Long-haul Covid-19 patients – individuals who continue to experience symptoms for at least 3 months or so after their initial diagnosis – may present with a spectrum of severity of illness whether or not they have been hospitalized. Unfortunately, there is a limited amount of clinical evidence concerning what causes long-haul COVID-19 although early research has linked the condition to other chronic illnesses such as chronic fatigue syndrome.
To date, there is no real consensus on how to define Covid-19 long-haulers. This cohort of “long-haulers” also includes young, healthy people who had a mild initial infection. However, it appears that the risk factors for experiencing these syndromes are an ICU stay in hospital, prior depression, prior anxiety, and obesity (Gorna R, MacDermott N, Rayner C, et al. Long COVID guidelines need to reflect lived experience. Lancet. 2021;397(10273):455-457).
Common complaints and symptoms may include: fatigue, shortness of breath, racing heart or heart palpitations, continued loss of smell and taste, reduced mobility, loss of occupational functioning and cognitive complications such as “brain fog”, and post-traumatic stress disorder.
Apart from medical evaluation to potentially identify any specific causes (e.g. patients with persistent shortness of breath may need pulmonary rehabilitation), post-Covid clinical treatment requires a multidisciplinary and integrated approach. In terms of treatment, post-Covid clinical treatment requires a comprehensive recovery plan which may include improving sleep, nutritional support, mental health support, and any medication if needed. In terms of physical rehabilitation, there is a wide variety of things being used including Cognitive Behavioural Therapy (CBT), physical therapy, supplements, and herbal therapies.
Furthermore, all of these problems may be further exacerbated by social limitations and economic stress many are experiencing. Ongoing symptoms may be due to an immune-inflammatory response, ongoing viral activity or other factors causing ongoing symptoms such as reductions in lung function.
