’Long-Covid’ patients still haunted by symptoms

File picture: Tracey Adams/African News Agency (ANA)

File picture: Tracey Adams/African News Agency (ANA)

Published Jan 7, 2021

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Cape Town - A number of Covid-19 survivors have said that despite recovering in the first wave of infections, they are still haunted by some of the symptoms which experts have termed “Long-Covid”.

“Long-Covid” or “Covid long-haulers” describes people with Covid-19 who experience symptoms for more than 28 days after diagnosis.

Nearly seven months after her diagnosis, Nosithembiso Mgewu said she still experienced the same symptoms.

“Even last week, I was sick the whole week, I had all the symptoms of Covid all over again. I now depend on medication. It’s shortness of breath, body aches, dry throat and nose, all the symptoms I had when I had corona. I want to think maybe mine was more severe than other people, because why can’t I seem to get better,” she said.

Pumla Milisi, 43, from Mfuleni, said that even though she recovered from the virus at the beginning of May, she was still not the same.

“I have symptoms that never went away when I recovered. It now feels like I was born with them. Chest pains, sore throat, body aches… sometimes all this will go away for three days and then come back. I am now always sleepy and fatigued. I am still suffering, but also thankful that I survived the first wave,” Milisi said.

The head of Infectious Diseases and HIV Medicine at Groote Schuur Hospital, UCT Professor Marc Mendelson, said anosmia, the partial or complete loss of the sense of smell, has been witnessed in Long-Covid patients.

He said sniffing a set of odorants may speed recovery.

Mendelson is also one of the authors of a recently published South African Medical Journal (SAMJ) article titled Long-COVID: An evolving problem with an extensive impact.

“Persistence of symptoms or development of new symptoms relating to Sars-CoV-2 infection late in the course of Covid-19 is an increasingly recognised problem facing the globally infected population and its health systems.

“At this stage, there is some uncertainty as to which symptoms of acute Covid-19 will persist up to one month, which may continue as Long-Covid, and which may only start during the LongCovid time frame. Long-Covid was also more likely to occur in women, older people, and those with obesity,” the article reads.

It further cited a study from the US Centers for Disease Control and Prevention, which interviewed 274 individuals with proven Covid-19 who had not returned to health after 21 days.

Twenty-six percent of interviewees aged 18-34 reported not having returned to their usual state of health within 14-21 days of their test, the figure rising to 47% in those aged over 50. The greater the number of pre-existing chronic conditions, the greater was the likelihood that symptom resolution would be delayed.

Like acute Covid-19, the authors said patients with Long-Covid could also experience multiple symptoms involving the lungs and other parts of the body, including, but not limited to, fatigue, muscle pains, weakness and low-grade fever; cough, shortness of breath and chest pain (“lung burn”); headaches, cognitive blunting (“brain fog”) and pins and needles; rashes such as chilblain-like lesions and vesicular or maculopapular rash; mental health conditions including mood swings; and thromboembolic disease.

“Some symptoms, such as fatigue may be continuous, while others are intermittent.”

The authors also cited a study that showed Covid-19 had consequences for prolonged cognitive dysfunction even in persons who had relatively mild symptoms that were managed at home. “For the most severely affected participants with Covid-19, i.e. those who had been hospitalised and required mechanical ventilation, the study found a significant loss of function, equivalent to an average 10-year decline in global cognitive performance between the ages of 20 and 70 years.”

The authors said more research needed to be done, concluding that although many persons with LongCovid will be managed in primary care, others will require greater input from rehabilitation medicine experts.

“For both eventualities, planning is urgently required to ensure that the South African public health service is ready and able to respond.”

nicola.daniels@inl.co.za

siphokazi.vuso@inl.co.za