What is Long COVID?

For most people, COVID-19 is a mild illness that passes quickly. Individuals' symptoms can differ dramatically, while a significant percentage of people experience no symptoms at all.

At around the mid-point of 2020, reports began to emerge of people experiencing prolonged COVID-19 symptoms. While many of these people had previously tested positive for COVID-19 and recovered from their illness, a significant percentage reported symptoms despite never having had COVID-19, at least as far as they knew.

This quickly led to the continuation of symptoms being labelled as post-COVID-19 syndrome, or long COVID.

How do we define long COVID, and how common is it?

The United Kingdom’s National Institute for Health and Care Excellence (NICE) defines long COVID as experiencing COVID-19 symptoms for over 12 weeks.

As with everything else concerning COVID-19, we continue to learn more every day; however, we do know at present:

• Approximately 20% of COVID-19 patients experience symptoms for longer than five weeks.
• Approximately 10% of COVID-19 patients experience symptoms for longer than 12 weeks.

At the time of writing, the World Health Organization’s (WHO) COVID-19 dashboard reported over 103 million positive global COVID-19 cases. We know this data is incomplete, due to a combination of factors, including:

• Shortfalls and gaps in testing capacity in many countries, particularly in the early months of the pandemic.
• The number of asymptomatic COVID-19 cases being unknown. However, the British Medical Journal's most recent estimate is that between 17% and 20% of COVID-19 cases are asymptomatic.

However, we can still assume that at least 10 million people worldwide are experiencing or will experience long COVID.

What are the symptoms of long COVID?

As with COVID-19 itself, the symptoms of long COVID can differ between patients.

We know that patients who experience severe COVID-19 illness leading to pneumonia or respiratory failure may suffer lung scarring and long-term damage to other organs. Some studies also indicate that severe COVID-19 patients have a higher risk of suffering a subsequent dangerous blood clot, heart attack, or stroke.

However, you can experience long COVID symptoms no matter how severe your experience of COVID-19. Indeed, as we saw earlier, some people will develop symptoms following an asymptomatic COVID-19 infection!

Commonly identified and observed symptoms of long COVID include:

• Anxiety and depression.
• “Brain fog,” where you find it difficult to concentrate or focus, even for short periods.
• Breathlessness, even after doing something relatively trivial such as walking a short distance.
• Chest pains.
• Fatigue and general tiredness.
• Heart palpitations.
• Joint or muscle pain, even after prolonged periods of rest.

It’s easy to see how experiencing some specific symptoms can exacerbate others. For example, there have been several reports of people experiencing worsening mental health, due to previously being fit and active, but now unable to pursue certain hobbies and passions.

As well as the symptoms themselves differing, individual experiences of long COVID tend to be unique, too.

While some patients experience continuous symptoms, for others they can come and go, sometimes returning suddenly and without warning. As such, long COVID can have a prolonged effect on our careers and personal lives, as well as our health.

What causes long COVID?

We do!

Long COVID is our body continuing to react to the initial COVID-19 infection. We experience symptoms and illness as our body effectively ends up attacking itself once we've rid ourselves of the virus.

How long does it take to recover from long COVID?

It depends; everyone is different.

It’s perhaps most crucial to remember that it's common for viral illnesses to have long-lasting effects. We have heard much about long COVID in recent months because of the pandemic's continuing prevalence and visibility. Still, you're just as likely to have felt long-term effects from an influenza virus as you are to experience long COVID.

At the same time, for most other viruses, we would expect to be free of symptoms, other than tiredness, within three months, which is why long COVID may be unique.

Is long COVID contagious?

No. Once you have completed any required period of isolation following a positive COVID-19 test, you will no longer be contagious.

Depending on the treatments available to help you deal with long COVID, you might be able to access further COVID-19 tests to ensure you continue to test negative. While a recent UK Biobank report highlights that up to 80% of people retain COVID-19 antibodies six-months post-recovery, there is still a chance you could become re-infected.

How is the global community dealing with long COVID?

Many countries have already created physiotherapy and rehabilitation centres to treat long COVID patients and ease pressure on healthcare systems still dealing with vast numbers of COVID-19 patients. Countries have also deployed various treatment plans to help patients, depending on the severity of their symptoms. For example, in the United Kingdom, some healthcare providers offer a four-week in-patient stay for long COVID patients. However, for many patients, a self-guided rehabilitation program and regular outpatient check-ups are sufficient.

How should I deal with long COVID?

It depends on the specific symptoms you’re experiencing. Speak with your doctor about your symptoms and take their guidance. You may also consider:

• Building up your activity levels rather than trying to run long distances, for example, if you're experiencing fatigue. However, you should try and push yourself to do as much as you can, to ensure your muscles keep working and don't atrophy.
• Connect with others and create yourself a daily routine if you’re struggling with your mental health. Staying active can also help you to manage your mental health and mood.
• Develop a habit of taking notes if you’re struggling with brain fog. Create plans at moments of clarity. This means even when you are struggling to focus, you’ll have something refer to that will tell you what to do.
• Embracing a new hobby such as yoga to work on your joints and muscles, stay active, while improving your mood and overall mental health.