Johannesburg- Clinician, Doctor Jeremy Nel, said while many people do recover from the deadly virus, there are those who suffer longer and are diagnosed with ‘Long Covid’.
Professor Ameena Goga from the South African Medical Research Council said Long covid is when you have symptoms for longer than four weeks.
She said the symptoms are many and can overlap.
These symptoms include extreme tiredness (fatigue), shortness of breath, chest pain or tightness, problems with memory and concentration (“brain fog”), difficulty sleeping (insomnia), heart palpitations, dizziness, pins and needles, joint pain, depression and anxiety, tinnitus, earaches, diarrhoea, stomach aches, loss of appetite, a high temperature, cough, headaches, sore throat, changes to sense of smell or taste and rashes.
“It’s a clinical diagnosis based on symptoms – doctors may ask for tests that assess blood haemoglobin, immunology, electrolytes, inflammatory markers, blood pressure, heart rate and an x-ray to assess lungs,” said Goga.
Nel also said that it’s not known how many people in South Africa are suffering from long covid as many don’t present to the hospital until they are very sick.
He said most patients go to their local doctors and clinics when they don’t get better after being diagnosed with Covid.
Goga said the fortunate element is that one is not infectious at this point.
“When it comes to treatment, you may be given advice about how to manage and monitor your symptoms at home. If the symptoms are having a big impact on your life, you may be referred to a specialist rehabilitation service or a service that specialises in the specific symptoms you have. These services can help manage your symptoms and help you recover,” said Goga.
Nel said treatment is often individualised as symptoms vary from person to person. He said the approach should be multidisciplinary from having an Occupational therapist, psychologist, physiotherapist, and other experts on board.
Dr Nivesh Sewlall, a pulmonologist at Mediclinic said the virus does not only affect the respiratory tract and the lungs, it can also cause damage to your heart and other organs.
“The virus affects the entire body and is capable of causing damage to multiple organs.
These include the brain, gut, pancreas, blood vessels, kidneys, and the lining of the nose and mouth. Wherever the virus can gain entry, it can also cause damage. That’s why patients suffering from long COVID tend to experience such a wide array of symptoms.”
She said when it comes to the heart, this damage takes the form of scar tissue that forms on the muscles of the organ.
The virus can also cause blood clots in the vessels around the heart, and can lead to a cytokine storm; a condition where the immune system overreacts to the presence of a bacterium, virus, or other microorganisms (all known as pathogens), which causes inflammation.
This can disrupt the proper functioning of the organ, leading to an arrhythmia, where the heart pumps either too quickly or too slowly. She warned that both conditions are dangerous and can lead to a heart attack or stroke.
“Cardiac issues among COVID-19 patients are more common than you may think. According to the American Heart Association, around 25% of US COVID-19 patients admitted to the hospital have experienced cardiac complications, and even recovered patients have presented with abnormalities in the heart. If the heart rate slows, the patient may faint.
Even if patients don’t experience damage to the heart at the time of infection, some of the virus’s effects on the heart, such as myocarditis or inflammation of the heart muscle, can put them at risk for heart failure in years to come,” explained Sewlall.
Goga said when it comes to vaccination against Covid-19 after having the virus, it is better to wait until inflammatory markers are down and the person is symptom-free.
“Usually this takes 28-30 days. Some people who were severely or moderately ill may take longer to be symptom-free and this may have to wait for 60 or 90-days depending on how sick they were when they had Covid and how long it takes them to return to normal and be symptom-free,” she said.
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