MILD or moderate COVID-19 lasts about two weeks for most people. But others experience lingering health problems even after they have recovered from the acute phase of the illness. For Dr Henry Adekola (not real name), uncontrolled blood pressure and insomnia persisted after the initial recovery. He is still not back to his old self.
Dr Adekola had experienced the severe form of COVID-19 in January 2021. It started with a general feeling of unwellness. Subsequently, he lost his sense of smell and taste. An overwhelming headache came up the moment he woke up in the morning. His blood pressure went up because he was not sleeping well.
“The feeling of being unwell was so bad that even in isolation, saying my prayers became a big challenge. I couldn’t stand up to pray. This went on for about two weeks. I ended up testing negative after two weeks. Some days, despite been negative, I still end up having insomnia for upwards of four months. Now my blood pressure is still relatively uncontrolled; it was never like this before COVID-19,” Dr Adekola said.
Seven months after, there is no longer live coronavirus running amok in his body. Dr Adekola said an onset of headache after a poor night sleep or stress only sent signals that his blood pressure was going up even though he was not hypertensive. So, he was forced to take medicines to calm down.
Sadly, Dr Adekola is one of thousands of people dealing with residual side effects of the virus. The condition has been called post-COVID-19 syndrome or “long COVID-19.” It is generally considered to be the effects of COVID-19 that persist for more than four weeks after diagnosis.
There was persistence of COVID-19 symptoms of varying patterns among survivors managed in Lagos State. Of the 274 discharged COVID-19 patients enrolled in a study, more than one-third (40.9 per cent) had persistent COVID-19 symptoms after discharge, and 19.7 per cent had more than three persistent COVID-like symptoms.
Experts, in the March 2021 edition of the BMC Infectious Diseases, stated that in Lagos, the most persistent COVID-like symptoms experienced were easy fatigability (12.8 per cent), headaches (12.8 per cent), and chest pain (9.8per cent). Also, symptomatic COVID-19 disease with moderate severity compared to mild severity was a predictor of persistent COVID-like symptoms after discharge.
Available evidence based on existing studies on the virus suggest that there are as many as 55 long-term effects of COVID-19 that affect the body, with fatigue being the most common among recovered patients.
The study, published in the journal, Scientific Reports, had included eight studies from Europe and the United Kingdom, three from the United States and one each from Australia, China, Egypt and Mexico. The number of patients that were followed up in the studies ranged from 102 to 44,799. Adults ranging from 17 to 87 years of age were included in them and the patients follow-up time ranged from 14 to 110 days.
Fatigue is the most common long-term effect suffered by people who have recovered from Covid, with 58 per cent patients reporting it. Attention disorder and hair loss were also reported by more than a quarter of those who had suffered from COVID-19 while 44 per cent of the patients suffered from headaches after recovery.
Other long-term symptoms were related to lung disease such as cough, chest discomfort, reduced lung capacity, sleep apnea (when breathing is interrupted while sleeping) and pulmonary fibrosis, which refers to lung diseases that affect the respiratory system.
Equally reported were cardiovascular symptoms such as arrhythmias (irregular heartbeats) and myocarditis (heart tissue inflammation, usually caused by viral infection. Also, 15 per cent of the participants reported experiencing hearing loss or tinnitus — a buzzing noise in one or both ears.
Neurological symptoms such as dementia, depression, anxiety and obsessive-compulsive disorders are also some of the long-term effects suffered post-recovery.
Howbeit, researchers, in shedding more light on the lingering effects of COVID-19, said people with more severe initial infections are at greater risk for long-term complications in a study published in Nature.
Six months later, according to the study, those who had had COVID-19 were found to be at higher risk of new-onset heart disease, diabetes, mental health disorders, including anxiety and depression, substance use disorders, kidney disease and other problems.
The researchers had used the databases of the U.S. Department of Veterans Affairs to examine health outcomes in more than 73,000 people who had had COVID-19 and were not hospitalised, comparing them with nearly five million users of the VA health system who did not have COVID-19 and were not hospitalized.
The chairman of the Oyo State COVID-19 technical task force, Professor Temitope Alonge, said “long COVID-19” or Covid syndrome is a known phenomenon but the extent to which it is playing out in Nigeria is yet to be fully determined.
He stated that calls come in at the Infectious Disease Centre at Olodo, saying that patients, after there is no longer live coronavirus running amok in their bodies and were discharged, experience some bizarre symptoms like loss of appetite, difficulty concentrating and irrational behaviour although they did not have a history of psychological or psychiatric illness before COVID-19.
He added that some patients also had their blood pressure persistently elevated; some persistent fatigue and others difficulty sleeping.
Professor Alonge said in most of the cases, within the spate of four to six weeks, a lot of these major symptoms resolve, adding that plans were in top gear to establish and commence a post-Covid clinic in Oyo State, with clinicians, clinical psychologists and other experts to help individuals with “long COVID-19”.
He said: “For instance, in total before 22nd June, 645 patients had come to the Infectious Disease Centre at Olodo and about 130 of them had pulmonary complications and had oxygen support. We intend to further disintegrate the data, walking backwards to ascertain those who had comorbidities, hypertension, diabetes and all of that.
“They will review their cardiac status; they will undergo tests such as chest X-ray and electrocardiograph (ECG) to check their heart rate; have their blood pressure measured and so on. The clinical psychologist, by administering questionnaire, can help to pick out any behavioural changes post-COVID-19.”
While it is clear that people with certain risk factors such as high blood pressure, smoking, diabetes, obesity and other conditions are much likely to have a serious bout of COVID-19, there is not a clear link between these risk factors and long-term problems. Also, the reason why some patients experience long-term symptoms after COVID-19 remains uncertain.
One possibility is that the infection makes some people’s immune systems go into overdrive, attacking not just the virus but their own tissues. That can happen in people who have very strong immune responses. The virus itself getting into and damaging cells in the body might explain some symptoms like brain fog and a loss of smell and taste, while damage to blood vessels in particular could lead to heart, lung and brain problems.
Another theory is that fragments of the virus could remain in the body, possibly lying dormant and then becoming reactivated. This occurs with other viruses like herpes and the Epstein Barr virus which causes glandular fever. However, there isn’t much evidence to corroborate this happening with COVID-19 at the moment.
There is currently no test for “long COVID-19”. Its diagnosis is currently based on a “diagnosis of exclusion”. Doctors first of all rule out other possible causes. Tests for other issues like diabetes, thyroid function, and iron deficiency are all clear before diagnosing.
Currently, there are no proven drug treatments and the main focus is on managing symptoms and gradually increasing activity. Of course, vaccination can also help prevent people from contracting the virus and developing long COVID-19 in the first place.
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