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Low-down on long Covid

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Most people who become sick with Covid-19 may not get seriously ill, and get better relatively quickly. But a significant number have long-term problems after recovering from the initial infection, even if they weren’t very ill in the first place.

Ongoing symptomatic Covid-19 consists of signs and symptoms from four to 12 weeks of initial infection.

Post-Covid19 syndrome consists of signs and symptoms that continue for more than 12 weeks and are not explained by any alternative diagnosis.

Long Covid consists of both ongoing symptomatic Covid-19 and post-covid-19 syndrome – ie it is commonly used to describe signs and symptoms that continue or develop after acute Covid19.

Those suffering from persistent symptoms even after four weeks of initial infection may not suffer from long Covid.

What are the symptoms of long Covid?

Many people with long Covid report a cycle of improvement for a time before getting worse again.

These lasting symptoms can include:. Fatigue – this is normal after a viral infection such as Covid-19 and it usually settles within two to three weeks. However, in some people it can linger on for weeks and months. Reasons for lingering fatigue maybe due to a continuing response to coronavirus even though the infection has subsided or due to a serious illness such as Covid pneumonia which can take six months to resolve.

Try to continue doing your daily tasks but at a manageable slower pace. Do not hesitate to ask for help where needed. . Breathlessness or shortness of breath – this can make people anxious which can further worsen shortness of breath. It is normal to feel breathless during and after a respiratory illness.

You must continue doing normal activities but at a pace which can be tolerated.

Breathing exercises which include relaxation with abdominal breathing will make your muscles stronger and assist in recovery – for example, yoga breathing techniques and “breathing control technique” (explained online).

A spirometer device used during early stages of recovery also helps to strengthen the breathing muscles. (Spirometer is available at most pharmacies such as Dischem/Clicks). . Heart palpitations – these are heartbeats that are more noticeable to you. Palpitations are very common and are not just specific to the Covid-19 recovery period. They may be caused by your increased awareness of a normal heart rhythm, for example due to anxiety, pregnancy, fever or exercise or due to certain drinks such as coffee, energy drinks and some medications.

In a small number of cases, palpitations can be due to an abnormal heart rhythm known as a “cardiac arrhythmia”.

Consult with your physician if palpitations last long time, do not improve or are getting worse, and if they are accompanied with chest pain, dizziness or loss of consciousness.

Some people who develop long Covid have similar symptoms to people with postural orthostatic tachycardia syndrome (PoTS). They feel lightheaded, palpitations and fatigue when they stand up or sit up. When you stand up or sit up gravity makes some blood to flow downwards dropping the blood pressure in the brain and heart. Normally the body adjusts to this sudden drop in blood pressure by constricting the blood vessels. In PoTS this automatic response does not happen.

It can be managed by diet, exercise, and medication.. Chest tightness or pain – chest pain could be non-specific/non-cardiac, musculoskeletal chest pain involving chest muscles and superficial tissues, pleuritic chest pain involving the pleura, which envelopes the lungs, and chest pain due to a heart condition such as inflammation of the heart layers, causing pericarditis, myocarditis, endocarditis and ischemic heart disease. Hence it is very important to consult a physician regarding any chest pain to rule out serious issues.. Not being able to think straight or focus (“brain fog”); in some patients who have had Covid-19 memory, attention and concentration and executive functions of the brain will be affected.

Memory: If your memory is affected, you may find it difficult to hold information or to recall information when needed.

Attention and concentration: Problems with attention/concentration can make it hard to focus and ignore distractions. It may be more difficult to multi-task, ie do two things at the same time, such as watch TV and hold a conversation.

Executive functions: these are the mental processes that allow us to solve problems, plan ahead and see tasks thorough to completion -- for example, organising a holiday, getting the car fixed, and so on.

People with executive functioning problems may find it difficult to finish tasks, and become distracted by something irrelevant without noticing that they have drifted off task.

The reasons people, post-Covid-19, may experience brain fog include less serious causes such as fatigue, anxiety, depression and more serious causes such as brain inflammation (encephalitis), acute respiratory distress disorder (Ards) and stroke, all of which are serious complications of the coronavirus. All of these interrupt brain functioning due to inflammation, decreased oxygenation and/or decreased blood flow.. A change to one’s sense of smell or taste – One may find foods taste and smell differently following Covid-19. Food may taste bland, salty, sweet or metallic.

These changes, which are usually short-term, can affect one’s appetite and how much one eats.. Persistent cough – this is usually a reflex action to clear dust, phlegm and irritants from one’s airways. While recovering from Covid-19 one may continue to experience a dry cough or productive (wet) cough for some time.

A dry cough can develop into a cycle, where excessive coughing causes irritation and inflammation, which worsens the cough. Breathing through the mouth due to coughing further dries the airways causing coughing.

Productive cough, which means coughing phlegm is initially caused by Covid-19 infection and overtime, due to body’s continued reaction to an infection which has subsided.

Relaxed breathing techniques such as “breathing control” will help relieve some of the cough. Using lozenges to stop one’s throat from getting dry and chest physiotherapy are other ways to alleviate cough.

If symptoms do not improve and are getting worse visit the physician, who may do a chest x-ray and prescribe an inhaler, antibiotics or steroids depending on the physical findings.

Some other symptoms of Long Covid include rashes, difficulty sleeping, anxiety and depression, joint and muscle pains.

How long does it take to recover from long Covid-19?

For now, from ongoing research, it has been observed long Covid can commonly last for five months and in rare cases 12 months.

Can children get long Covid?

Data from the UK Coronavirus Infection Survey suggests almost 13% of children in the survey aged between 2 and 11, and 14,5% of children aged 12 to 16 reported certain symptoms including fatigue, cough, headache, muscle aches or loss of taste or smell five weeks after falling ill with Covid-19. Hence, according to data so far, children have developed long Covid.

Does getting vaccinated reduce the risk of long Covid?

Yes, research suggests that having two doses of the Pfizer vaccine halves the risk of developing long Covid in adults, who become infected.

If people are struggling with ongoing symptoms of coronavirus they should take comfort in the knowledge that Covid-19 is a manageable disease. Always seek your physicians advice whenever you find that you are developing more symptoms or are getting worse.

However, it is important to be kind to oneself and give sufficient time for one’s body to heal.

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