Long Covid, what stays long after you are done with Covid. 6 points

Two years into the pandemic fuelled by the novel coronavirus, the world is still grappling with the recovery from Covid, hospitalisations and treatments. But marks of Covid last long after you are done with the disease. The post-Covid complications have been termed Long Covid, and is routinely found among people who have recovered from the disease.

A meta analysis of studies done by Penn State researchers found more than half of 275 million people who had Covid had symptoms in the body for more than six months.

Amitava Banerje, Professor at the Clinical Data Science at University College London, said that even after two years of pandemic, 'we are still caught in the headlights, focussed on dashboards that track intensive care admissions and deaths but not Long Covid crisis'.

Here's what you need to know about Long Covid and the four major complications:

1. WHAT IS LONG COVID?

Long Covid is defined as suffering from symptoms more than 12 weeks after the diagnosis. As per the Centers for Disease Control and Prevention (CDC), Long Covid can happen to anyone who has contracted the disease even if their infection was mild or even if they didn’t have any symptoms of it.

The symptoms of Long Covid are fatigue, breathing issues, kidney complications, body pain, brain frog, concentration issues, arrhythmia (irregular heartbeat), etc.

2. ALL IS NOT WELL

Kevin Kavanagh, MD, a member of ICT (Infection Control Today), notes that a core difficulty in society’s attempt to guide Covid-19 from pandemic to endemic is that Covid-19 is not just a respiratory virus. In October 2021, he wrote that SARS-CoV-2 is similar to HIV because it can “silently spread throughout the host’s body and attack almost every organ”.

Kavanagh says that the premise that mild infections do not carry risks is false. This belief is there in people who have recovered from Covid-19 infection and have survived. “Even those who develop ‘mild’ Covid-19 can develop Long Covid, which in many cases lasts for a year or longer,” he said.

He explains that the SARS-CoV-2 infection mostly affects the centres of brain and heart, which leads to loss of taste and smell caused by brain tissue destruction and the loss of cardiac function from myocarditis.

3. HEART MUSCLE DAMAGE

John Hopkins medicine said that Covid can leave people with a heart infection that includes inflammation of the heart muscle. One study done by the university showed that 60 per cent of the people who had recovered from the infection showed signs of ongoing heart inflammation, which further leads to palpitation, shortness of breath and rapid heartbeat.

The university said that cardiovascular issues showed even in those patients who had a mild infection or did not have any comorbity before falling sick.

P Krishna Prasanthi, a physician based in Tirupati, Andhra Pradesh, chairperson of Academy of Medical Specialities, Indian Medical Associated, told Down to Earth magazine that she is overwhelmed with the number of Long Covid patients. She said that the major complications found in the patients were diabetes, cardiac issues and extreme fatigue.

In fact, patients with high rates of cardiovascular issues were worrying to her. She said that 80% of the patients reported heart palpitation. Even ECG done on young people showed considerable abnormalities. Even those who didn’t have hypertension, developed it. She said the patient would then stabilise in the next one or two months.

A research paper in the Journal of Clinical Epidemiology, published on October 26, 2021, found that Long Covid is extremely deadly and its effects are still not documented. “Healthy years lost per Covid-19 case ranged from 0.92 (male in his 30s) to 5.71 (girl under 10), and were 3.5 and 3.6 for the oldest females and males, the paper states.

In India, the rates of post-Covid complications arose after the infection, and this has left doctors baffled. 

4. BRAIN FUNCTION ALTERED

This is strange but true that a vast number of patients who recovered from Covid-19 after a mild infection report anxiety, depression and most often ‘brain fog’ where a person is unable to put his thoughts properly.

A new study from Oxford found that one out of three people who have been diagnosed with Covid-19 report neurological or psychiatry issues within six months of infection. The most common conditions that were reported are anxiety disorder, depression, insomnia and substance misuse disorder. Other conditions that were reported were brain haemorrhage, dementia and ischemic stroke, condition caused when a vessel supplying blood to brain is blocked.

The study done by Oxford took a sample size of 2,30,000 people in the US who had confirmed cases of Covid-19 infection. It was found that almost 34% of the people who had the infection reported neurological issues after the infection. But how did a virus that was thought to affect the respiratory function start affecting the brain?

As per a study done in the New England Journal of Medicine, brain tissue of people who died from Covid-19 was examined and it was found that there was a combination of inflammation and leaking blood vessels in the brain.

5. FASTENS DIABETES

The relationship between Covid-19 and Type 2 diabetes is complex, and researchers are trying to find the exact effect of the virus on the insulin-producing beta cells of the pancreas.

In November 2020, a global analysis published in the journal, Diabetes, Obesity and Metabolism, found that 14.4% of people who were hospitalised with severe Covid-19 developed diabetes.

The question is - did the Covid-19 infection just bring out the disease in patients sooner than it would have otherwise been detected? Did the virus just attack the beta cells of the pancreas?

Author Kathleen Wyne, MD, PhD says that one of the reasons a person developing diabetes after Covid-19 is that acute infllamation or the steroid treatment during the infection pushed them into diabetes. She says that the person may have diabetes and 'acute stressor increased their insulin resistance enough that the relative deficiency of insulin production was revealed, and glucose went above the normal level'.

Another reason Wyne said as to why a person develops diabetes after Covid-19 infection is that the person may genetically be at risk due to obesity or a sedentary lifestyle. Insulin resistance from acute infection and high dose steroids used to treat Covid-19 resulted in increased production of insulin, which was required to keep the blood glucose normal, and the pancreas was just not able to increase output to that level.

6. LUNG DAMAGE

Shortness of breath and fatigue, are one of the major long haulers of Covid-19 reported by patients even after recovery. Covid infection causes severe lung complications such as pneumonia and acute respiratory distress syndrome (ARDS). In some people with comorbidities like COPD, heart disease or diabetes, the chances of lung damage increase severely.

According to Dr Zaid Abdelsattar, a thoracic and cardiovascular surgeon at Loyola Medicine, in Illinois, US, in a recent online study in The Annals of Thoracic Surgery was done on deceased Covid-19 patients and in patients with end stage lung disease, and it was found the patients had serious lung problems in them. The scientists are doing further research to understand why some patients recover completely and why others don't.

"Our study also shows that if you contract Covid-19 and then completely recover clinically and on imaging, your lung tissues are also likely to have completely healed as well, without permanent damage," Abdelsattar said.