Breaking News: Long COVID Update
Jake Anderson, DO and Heidi James, MD
Jake Anderson and Heidi James bring us an update on Long COVID.
- Broadly, Long COVID refers to the constellation of symptoms persisting, or recurring long after an initial acute COVID-19 illness.
- Common Long COVID symptoms include
- Fatigue
- Muscle weakness
- Dyspnea
- Sleep disturbances
- Anxiety or depression
- Other less common symptoms include
- Anosmia
- Hair loss
- Joint pain
- Palpitations
- Dizziness
- Decreased appetite
- Several studies have looked at the prevalence of these symptoms
- UK Office of National Statistics survey
- 1 in 10 patients had symptoms at 12 weeks or beyond
- Large cohort study from Wuhan published in LANCET
- 76% had at least 1 symptom at 6 months after initial COVID symptom
- Those with severe acute COVID illness appear more likely to develop long COVID symptoms, but even those with mild disease are at risk.
- Symptoms have been documented in young adults and children as well as adults
- In December 2020, the National Institute for Health and Care Excellence (NICE) published a guideline on Long COVID management. Their recommendations include
- Appropriate, urgent evaluation of concerning symptoms
- Determine if symptoms are related to long COVID or an alternate diagnosis
- Investigations can include
- Blood work to rule out anemia, hypothyroidism, renal disease
- CXR at 12 weeks (if not done prior)
- Exercise stress testing
- Management suggestions include
- Referral to pulmonary rehab
- Referral to multidisciplinary teams as needed (and available)
- Focussing on the whole person impact of COVID and long COVID
- Encourage gradual increase in activity tolerance
- Close follow-up with primary care providers and other health care team members is important.
