At the start of 2020, coronavirus was still a relatively new illness with little knowledge around it.
With still much to learn about the virus, new information is being revealed all the time – and in recent weeks it has come to light that symptoms could last much longer than first thought, in a phenomenon called ‘long Covid’.
A recent study found almost three quarters of patients admitted to hospital with the virus still have ongoing symptoms three months later.
And following concerns the numbers of people suffering with long Covid may surge over the winter, it was reported yesterday how a man died from long-term symptoms despite being discharged from intensive care three months ago.
And the Government has just released a video warning of the effects long Covid can have on people’s lives.
Metro.co.uk consulted medical experts to find out exactly what the symptoms are, who is likely to be affected and whether to seek medical care.
Long Covid symptoms
‘Long Covid’ is a casual term being used to describe people whose symptoms go on for longer than the officially recognised two-week symptom period.
Dr Ravi Tomar, a GP partner at Portland Medical in Croydon, said: ‘It is important to note that this is yet to be ratified into a formal diagnosis and given limited research is based mainly on anecdotal case report evidence.
‘Some evidence suggests long Covid may actually be a mix of other known diagnoses such as post-viral fatigue syndrome, and post-intensive care syndrome among others.’
Although long Covid is not yet a clinically defined illness, symptoms of it have been reported in a number of otherwise fit and healthy individuals.
So far the World Health Organisation only officially recognises a two-week symptom period, and research into the longer-term consequences of contracting Covid-19 is ongoing.
Ben Littlewood-Hilson, chief medical officer at digital assessment tool Doctorlink, said: ‘As with the acute stage of the disease, the long-term symptoms are still far from being fully understood.
‘You may have seen news articles reporting there are hundreds of potential symptoms of long Covid, ranging from heart palpitations to bed wetting.
‘The all-party parliamentary group of MPs on coronavirus has also formed a list of 16 symptoms which “long-haulers” are reportedly suffering from.’
He said there are seven main symptoms to look out for, which are:
- Aches and pains
- Cognitive problems
- Dry cough
- Loss of taste and/or smell
- A skin rash, or discolouration of the skin
This list is by no means exhaustive – some of these symptoms could be accompanied by other issues such as insomnia, hallucinations or even hair loss.
Dr Littlewood-Hilson added these should not be taken as official after-effects of the virus, as it has yet to be recognised by health authorities.
But he below dives into each of what are widely agreed to be the main seven symptoms, and how they could be pointers to having long Covid.
‘People suspected of suffering with long-Covid are reporting ongoing fatigue and extreme tiredness,’ Dr Littlewood-Hilson said.
‘Some have reported struggling to carry out even basic activities such as walking up the stairs.’
Dr Tomar agreed: ‘When discussing the symptoms it is widely believed that extreme fatigue is that predominating feature.
‘This is often associated with ongoing breathlessness, muscle aches and a pattern of coming and going symptoms.’
Some people have reported not being able to work for months, finding even basic day-to-day tasks a lot of effort.
‘It’s unknown how long I’m going to have these kind of spells of fatigue,’ said John, 48, in the Government video.
‘It is massively impacting not only my life but also the family’s, and you know.’
He added the ‘hangover’ has been much worse than the original few days of illness.
Aches and pains
Muscle aches and pains are a commonly experienced symptom of Covid-19.
‘The chest pain in particular feels is as if I’d been just hit by a train,’ said Tom, 32, in the video.
‘If your limbs are still feeling achy and heavy weeks or months after your diagnoses, you may be experiencing long Covid,’ Dr Littlewood-Hilson explained.
He added that while cognitive problems are not a recognised symptom of the virus, there is increasing evidence that brain fog, concentration difficulties and memory loss may be long-term effects of the virus.
The Government has also noted this in its video about long Covid.
‘I don’t feel like my brain is working the same way anymore,’ said Jade, 32.
These kinds of symptoms have been reported in patients both young and old.
Continued breathing problems weeks or even months after testing positive for coronavirus are common in a number of patients who suffered severe symptoms when they first contracted it.
‘Research teams are seeing a good proportion of people reporting, ongoing respiratory problems, such as breathlessness in the weeks and months after first experiencing symptoms,’ added Dr Littlewood-Hilson.
