The Mysterious COVID 'Long Haul'

"The Government of Canada is increasingly adopting the term 'resolved' ... as this better describes the public health implications of the case status, while allowing for the fact that the individual may not be recovered in terms of symptoms or longer-term health effects."

Health Canada

"A large percentage of this cohort of 'recovered' people are still suffering, and calling them 'recovered' is inaccurate, misleading and insensitive."

"We need to start counting long-haul COVID cases."

"We are not recognized and there seems to be no real urgency in dealing with us. We don't qualify for financial support because we're not actively looking for work and our EI sickness benefits are dried up."

"We're being forced to start selling homes and other assets. I haven't had benefits since before Christmas."

Susie Goulding, founder, COVID Long-Haulers Support Group Canada, Oakville, Ontario

"You actually have to be able to define it [before any decisions can be reached whether a disease should be prioritized and resources mobilized against it]."

The first step is going to be to say, OK, what precisely is this long COVID syndrome we're talking about. Are there actually several different conditions, or a single condition?"

"What's really interesting to me about long COVID is that it's clearly different from the consequence of simply having been gravely ill."

"[Changing] recovered [to] non-infectious [is a] great suggestion."

Dr.John Marshall, trauma surgeon, St.Michael's Hospital, Toronto

Novel coronavirus (COVID-19) symptoms can last weeks or months for some people. These patients, given the name "long haulers", have in theory recovered from the worst impacts of COVID-19 and have tested negative. However, they still have symptoms. There seems to be no consistent reason for this to happen.

 

British and U.S. researchers conducted a web-based survey involving over 3,700 people who had suspected or confirmed COVID-19 -- the effects of which were seen to be prolonged over more than 28 days. And out of that survey no fewer than 205 symptoms were categorized in ten organ systems.One-third of respondents with lab-confirmed COVID-19, part of a study published this week in JAMA Network Open involving 177 people, experienced lingering symptoms persistently continuing for a median of six months. This, even among those people who had experienced mild illness.

 

Professor Daniel Altmann specializing in immunology at Imperial College London, estimated the number of those affected by long COVID in the United Kingdom "is  roughly equivalent" to the number of people in the U.K. with rheumatoid arthritis. Professor Altmann and Rosemary Boyton stated that at least ten percent of people with symptomatic COVID-19 can leave a "lingering trail" of changes visible on CT scans of the lungs. The virus causing inflammation of the heart muscle, by attacking the same receptors in the heart, they wrote in the British Medical Journal.

 

Drs. Altmannn and Boyton wrote that gastrointestinal biopsies taken four months following an infection "show persistent live virus in about a third of individuals", in line with some studies that suggest SARS-CoV-2 virus can persist in the liver and spleen. What puzzles them is whether this indicates that people haven't managed to clear the virus, or some other underlying cause yet to be determined is involved. 

 

Dr.Marshall, on the other hand, theorizes that in most long-haul instances symptoms may be consistent with an autoimmune disorder -- itself caused by the body's widespread inflammatory response to the virus when someone's immune system goes completely out-of-whack, over-compensating harmfully to the viral intruder.

 

An international effort is now underway for doctors to explore the situation rigorously in an effort to arrive at a global consensus regarding what "long COVID" represents in an effort to explicate its cause. The lingering effects of COVID-19 has been afflicting quite a large number of post-COVID individuals left anxious and depressed; even while the medical community considers them to be 'recovered', they suffer from lingering effects of the virus, post-infection.

Most people undergo mild and short-lived effects from the coronavirus yet increasing numbers of other people report a puzzling array of symptoms, including breathlessness, exhaustion, tingling throughout the body, anxiety, brain fog and memory problems going on for weeks, even months after what appeared to be a mild infection. Health Canada considers 'recovery' to be consistent with the passage of at least ten days since the start of symptoms at which point infectiousness has passed, there is no longer fever, and "their symptoms have improved (even if not yet fully resolved)".

"It's a whitewash that conceals the fact that a large percentage of people are not recovering in 14 days", scoffs Susie Goulding. To which Dr.Marshal, a trauma surgeon, responds "You have to be able to define it". Recently Dr.Marshall co-chaired a World Health Organization group tasked with developing criteria for a working diagnosis for what the WHO calls the Post COVID-19 condition". And what Dr.Marshall looks for, is answers to:What's the epidemiology -- how common are the different symptoms: How many who've had COVID get it? Are there risk factors for acquiring it?

 

 Canadian Researchers looking into COVID "long-haul" effects.  Maeve Gamble

Older people and people with many serious medical conditions are the most likely to experience lingering COVID-19 symptoms, but even young, otherwise healthy people can feel unwell for weeks to months after infection. The most common signs and symptoms that linger over time include:

• Fatigue
• Shortness of breath
• Cough
• Joint pain
• Chest pain

Other long-term signs and symptoms may include:

• Muscle pain or headache
• Fast or pounding heartbeat
• Loss of smell or taste
• Memory, concentration or sleep problems
• Rash or hair loss

Mayo Clinic