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Getting to grips with Long Covid and all its effects

Study shows that Covid-19 continues to linger around, with long-term repercussions. HADI MIZBAN AP

Study shows that Covid-19 continues to linger around, with long-term repercussions. HADI MIZBAN AP

Published Feb 26, 2022

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Cape Town - The long-gone but never forgotten days of rampant Covid-19 cases continue to linger as a World Health Organization (WHO) analysis discovered that patients who recovered from the virus experienced long-term repercussions which have not been linked to any other diagnosis.

According to the National Institute for Communicable Diseases (NICD), with the current increase of 8.7% in Covid-19 cases, the development of symptoms after the initial illness may be due to the damage that had occurred in the body when patients first became ill.

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The NICD mentioned that patients who became ill with Covid-19 could have damage to their lungs, heart and brain, leaving other organs in the body affected, too, which resulted in a wide variety of symptoms.

Public Health Specialists at the NICD, Dr Waasila Jassat, said that while there are more than 50 symptoms for Long Covid-19, what is known of it is that it is caused by how the illness affected the body’s immune response to the virus during the initial illness.

“There are many theories around causes of Long Covid, including tissue/organ damage, inflammatory and immune pathways dysfunction, viral persistence, reactivation of latent pathogens (i.e. herpes viruses, Epstein Barr virus), disruption of commensal microbiomes/virome communities, clotting/coagulation issues, dysfunctional brainstem/vagus nerve signalling.”

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“There have been over 50 symptoms described, the most common being fatigue, shortness of breath, headaches, confusion or lack of concentration, headache, and problems seeing/blurred vision,” said Jassat.

With up to 15% of individuals with Covid-19 are said to develop Long Covid, Chair and Head of Department of Medicine at UCT and Groote Schuur Hospital, Dr Ntobeko Ntusi, said that people with Long Covid develop symptoms because there is an interaction between the virus and human host with subsequent responses of the immune system that make development of Long Covid more likely.

“While the exact causes of Long Covid are unknown, the predominant putative mechanisms of Long Covid include virus-specific factors, host-specific factors immunologic aberrations and inflammatory damage in response to the acute infection, autoimmune factors, and expected sequelae of post-critical illness.”

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“While it is true that patients with severe infection, in particular those admitted to intensive care units, with frequent instrumentation and mechanical ventilation, may continue to shed viable virus for a long time, in the vast majority of people, the coronavirus is viable for less than 10 days after diagnosis.

“Therefore, people with Long Covid develop their symptoms, not because Sars-CoV-2 is alive in their bodies for long, but because there is an interaction between the virus and human host with subsequent responses of the immune system that make the development of Long Covid more likely. This likelihood of development of Long Covid, we think, is also influenced by individual genetics.

“In addition to alterations in biology, mental health problems associated with Long Covid may arise from grief and loss, unresolved pain or fatigue, or from post-traumatic stress disorder after treatment in the intensive care unit,” said Ntusi.

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While a UK Health Security Agency (UKHSA) indicated that people who are vaccinated are less likely to develop Long Covid even if they catch the virus, rare cases of people experiencing issues ranging from hair loss, skin rashes and poor concentration span indicate that the unvaccinated people, who catch Covid-19 and show symptoms of Long Covid, do better if they had been vaccinated.

Going forward, Ntusi advised that individuals who experience Long Covid should seek medical attention and evaluation immediately.

“If an individual has symptoms of Long Covid or suspects they may have Long Covid, they need to see their doctor for evaluation. In many hospitals, like Groote Schuur Hospital, there are now dedicated clinics that look after people with Covid-19, providing multidisciplinary care,” said Ntusi.

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