UNDERSTANDING LONG COVID (LONG HAULERS)

You probably heard from those who recovered from COVID-19 that months after, they still experience symptoms. Or maybe you experienced it yourselves. Scientists call the condition post-acute sequelae of COVID-19 (PASC) and those who have it are popularly referred to as “COVID long haulers” and their symptoms as “residual.” However, these were loose terms and there was really no established definition. Recently, the World Health Organization (WHO) published a clinical case definition of post COVID-19 condition.

In the paper, WHO defined Post COVID-19 condition as:

- the condition that occurs in individuals with a history of probable or confirmed

SARSCoV-2 infection

- usually 3 months from the onset of COVID-19

- with symptoms that last for at least 2 months

- cannot be explained by an alternative diagnosis.

Common symptoms include fatigue, shortness of breath, gastrointestinal problems, cognitive dysfunction, etc. (see list below). They generally affect everyday functioning. They may be symptoms that persisted from the onset, or totally new symptoms that were not experienced during the active infection. The course of the symptoms is variable. They can change in frequency and intensity. They can also disappear and recur.

Common symptoms of post COVID-19 condition

Abdominal pain	Depression	Muscle pain/spasms
Acid reflux	Diarrhea	Neuralgias
Altered smell/taste	Dizziness	New onset allergies
Anxiety	​Fatigue	Pins and needles sensations
Blurred vision	Intermittent fever	Post-exertional malaise
Chest pain	​Headache	Shortness of breath
Cough	Joint pains	Sleep disorders
​Constipation	Memory issues	Tachycardia/palpitations
Cognitive dysfunction / brain fog	Menstrual and period problems	Tinnitus and other hearing issues

Incidence of post COVID-19 condition

A peer-reviewed study from Oxford University involving 270,000 COVID-19 survivors gave the following conclusions:

- 1 out of 3 COVID-19 survivors had one or more features of post COVID-19

condition 3 and 6 months after being diagnosed with COVID-19

- 40% had symptoms that they did not experience during infection or prior to

recovery

- survivors who had more severe COVID-19 illness had higher risk of having post

COVID-19 condition

In another study from Harvard University of 52,000 COVID-19 survivors, researchers found that new diagnosis of diabetes mellitus and neurological disorders were common complications after recovery. They also occur more frequently in patients below the age of 65. Another study reported that middle-aged women seem to be the worst affected.

Recovery

We do not have enough data yet to say conclusively how long it will take to recover from post COVID-19 condition, but a longitudinal cohort study suggests that significant improvement after a year was documented in patients with post COVID-19 condition. However, their overall health status was still lower than those who never had the condition -- more mobility problems, pain and discomfort, anxiety and depression, and generally with more prevalent symptoms.

Role of vaccines

Researchers from King's College London using real-world data reported that vaccination cuts not only the risk of contracting COVID-19 but also the chances of it developing into post COVID-19 condition.

As we gather more information from around the globe, we’ll have a wider perspective and better understanding of the situation. This will enable us to create more strategic programs to combat the COVID-19 pandemic. In the meantime, we must still observe the basic health and safety precautions – wearing mask, washing hands, physical distancing, and getting vaccinated.

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