OPINION

When does long Covid end?

As the Covid-19 Pandemic progresses, some patients are experiencing prolonged multi-organ symptoms and complications beyond the initial period of acute infection and illness.

Prof Morgan Chetty,

visiting Prof: Health Sciences, DUT chairman, IPAF, CEO: KZNDHC

THE LIST OF new and persisting affecting the heart, lungs, gastro-intestinal those who were not hospitalised response after the infection has symptoms reported by patients is system, muscles and joints. There was for severe Covid-19, the prolonged been cleared extensive and includes: also an in-depth look at neurological and symptoms are having a major impact on - Patients being biologically predisposed to Chronic cough, shortness of breath, neuropsychiatric symptoms. lives and livelihoods. such a response. chest tightness, cognitive dysfunction, In a survey of 3 762 individuals in USA Six months after onset of illness, more and extreme fatigue. This has been termed - More than 50% never sought hospital care than 75% of people hospitalised with Other theories proposed why some people’s

‘Long Covid’ or ‘Post Covid-19 Syndrome’. - 8% were admitted to hospital for Covid-19 Covid-19 in Wuhan between January and recovery is prolonged:

The Syndrome is defined as a collection of - 2 464 reported Covid-19 symptoms May 2020 continued to report at least one - Relapse or re-infection symptoms lasting more than 28 days. lasting six months. symptom: fatigue, muscle weakness, sleep - Inflammatory or other immune reactions The implications and consequences of difficulties, anxiety and depression. - Deconditioning such ongoing clinical manifestations are Among the most common symptoms More than 50% had significant - Mental disorders like Post Traumatic growing and is a health concern. were fatigue, worsening of symptoms persistent abnormalities, which were more Stress (PTS). Work is being done to try and understand after physical or mental activity, shortness common in those who had been more why following Covid-19 infection, the of breath, trouble sleeping and difficulty severely ill. A Study done at Kings College in SOME EXPLANATIONS impact varies from full recovery to severe thinking clearly. The majority, (80%) said the UK, found that one in every 20 people Interferon alpha, when given to people as a persistent debilitating symptoms affecting that they coped with some form of cognitive experienced long term symptoms. Work treatment for Hepatitis C, generated a ‘flumultiple organs and mental health. dysfunction or memory loss that to varying done in the NHS in Wales reported one in 10 like illness’ in many patients and post viral Research suggests that one in five degrees affected their everyday lives. This have symptoms after three weeks and some fatigue in a few. people who test positive for Covid-19 have includes the ability to make decisions, have may suffer for months. Researchers have studied this symptoms for five weeks or longer. In the UK conversations, follow instructions and drive. Journal of American Medical Association artificial infection response as a model of this equates to 186 000 individuals with Those who had Covid-19 symptoms for – Team of Researchers from Italy reported chronic fatigue. They found the baseline symptoms persisting for five to 12 weeks. more than six months reported contending nearly nine out of 10 patients (87%) levels of two molecules in the body that Med RX IV preprint survey done on with 14 symptoms on average. discharged from hospital in Rome were still promote inflammation: Interleuken 6 and 3 700 self-described Covid-19 ‘Long Many reported relapses of symptoms experiencing at least one symptom, 60 days Interleuken 10, predicts people’s subsequent

Haulers’ in 56 countries showed that nearly seemingly triggered by exercise, mental after onset. development of chronic fatigue. 50% could not return to full-time work activity or just everyday stress. The theory of ‘Super Antigen’ in the spike six months after unexpectedly developing More than 50% of respondents said that Why do people suffer longer? of the coronavirus, which causes multiple prolonged symptoms of Covid-19. they had to reduce their hours at work due to There are a number of theories. Some inflammatory syndrome in children is being The second study emphasised the the severity of the symptoms. theories from Kings College in the UK: proposed to cause multiple inflammatory course and severity of more than 200 Another 22% were not working at all due - Severity of the initial illness syndrome in adults that may results in the symptoms over time, including those to their Long Covid. Studies show that even - Prolonged and inappropriate immune presentation of Long Covid.