IT is over a year since the first diagnosed cases of coronavirus-19 and in this time the world has changed significantly. The once abnormal has become the “new norm”, and words that might not have been uttered before, including social distancing and self-isolation are on the tip of every tongue. Another phrase gaining ground is Long Covid, an umbrella term to describe the effects of the virus on those who unfortunately haven’t made a satisfactory recovery in the few weeks following infection. Data compiled by the Office for National Statistics (ONS) show one in five with a positive test still having symptoms of unwell after five weeks, with one in ten at twelve weeks or more.

Such presentations are not unique to COVID-19, and have been observed in other viral infections including glandular fever. It may take up to twelve months to completely recover from pneumonia.

Long Covid encompasses a variety of complaints both physical and mental, the virus attacking the whole body, not just one organ. It affects the heart and lungs causing chest pains, irregular heart rhythms, continued cough and shortness of breath. It has been linked to heart attack, stroke, chest infection and clots in the lung. Involvement of the musculoskeletal system can lead to joint and muscle pains with reduced mobility. The gastrointestinal tract may succumb with bouts of abdominal pain and diarrhoea. “Brain fog” describes impaired cognition, such that the most basic tasks appear mammoth in nature. Perhaps as a result of pain and physical disability, or possibly as a separate issue, increased levels of anxiety and depression are reported in those suffering Long Covid.

Long Covid is not contagious as it is the effects of the virus on the body after the acute infection has subsided.

The condition doesn’t seem to be related to the severity of the initial infection. Neither hospital admission nor being escalated to an intensive care unit make the syndrome more likely, though it is acknowledged that these can be traumatic events in their own right. Women and children are affected in greater numbers.

A survey of over 3,000 individuals with Long Covid, by the National Institute for Health Research (NIHR), demonstrated considerable impact on the person’s daily life. Eighty percent reported struggling at work, over seventy percent admitted it had had a negative impact on family life and four in ten were less able to function in their roles as parents or carers, demonstrating that Long Covid not only has significant ramifications for the individual, but also families and perhaps the economy and society.

Estimates of numbers affected range from three hundred thousand to a million. To cope with this, 60 NHS Long Covid clinics have been assembled in England, run by multidisciplinary teams of specialist doctors including respiratory physicians, rheumatologists and neurologists, as well as dedicated nursing staff and allied health professionals. Due to the variety of symptoms and indeed symptom combinations, a “one size fits all” strategy will not work, and the structure of these services and what they are able to provide is likely to be a work in progress.

There is strong interest in the links between Long Covid and Myalgic Encephalomyelitis (ME), also known as Chronic Fatigue Syndrome (CFS). Viral infection is a trigger for the development of ME and it is hoped that research into Long Covid may also help the thousands of ME sufferers.

For many struggling with Long Covid, websites on ME/CFS have provided useful information and support, including practical tips on how to effectively pace yourself. The British Heart Foundation provides robust and easy to understand advice for both physical and psychological wellbeing, including diet, continuing to exercise within your tolerance, but also being kind to yourself.

Recovery from Long Covid is not necessarily in a linear fashion, and there will undoubtably be good and bad days along what may be a very uncertain path.

Scientists in Cambridge are analysing DNA obtained from the saliva of those with Long Covid to look for clues which may guide treatment and also potentially prevent the acute infection developing into the chronic condition.

Healthcare professionals are working hand in hand with Long Covid sufferers both as patients and advisors, a double pronged approach proven to work. Although the lack of definite understanding and concrete answers is frustrating at this point, acknowledgement and acceptance of Long Covid will hopefully reduce any stigma towards those afflicted, a vitally important cornerstone to recovery.