
• Microvascular damage: The virus may damage small blood vessels, affecting the function of multiple organs, including the heart and brain.
• Psychological factors: The stress and trauma of dealing with a severe illness and the social and economic impacts of the pandemic can contribute to Long COVID symptoms.

Symptoms of Long COVID

Common symptoms include

• Fatigue: Persistent and often debilitating tiredness that can interfere with daily activities.
• Shortness of Breath: Difficulty breathing, even with mild exertion, which may be accompanied by chest pain.
• Cognitive Issues: Often referred to as "brain fog," this can include memory problems, difficulty concentrating, and mental fatigue.
• Joint and Muscle Pain: Persistent muscle and joint pain can be widespread.
• Headaches: Frequent or severe headaches are a common symptom of Long COVID.
• Loss of Taste or Smell: Some people experience a prolonged loss or alteration of their sense of taste or smell.
• Heart Palpitations: Irregular or rapid heartbeats, often accompanied by chest discomfort.
• Gastrointestinal Symptoms: Digestive issues like diarrhoea, abdominal pain, or nausea may persist.
• Sleep Disturbances: Insomnia, disrupted sleep patterns, or excessive sleep can be part of Long COVID.
• Mood and Mental Health Changes: Anxiety, depression, and mood swings are reported by some Long COVID patients.
• Skin Rashes: Skin issues, including rashes and hives, have been observed in some cases.
• Hair Loss: Thinning hair or hair loss can occur as a symptom.
• Temperature Dysregulation: Fluctuations in body temperature, including chills and low-grade fevers.
• Dizziness and Balance Problems: Some individuals experience dizziness or balance issues.
• Swelling and Inflammation: Swollen lymph nodes or other signs of inflammation in various body parts.

Phases of Long COVID

Individuals with Long COVID often describe their experiences in terms of different phases or stages based on the progression of their symptoms. These phases can vary in duration and severity from person to person. Here's a general description:

• Acute Phase: This is the initial phase when a person is recovering from the acute infection but may still experience persistent symptoms.
• Subacute Phase: This phase follows the acute phase and is characterised by ongoing symptoms, which may change or evolve. Symptoms may still be severe during this stage.
• Chronic Phase: When symptoms persist for several months, they are often considered part of the chronic phase. At this point, some individuals may see improvements in certain symptoms while others may experience various issues.
• Management and Recovery Phase: This phase is characterised by symptom management and efforts to improve quality of life. Rehabilitation, therapies, and support are often part of this stage as individuals work towards recovery.

Diagnosis of Long COVID

Diagnosing Long COVID can be challenging because it is primarily based on persistent symptoms following a confirmed or suspected COVID-19 infection. There is no specific test or marker for Long COVID; the diagnosis is usually made through clinical evaluation and a detailed medical history.

• Clinical Assessment: doctors will assess your medical history, including whether you had a COVID-19 infection in the past. They will ask about the nature and duration of your persistent symptoms.
• Physical Examination: A physical examination may be performed to check for signs or physical findings related to Long COVID.
• Laboratory Tests: Depending on your symptoms and medical history, your doctor may order specific tests to rule out other potential causes of your symptoms. These tests can include blood tests, imaging studies, and pulmonary function tests.
• Rule Out Other Conditions: Long COVID symptoms can overlap with those of other medical conditions. It's essential to rule out other possible causes of your symptoms, such as heart disease, lung conditions, autoimmune disorders, etc.
• Consultation with Specialists: Depending on the nature of your symptoms, you may be referred to pulmonologists, cardiologists, neurologists, or rheumatologists to assess and manage specific aspects of Long COVID.

Treatment for Long COVID

Dr Samra and many other nutritionally oriented doctors have developed special skills in treating this often prolonged and difficult condition. Using natural therapies, dietary changes, vitamin and mineral supplements often as injections or infusions], and behavioural modifications, the symptoms and the condition are often dramatically improved in far less time.

Treatment for Long COVID primarily focuses on managing and alleviating specific symptoms and improving the patient's quality of life. Treatment approaches may include:

• Symptom Management: Various medications may be prescribed to manage specific symptoms. For example, pain relievers may be used for muscle and joint pain, and medications can be prescribed for sleep problems, anxiety, or depression.
• Physical and Occupational Therapy: Physical therapy can help individuals regain strength and mobility, while occupational therapy can assist with daily activities affected by cognitive or physical symptoms.
• Pulmonary Rehabilitation: Pulmonary rehabilitation programs can help improve lung function and respiratory endurance for individuals with respiratory symptoms.
• Mental Health Support: Psychological support and counselling may be beneficial for managing anxiety, depression, and other mental health issues that can accompany Long COVID.
• Diet and Nutrition: A balanced diet and nutritional support can be important for overall health and energy levels.
• Rest and Self-Care: Rest and pacing activities can be crucial for managing fatigue and preventing symptom exacerbation.
• Hydration: Maintaining good hydration is essential, especially if gastrointestinal symptoms are present.
• Support Groups: Joining support groups or seeking peer support can provide emotional support and helpful information from others dealing with Long COVID.

What if Long COVID is Untreated?

Untreated Long COVID can lead to ongoing physical and mental health issues, reduced ability to perform daily activities and an increased risk of disability. It is crucial to seek medical care and support if you are experiencing persistent symptoms after a COVID-19 infection, as early intervention and symptom management can improve outcomes and overall well-being. Effective management and treatment may also help prevent the progression of symptoms into the chronic phase.