Everything You Want to Know About Long COVID Since Many of Us Are Now Infected

2022-03-02 , 1:50 pm

Does recovering from COVID-19 mean being rid of the symptoms that come with it?

This is the question that is beginning to surface recently.

With an increasing number of new cases being reported daily, it almost seems like being infected by the virus is now a “when” and not an “if”.

Hence, here is everything you need to know about “long COVID” that has gotten some infected individuals quite worried.

What is Long COVID

Long COVID syndrome is a condition where some people continue to experience COVID-19 symptoms for longer than usual, even after recovering from the disease.

Once thought to be a myth, it is now more widely recognised after many reported showing symptoms of the virus despite long recovering from it.

These symptoms include:

Fatigue
Shortness of breath
Chest pains
Dizziness
Problems with memory or concentration (“brain fog”)
Insomnia
Loss of taste or smell, which does not seem to return

They usually last for four weeks or more after the initial diagnosis.

As such if these symptoms persist, you should not hesitate to consult a doctor for medical advice and medication.

Less Common in Vaccinated Individuals

However, if you are vaccinated, rest assured. Only a small number of vaccinated COVID-19 cases in Singapore have developed “long COVID” symptoms so far.

According to a study conducted in Britain, the risk of developing the condition could be reduced by half in vaccinated people as compared to those who are unvaccinated.

“This is an encouraging result, and I suspect that it may even be an underestimate of the effectiveness of vaccination against long COVID symptoms, which are a direct result of a severe illness,” said Dr Barnaby Young, head of the National Centre for Infectious Diseases’ (NCID) Singapore Infectious Disease Clinical Research Network.

While there have been cases of long COVID among vaccinated people overseas, the number of cases locally so far appears to be small, said Dr Young.

This is because severe infection is less common in those infected post-vaccination, so vaccinated people are protected against these longer-term complications, he said.

An earlier NCID study also found that one in 10 recovered COVID-19 patients who were unvaccinated had persistent symptoms six months after their initial infection.

Still Requires Further Study

However, Dr Young maintains that long COVID is something which needs careful study to determine if it continues to remain true over time, and whether with increased awareness of it, more cases may emerge.

The driver of persistent inflammation after a COVID-19 infection still remains unclear, with different explanations behind the cause of the disease for different people.

On the one hand, there may be an autoimmune component, where one may have an overactive immune response, which causes persistent side effects due to the body attacking itself.

On the other hand, the persistent inflammation may be due to fragments of the virus still remaining in the body, or echoes of the initial inflammatory response to infection, said Dr Young.

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Professor Paul Tambyah, a senior consultant at the National University Hospital’s (NUH) Division of Infectious Diseases, agreed with Dr Young.

While the mechanism of long COVID is not yet known, vaccination might reduce the viral load after the fifth day of infection, and thus reduce the antigenic stimulation (by antigens that are capable of stimulating an immune response), which triggers autoimmunity or other kinds of reactions, Prof Tambyah said.

He said that long-term symptoms have also been seen in other infectious diseases, such as influenza.

US Study Correlates Long COVID with Nerve Damage

Over in the United States, a small study of patients suffering from persistent symptoms long after a bout of COVID-19 found that nearly 60% had nerve damage possibly caused by a defective immune response.

The study involved in-depth examination of 17 people with “long COVID”.

“I think what’s going on here is that the nerves that control things like our breathing, blood vessels and our digestion in some cases are damaged in these long-COVID-19 patients,” said Dr Anne Louise Oaklander, a neurologist at Massachusetts General Hospital.

Dr Oaklander and her colleagues focused on patients with symptoms consistent with a type of nerve damage known as peripheral neuropathy. All but one had had mild cases of COVID-19, and none had nerve damage prior to their infections.

After ruling out other possible explanations for the patients’ complaints, the researchers ran a series of tests to identify whether the nerves were involved.

The vast majority had small fibre neuropathy damage to small nerve fibres that detect sensations and regulate involuntary bodily functions such as the cardiovascular system and breathing.

11 of the 17 patients were treated with either steroids or intravenous immunoglobulin, a standard treatment for patients with small nerve fibre damage caused by an immune response.

Some improved, though none were cured.

Possible Treatment

While the results would apply only to long-COVID-19 patients with this type of nerve damage, it is possible that immunotherapy could be helpful, said Dr Avindra Nath, an expert in neuroimmunology at the National Institute of Neurological Disorders and Stroke.

Dr Nath said the finding suggested there was a need to do “a proper prospective study of these kinds of patients”, testing the drugs in a randomised trial.

Despite the study only catering to a specific nerve damage, it has nevertheless opened up more doors for possible treatment. However, as much information is still unknown and research is still being carried out, don’t spread fake news lah.

Meanwhile, mask up, stay safe and don’t be too alarmed if you experience symptoms post-recovery from the virus.