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Infectious Diseases

Updated 18 September 2020

'Long Covid': Clinics could be our future as recovered patients struggle with after effects

For some, the effects of Covid-19 linger long after recovery.

  • There are reports of long-term health effects in people who have recovered from Covid-19
  • Lung, heart and other organ damage could result in lifelong complications
  • Chronic fatigue is one of the most common complaints 

For some Covid-19 patients, the effects linger long after recovery.

Colloquially called "long Covid", some people who have recovered from Covid-19 are suffering from health issues like chronic fatigue, heart difficulties, breathing problems, and even a decline in mental health. Basically, the longer-term effects of Covid-19 are unknown, as we're still in the throes of the pandemic.

Even children – who generally have mild reactions to the virus – might face long-term health effects indirectly linked to the disease.

READ | Why check-ups for Covid-19 recoveries are important 

Organ damage

Research from Austria showed lung and heart damage weeks after recovery, although there appeared to be some self-recovery after a longer period of time, highlighting the importance of pulmonary rehabilitation for hospitalised patients.

According to a Nature article, research yet to be published arrived at similar findings, seeing scarring on lungs more than a month later in a third of a 33-patient cohort. While these were severe cases, the overall rate of this kind of lung damage is expected to be 10% of total infections. On a global scale, that's, however, still hundreds of thousands of people that have to deal with new health issues and disabilities.

The long-term impact could include easy onset of fatigue, difficulty exercising and low levels of oxygen in the blood.

It's not only the lungs that are affected as Covid-19 has been proven to target multiple organs, including the brain – and previous coronavirus outbreaks have involved people struggling with these consequences for years.

The heart could also suffer long-term damage as the virus can also infect this vital organ, with heart failure and myocarditis being common conditions in severe Covid-19 cases. After recovery, patients could still suffer from heart damage even if they had a healthy heart before and weren't hospitalised. 

READ MORE | Lab-grown mini-organs reveal the damage inflicted by Covid-19 

Inflammation and fatigue

The impact of Covid-19 on the immune system is also well documented, which may not fully recover after the infection has waned, potentially weakening the system against future disease. Conversely, it can also make the immune system too sensitive, triggering chronic inflammation, leading to other issues, like heart disease.

Chronic fatigue, however, appears to be the most common long-term effect according to Nature.

Little is known about this effect, although some studies have shown how recovered patients struggle to get out of bed or do work for extended periods. It's difficult to diagnose and treat, depending on patients' reported symptoms rather than any clinical tests, yet those with mild cases report struggling with this for months after recovery. 

This fatigue could, however, also be the result of damage done to other organs by the disease – which is easier to determine in hospitalised cases.

READ | Most survivors of severe Covid-19 report symptoms many weeks after 'recovery', study shows 

Long-term research needed

Studies so far have also focused on severe cases and the difficult recovery from intubation after being on a ventilator, but mild cases are also struggling with long Covid. More research is now being launched to better understand the after-effects of the coronavirus, like the UK's Post-Hospitalisation Covid-19 Study (PHOSP-COVID).

They aim to recruit 10 000 patients who were hospitalised with Covid-19 and would agree to do clinical follow-ups with them for a year. The data would then be analysed by a consortium of the country's top researchers and clinicians.

"The PHOSP-COVID team will then develop trials of new strategies for clinical care, including personalised treatments for groups of patients based on the particular disease characteristics they show as a result of having Covid-19 to improve their long term health," according to their website.

Similar studies have been launched in other countries as well as global initiatives.

Like we have HIV and tuberculosis clinics, Covid-19 clinics might be a part of our future healthcare system to look after those still struggling with the disease's after-effects for years to come.

Only time will tell.

READ MORE | Stress from Covid-19 may be hard to shake, even with exercise

Image credit: Getty Images