Long COVID
Commonly reported symptoms of long COVID are fatigue, memory problems, shortness of breath, and sleep disorder.
[5][4][6] Several other symptoms, including headaches, mental health issues, initial loss of smell or taste, muscle weakness, fever, and cognitive dysfunction may also present.
[16][17][18][19][20] Both terms refer to the range of symptoms that continue for weeks or even months after the acute phase of the SARS-CoV-2 infection.
[15] The British National Institute for Health and Care Excellence (NICE) divides long COVID into two categories:[22] The clinical case definitions specify symptom onset and development.
This consensus research definition for long COVID in children and young people is: “Post COVID-19 condition occurs in young people with a history of confirmed SARS-CoV-2 infection, with at least one persisting physical symptom for a minimum duration of 12 weeks after initial testing that cannot be explained by an alternative diagnosis.
The symptoms have an impact on everyday functioning, may continue or develop after COVID infection, and may fluctuate of relapse over time.
[27][2] Dysautonomia and postural orthostatic tachycardia syndrome (POTS) are also potential shared aspects of long COVID and ME/CFS.
[36][28] People with dysautonomia may experience palpitations and tachycardia (raised heart rate) after minor effort or upon standing up.
If the heart rate is raised by 30 beats per minute or more after continuous standing; this is described as postural orthostatic tachycardia syndrome.
[2] In the female reproductive system, long COVID may disrupt fertility, the menstrual cycle, menopause, gonadal function, and ovarian sufficiency.
Other tests, such as a dual-energy CT scan, do show perfusion defects in a subset of people with respiratory symptoms.
A small study demonstrated viral RNA up to nearly two years after an acute infection in people with long COVID.
Evidence from electronic health care records show that people develop auto-immune diseases, such as lupus and rheumatoid arthritis, more frequently after a COVID-19 infection, compared to controls.
[2] Several studies suggest that brain penetration of serum components and cytokines as derived from breakdowns to the integrity of the blood–brain barrier could contribute to the neurological manifestations of long Covid.
[4] In children and young people, the risk factors for long COVID include female sex, older age, and pre-existing diseases or mental health problems.
[62] In some countries, such as the UK and Germany, specialised long COVID outpatient clinics have been established to assess individual cases for the extent of surveillance and treatment needed.
[62][63][64] Digital technologies, such as videoconferencing, are being implemented between primary care physicians and people with long COVID as part of long-term monitoring.
Further, since incidence appears to be correlated with severity of infection, it is lower in vaccinated groups, on reinfection and during the omicron era, meaning that the time when data was recorded is important.
The typical recovery time for those with mild illness was said to be around two weeks[72] and media attention was mostly focused on those with a severe infection.
Patients with long-lasting systems after a mild infection started to describe their symptoms on Twitter and blogs,[73] challenging official assumptions.
[13] The term long COVID was reportedly first used in May 2020 as a hashtag on Twitter by Elisa Perego, a health and disability researcher at University College London.
[73] Via the media, the knowledge reached governments and health officials, making long COVID "the first illness created through patients finding one another on Twitter".
[13] Some people experiencing long COVID have formed community care networks and support groups on social media websites.
When taking into account reduced quality of life as well, yearly economics costs due to long COVID were estimated to be between $864 billion and $1.04 trillion USD.
[9] A recent study estimated that long COVID contributes to global economic cost of about $1 trillion a year for the 400 million afflicted.
Research is ongoing in many areas, including developing more accurate diagnostic criteria, refining estimates of its likelihood, identifying risk factors, gathering data for its impact on daily life, discovering which populations face barriers to adequate care, and learning how much protection vaccination provides.
[3][88] These include the anti-inflammatory colchicine, the anticoagulant rivaroxaban, the antihistamines famotidine and loratadine, various immune-modulating drugs, and the experimental aptamer compound BC-007 (Rovunaptabin).
[2][3] In 2021, the US National Institutes of Health started funding the RECOVER Initiative, backed by $1.15 billion over four years,[89] to identify the causes, prevention and treatment of long COVID.
[91] In 2023, a survey of over 3,700 people in the UK with long COVID, fatigue was the strongest predictor of poor everyday functioning, with depression and brain fog also being linked.
[92][93] In 2024, researchers working at UK universities published a commentary on what can be learned from long COVID in order to be better prepared for and recover faster from future pandemics.
