Long Covid: Rehab and the Long Term Impact | Prognosis: Covid UNCUT

Most patients who suffer from Covid-19 fully recover, but some suffer long-term pulmonary, cardiovascular and nervous-system problems as well as psychological effects. These can occur irrespective of the initial severity of the SARS-CoV-2 infection, but happen more frequently in women, the middle-aged, and in individuals who experienced more Covid symptoms initially. Although most long Covid symptoms don’t seem to be life-threatening, a study published in April 2021 in the journal Nature found that sufferers had a 59% increased risk of dying within six months. That works out to about eight extra deaths per 1,000 Covid patients -- adding to the pandemic’s hidden toll.

What’s the definition?

According to the World Health Organization, people with what it calls “post Covid-19 condition” have symptoms usually three months after an initial bout of Covid that last for at least two months and can’t be explained by an alternative diagnosis. Common ones include fatigue, shortness of breath and cognitive dysfunction -- all of which affect everyday functioning. These ailments may appear following recovery from the acute phase of Covid -- even one with no noticeable symptoms -- or persist well after the initial illness. Symptoms may also fluctuate or relapse over time.

How prevalent are long-term effects?

About 1.1 million people in the U.K. reported experiencing long Covid as of early September, according to the Office for National Statistics. Of those:

- 405,000, or 37%, had confirmed or suspected Covid-19 at least one year previously;

- 706,000, or 65%, said symptoms adversely affected day-to-day activities;

- 211,000, or 19%, reported that their ability to undertake day-to-day activities had been “limited a lot.”

Is Covid-19 definitely to blame for these symptoms?

Not necessarily. A large study based on data from a U.S. health plan published in the BMJ in May found that 14% of people infected with the coronavirus developed one or more related complications requiring medical care beyond the acute phase. But so did 9% of people in a control group. Some symptoms might occur by chance or be triggered by stress and anxiety. Social restrictions, lockdowns, school and business closures, loss of livelihood, decreases in economic activity and shifting priorities of governments all have the potential to substantially affect mental health, according to a study that appeared Oct. 8 in the Lancet. It found the pandemic has resulted in an extra 53.2 million cases of major depressive disorder and an extra 76.2 million cases of anxiety disorders globally. In some critical Covid cases, life-saving treatment itself may cause problems. Such uncertainties have sometimes led to what patients describe as “medical gaslighting” by health professionals who don’t take their complaints seriously, especially if the patient is a woman.

What is being done?

In the U.S., Congress is providing some $1.15 billion in funding over four years for the National Institutes of Health to support research into the long-term effects of Covid. The studies hopes to get at issues such as the underlying biological causes and how they might be treated and prevented. Some researchers are pressing governments to focus attention not only on infection and vaccination rates but on potential long-term organ damage. For example, researchers have shown the virus can infect insulin-producing pancreatic tissue, potentially triggering diabetes that in some cases persists beyond the acute infection. That’s prompted Australia’s Monash University and King’s College London to create a global registry for studying “new onset” diabetes. Some long haulers have reported feeling better after receiving a Covid vaccination, prompting researchers to examine the phenomenon and whether vaccines can offer clues to treatment. Avindra Nath, clinical director of the U.S. National Institute of Neurological Disorders and Stroke, said vaccines, including for flu, have been known to help patients with chronic fatigue, but relief has almost always been temporary.

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