Long Covid is a condition in which the effects of COVID-19 continue for weeks or months beyond the initial illness. It is early in the understanding of this condition but the evidence is accumulating that the condition may be widespread. A recent review in The Lancet titled 'Long COVID has exposed medicine’s blind-spot' considers the long recognised association of fatigue and neurological conditions which have historically been labelled as 'post viral' or 'chronic fatigue'. In February 2021 the National Institutes of Health announced a US$1.15 billion initiative to support research and resources into Long Covid. In the UK it is estimated that 14% of cases of Covid lead to symptoms which last for longer than 3 months and in 90% of these cases the original symptoms were not severe enough to require hospitalisation.
Broadly, Long Covid symptoms fall into three main categories. There are those of impaired cognitive or brain function. This may include impairment of mood, memory or the feeling of 'brain fog'. The second group includes poor exercise tolerance, this may involve shortness of breath or fatigue with minimal activity. The final group of symptoms are caused by an upset in the automatic or autonomic nervous system. This leads to symptoms such as dizziness, indigestion or palpitations. The symptoms of Long Covid may change over time and individuals can move between the symptoms above.
The Lancet article describes the hypotheses around Long Covid as broadly a) this is something new and unique to the SARS-CoV-2 virus or b) although we do not yet understand the mechanisms, ultimately Long Covid will be caused by similar processes that occur in other chronic fatigue and post-viral syndromes. The latter seems intuitively logical and offers hope that we can both learn from existing chronic fatigue research and that research into Long Covid may hopefully help in other medical conditions associated with fatigue.
The research around Long Covid is currently focused on:
- Persistence of viral infection
- Autoimmune reactions to the primary viral trigger
The lack of a single specific test makes the diagnosis and management of Long Covid challenging. Best results are achieved by honest and open communication with a focus on the management of the physical, psychological and social aspects of the condition.
At OT&P we remain committed to providing a balanced and evidence-based analysis of Long Covid. We have set up a resource centre where we will continue to provide ongoing updates and share research and resources. If you have any research or articles you would like to share please contact us at firstname.lastname@example.org.
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