Although a new and persistent dry cough was one of the first recognised symptoms of Covid-19, there are reports the cough could continue past the typical two-week recovery period.
Dr Littlewood-Hilson said a large number of patients are reporting these symptoms continuing weeks later.
Loss of taste and/or smell
Another officially recognised symptom of coronavirus by the World Health Organisation is a loss or change to your sense of smell or taste.
This means you’ve noticed you cannot smell or taste anything, or things smell or taste different to normal.
‘Some people suspected of suffering with long-Covid have reported the persistence of this symptom,’ Dr Littlewood-Hilson said.
A rash on skin, or discolouration of the skin
He noted how purple lesions and blisters have been spotted on patients’ toes.
‘Doctors think it could be the result of inflammation, which has been linked to coronavirus,’ he explained.
It comes after medical experts back in April suggested there may be a link between coronavirus and Kawasaki disease in children, where rashes are often a symptom. This is still being investigated.
How many people are experiencing long Covid?
Dr Littlewood-Hilson said it is ‘unclear’ how many patients could be suffering from long Covid, and research is ongoing.
‘Reports suggest that there is not a direct correlation between the severity of the initial illness to who is then developing long-term symptoms,’ he added,
‘There have been people who have been in intensive care with Covid-19, but who have made a full recovery, while on the other end of the scale, there are people who had a relatively minor infection, but have then gone on to experience symptoms that don’t go away for months.’
But an NHS clinic dedicated to treating long Covid cases in five London boroughs reported on Monday that it has now treated more than 1,000 patients.
The clinic’s doctors think fewer than 5% of people who catch coronavirus will develop long Covid.
Why are people experiencing long Covid?
Experts do not yet know why some people are suffering with long Covid, but they do know coronavirus can trigger an overactive immune response which causes damage throughout the body.
It is believed the immune system does not return to normal after Covid-19, causing long-term symptoms.
The virus may even cause scarring of the lungs in severe cases, which may affect how oxygen is supplied to the body, causing continued breathlessness and general grogginess.
But despite the unknowns, the NHS announced earlier this month long Covid will soon be written into official paperwork so doctors can advise patients better.
Who is likely to experience long Covid?
Half of people in a study in Dublin still had fatigue 10 weeks after being infected with coronavirus. A third were physically unable to return to work.
Dr Tomar suggested: ‘Of those affected by Covid-19, it is thought about 10% will go on to be affected by the prolonged illness.
‘It is thought to be twice as common in women as men, with a skew toward the older population.’
Should you seek medical care for long Covid?
Both doctors recommended that as soon as anyone develops any symptoms of coronavirus, they should get a test and isolate until they receive a result.
If they test positive, NHS Test and Trace will be in touch to explain how long to isolate for and ask who they have been physically close to.
Dr Littlewood-Hilson said: ‘Keep a close eye on your symptoms and keep note of when they started and how long they are going on for.
‘The World Health Organisation has stated that symptoms of Covid-19 should generally clear up within 14 days, so if any of your symptoms persist for longer than this, it’s possible you are experiencing long Covid.’
He said although there is currently no treatment prescribed, patients should try to support their immune systems through healthy, balanced eating, drinking enough fluids and general exercise.
Anyone who is concerned or suffering more severe symptoms should call 111 or their GP, or use a digital system assessment tool like Doctorlink which provides online triage and video consultations.
Depending on the combination of symptoms and their severity, sufferers may be advised to seek further medical attention.
Dr Tomar added: ‘Treating this condition is based on common sense rather than any research, as the majority of research into the treatment of Covid-19 applies to the first three weeks of infection.
‘For most, the recovery will be slow but will only require supportive care with rest, treating specific symptoms, and a slow build up in activity as the fatigue settles.’
He said if breathlessness persists, patients could be given a home pulse oximeter to monitor oxygen levels in case emergency treatment is needed.
Dr Tomar concluded though the future is positive, with 10,000 patients recruited for testing to help experts better understand the long-term effects of coronavirus.
READ MORE: How to tell the difference between flu, a cold and coronavirus this winter
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