Coping with Long COVID
Are you still suffering the effects of prolonged COVID symptoms? You’re not alone. Studies have suggested that it takes about 3 months to recover from the effects of COVID, but many people are still dealing with fatigue, muscle aches, lung burn, and brain fog 6 – 9 months after the initial diagnosis of COVID. So what can you do?
It’s not really known if the symptoms of long COVID are due to persistent infection, recurrent infection, or a post-infection auto immune response, that is, the body’s own immune system attacking its own cells. We do know that most people are not contagious with it. It’s suspected that it’s due to a multi-organ micro-vasculitis due to endothelial damage. It’s postulated that a few days of hypoxia or low oxygen levels at the start of an infection is the culprit especially in people who did not go to or were not admitted to the hospital.
What we do know:
Medications don’t seem to help. Studies have been done with colchicine and prednisolone and they don’t change the course. It is important to optimize control of other illnesses including diabetes and high blood pressure. But there is no evidence for explicitly treating the COVID symptoms
Rest and recuperate. Eat a healthy diet. Get plenty of sleep.
Online support provides encouragement. Knowing that others are going through the same thing – and are getting better – may give a sense of relief. It’s a real thing.
You don’t need a bunch of tests. It’s wise to form a relationship with a clinician. A careful clinical assessment can exclude rare complications, but most patients don’t need a battery of tests or investigations.
Pace your return to work and other activities. A rehab program and a gradual increase in exercise – with a mind to possible lung and heart inflammation – has been shown to help.
We’re learning more about this every day and there are studies underway to collect information and data. If you’re suffering from long COVID, it would help to share your experience. If you live in Canada consider becoming involved in the CANCOV study. You can contact the researchers at the University of Toronto at https://www.CANCOV.net
Resources:
Mapping how COVID-19 impacts the health of multiple organs (COVERSCAN study) https://www.pslhub.org/learn/coronavirus-covid19/data-and-statistics/mapping-how-covid-19-impacts-the-health-of-multiple-organs-coverscan-study-r3400/
Management of post-acute covid-19 in primary care. Greenhalgh et al https://www.bmj.com/content/370/bmj.m3026
Persistent symptoms after Covid-19: qualitative study of 114 “long COVID-19” patients and draft quality principles for services (Ladds et al) https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-06001-y
Persistent Symptoms in Patients After Acute COVID-19 (Carfi et al) https://jamanetwork.com/journals/jama/fullarticle/2768351
Long COVID: A Primer for Family Physicians; Greenhalgh et al: https://www.aafp.org/afp/2020/1215/p716.html
NICE guideline: COVID-19 rapid guideline: managing the long-term effects of COVID-19 https://www.nice.org.uk/guidance/ng188
https://academic.oup.com/eurheartj/article/41/32/3038/5901158?login=true