THE COVID HANGOVER


The Covid pandemic has cast a long and bewildering shadow that continues to confound scientists – long Covid – an all-encompassing term used to describe more than 200 different symptoms suffered by people long after they were first infected by the coronavirus. 

The scientific community is unsure why certain conditions persist, who will be affected, and for how long. The World Health Organization (WHO) has given it a name – post-Covid condition – and is focusing more resources on refining the diagnosis. 

Hospitals continue to improvise their treatment approaches, while patients and physicians struggle with all the uncertainty. The most in-depth research study to date on long Covid was recently published in The Lancet. It found that one in eight adults (13%) infected with coronavirus suffered post-Covid symptoms, but experts are calling for more research and specialized healthcare facilities for this “urgent health problem.”

Lorenzo Armenteros, a spokesperson for the Spanish Society of General Practitioners (Sociedad Española de Médicos Generales), also claims that some colleagues “still do not believe that this condition exists.” Armenteros said, “It’s a public need and a significant epidemiological challenge – it must be treated.” The WHO’s clinical case definition of post-Covid condition states that it occurs in individuals, “… usually three months from the onset of Covid-19 with symptoms that last for at least two months and cannot be explained by an alternative diagnosis.”

But it’s hard to get a fix on the scope of long Covid. The WHO’s European Observatory on Health Systems and Policies noted in 2021 that 25% of people with Covid had symptoms up to a month after diagnosis, and 10% still had symptoms 12 weeks later. One study found that only 2.3% had post-Covid conditions, while another found at least one recurring symptom in 73% of those infected. A June 2022 survey by the US Centers for Disease Control and Prevention (CDC) reported that one in five adults who had Covid suffered from persistent symptoms.

One of the most common symptoms are neurocognitive disorders, said Domingo. People report having “… a kind of brain fog… they have trouble concentrating and can’t remember things.” He has also observed respiratory problems. “We saw a study of a group of patients with air trapping in the lungs, which is when the smallest airways remain inflamed, like asthma.” Vicky Béjar says that the most debilitating problem for her is the neurological deterioration and fatigue. “There are days when I just can’t get my body going and I can’t leave the house.”
 
 

Deciding on the right treatment for long Covid is difficult without knowing its cause. Specialists recommend mental exercises to overcome neurocognitive problems, physical exercise for motor damage, and training methods to recover the sense of smell. But all the experts agree that long Covid has a high impact on quality of life. It has “many social and personal implications,” said Armenteros. “Some patients don’t fully recover by the time they run out of sick leave from work, and their employers don’t offer any options for a gradual return to the workplace.” Other patients are still struggling to recover from long Covid. Armenteros says that it’s not clear what type of person is predisposed to long Covid. Some studies indicate that it affects women more than men, but he says “… we need more research to evaluate whether the female gender is a risk factor.”

One thing experts share is a concern about the uncertainty that surrounds long Covid and its impacts. Ballering warns that it is “an urgent health problem, with a growing number of victims.” US Assistant Secretary for Health Rachel Levine agreed in a recent JAMA article, “It is important to focus a new lens on the pandemic and direct much-needed attention to long Covid. Taking care of affected patients presents challenges given the incompleteness of research, the lack of sufficient diagnostics support, and pervasive problems with access to services.”