Long COVID, its complications and impact on quality of life

At least 8 out of 10 Australians have been infected by the virus that causes COVID-19, so it may be time to acknowledge that this illness is part of life. However, it feels like doctors are still being asked questions for which we can’t give satisfactory answers. The leading one of these questions may be ‘’How do you treat long COVID?” A close second is the question that usually comes first: “Do you think that I could have long COVID?”

COVID illness types

It’s estimated that up to 15% of people who are infected by SARS-CoV2 – the virus that causes COVID – have no symptoms. You can only say that you’ve had COVID-19 if you have been infected by the virus AND experience symptoms. About 80% of confirmed cases contract an illness that is regarded as mild. This means that while you may feel tired, and have a runny nose, sore throat, cough, headache, muscle or joint pain, loss of sense of taste and smell, sneezing and fever, you don’t have any inflammation in your lungs. No pneumonia. 

People with moderate, severe or critical disease have increasingly bad lung problems. Critical disease occurs in around 5% of cases around the world, although that number is a little bit high for the Australian experience. Patients with critical illness are those represented by the number of patients in ICU in the daily COVID statistics. 

Persistent symptoms

Long COVID is an imprecise, ‘’umbrella’’ term that is used to describe a condition where symptoms of poor health persist in the medium to long term after COVID. These symptoms may come and go, and may even represent a new chronic illness, such as heart disease, or diabetes. Many people with COVID will be almost back to normal after a few days, and most will be completely back to normal within a month. Some have persistent symptoms after a month, with around 5-10% of people in Australia having persistent symptoms beyond 12 weeks after their initial infection. 

The most common symptoms of long COVID are shortness of breath, fatigue and difficulty concentrating (“brain fog’’). Sleep difficulties are also common, along with a list of other possible complaints, such as muscle and joint pain and poor appetite. Long COVID is also known as post-covid syndrome or post-covid condition. The symptoms of long COVID can make it difficult for some people to return to their pre-COVID work and family responsibilities. 

Who is at risk?

While people who had a mild or moderate illness can have ongoing symptoms over months, long COVID is much more likely to affect people who have had severe or critical disease. Those of female sex, and those with other chronic health problems, are also at increased risk. It is most common in middle-aged adults. A COVID vaccination seems to reduce the risk of developing long COVID, while not being vaccinated increases the risk of contracting long COVID.

What should be done about it?

If you have persistent symptoms of shortness of breath, fatigue or brain fog – or any other new symptoms – following COVID, you should talk to your GP about them. ‘’Long COVID’’ is a term that describes a whole range of problems, and it’s important for you and your doctors not to apply this term as a label, and then stop thinking about your individual characteristics and difficulties. For example, some people with asthma will find that their breathing difficulties are much worse for months following COVID, due to a worsening of their underlying condition. This is not just a COVID ‘’thing’’, but can also happen after other viral infections, like Respiratory Syncytial Virus (RSV). In that situation, an escalation in asthma treatment will be required. The approach to helping this person will be very different to the person whose breathlessness is due to the impact of COVID on their heart when they were critically ill in intensive care. 

It’s important to carefully explore your experience of long COVID with your doctor, asking how it is that the virus has changed your health to cause these new and unwanted symptoms. Sometimes that will lead to a clear answer about what’s going on, and what physical, psychological or pharmacological intervention or treatment may help with your recovery. Sometimes it will not. There is no evidence at this stage of any universal ‘treatment’ to assist people with long COVID. 

This blog was written by Manse Medical.
Manse Medical is a leading Respiratory and Sleep Medical Practice dedicated to providing high-quality, comprehensive care for respiratory and sleep disorders. We are committed to providing equal treatment access for all our patients, regardless of their age, gender, faith, ethnicity and social background to empower them to lead happier and healthier lives.