Long Covid| April 07, 2021

Long Covid: All you need to know

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What is Long Covid? Qured’s Clinical Lead Dr Kishan Vithlani answers all.

Long Covid is when you have ongoing symptoms after the first 4 weeks of having an infection with Covid-19. The term also incorporates post Covid-19 syndrome which is when you have ongoing symptoms lasting for more than 12 weeks.

How common is Long Covid?

Around 10% of 18-49-year-olds who have had Covid-19 go on to develop prolonged symptoms. This rises to 22% in over 70s. If you are still having symptoms after 4 weeks of the initial infection, you should get in touch with your doctor.

What are the symptoms of Long Covid?

The symptoms of Long Covid can be wide-ranging and can affect several different body symptoms. They are usually a persistence of the symptoms you developed when you had the initial infection, but can also be any new symptoms that you develop in your recovery phase that persists. Here are some of the common symptoms you might experience if you have Long Covid: · General flu-like symptoms such as body aches and pains, tiredness and fever · Cough, breathlessness, feeling tight chested or the sensation of a faster than usual heartbeat · Difficulty concentrating or remembering, headaches, poor sleep and dizziness · Pins and needles or numbness · Abdominal pain, reduced appetite, feeling sick or diarrhoea · Feeling depressed or anxious · Persisting sore throat or loss of taste and smell · Earache or ringing in the ears · Skin rashes

Are there any tests for Long Covid?

Currently, there are no specific tests to diagnose Long Covid. However, with there being such a large spectrum of symptoms, it’s vital to speak to your doctor If you do have any persisting symptoms. Your doctor will then conduct tests to rule out any possible complication or sequelae of Covid-19 and then investigate for an alternative cause for your symptoms, such as a new or an unrelated illness.

Is there a higher risk of developing Long Covid if I was hospitalised or had a more serious illness during a Covid-19 infection?

Right now there isn’t any evidence to suggest that those with more serious symptoms of Covid-19 are more likely to develop Long Covid. Research from the King’s College Covid symptoms study app has shown that Long Covid is more common in older individuals, women and those with a greater number of symptoms in the first week.

When do I need to seek urgent help?

If your symptoms get worse, it’s important to seek urgent help. If you develop any of the following symptoms speak to a doctor urgently or dial 999 in an emergency: · Worsening shortness of breath or difficulty breathing · Chest pain · Recurring or persistent high fever · Reduced consciousness · Severe psychiatric symptoms such as self-harm or feeling suicidal

How do I manage symptoms of Long Covid?

As a general rule, it’s important to take it easy and set realistic expectations for yourself in terms of returning to your baseline health. Continue to monitor your symptoms and don’t hesitate to speak to a healthcare professional for advice and guidance. If you feel you need support in your day-to-day life, seek the help of friends and family. Sometimes it can be helpful to share your experience with others who are also recovering from Covid-19 with the use of support groups or online forums. When it comes to work and education commitments, speak to your employer or mentor on arranging a phased return or having amended duties if you feel this will help you.

For managing more specific symptoms, see below.

How do I manage fatigue and tiredness?

We can use evidence from rehabilitation in other health conditions and use the 3 P’s to cope with day-to-day life: Plan, Pace, Prioritise!

Planning in advance will help you achieve more of your goals and essential tasks. Do any essential and strenuous activities earlier in the day when you will probably have the most amount of energy. Plan your weekly routine in advance too so that longer tasks (such as your shopping) do not accumulate and lead to you feeling more tired. Make sure you set enough time aside for each individual task.

Pacing yourself will allow you to have enough energy to complete your planned tasks. Avoid rushing, take regular breaks and ensure you still save some energy for the rest of your day. It’s ok to have a power nap too to recharge your energy levels. Ensure you don’t push yourself until you're completely exhausted as the effects of this may limit what you can achieve later. Pacing also involves frequently changing your posture and position as this in itself can cause more aches and pains.

Prioritising is important so that you are using your energy on the most essential and most enjoyable tasks as feeling happy will help you feel less fatigue and less pain. As a result, be flexible in your routine so that you can achieve these tasks and seek the help of friends or family for the non-essential tasks.

How do I manage an ongoing cough?

Make sure you keep well hydrated, sipping water or a soft drink throughout the day and doing steam inhalation will all help with the cough. Warm drinks, particularly honey and lemon, can help soothe your throat if it is irritated from the coughing. If you have a productive/wet cough, you can utilise the Active Cycle of Breathing Technique (ACBT) which your doctor can give you more information on.

How do I manage ongoing breathlessness?

If you have worsening breathing please speak to your doctor urgently or call 111. If it is stable and part of your Covid recovery, consider the following to help you:

Controlling how you breathe can help you feel less breathless. Pace your breathing, taking a slow breath in through the nose aiming to fill your entire lungs, and then breath out gently and slowly through the mouth. If you are doing any activity, you can time your breathing according to the steps you take, so that you are breathing out for a longer period than breathing in.

How do I manage the emotional impact of how I feel because of long Covid?

Remember to not be too hard on yourself as recovery time is different for everyone and it can be normal to find things more difficult to do compared to when you were well. Speak to friends and family to help you stay positive. Engage in activities that make you feel happier – prioritise this over chores or other non-essential tasks. Watching the news and media coverage of Covid-19 can often make people feel more worried and anxious, so it is probably best to limit your exposure to it during your recovery. If, despite these efforts, you continue to feel low in mood or anxious, make sure to speak to your doctor as there is support they may be able to offer you.

How can I help my recovery?

Try to eat healthily, for example a Mediterranean-style diet incorporating plenty of fresh fruit and vegetables. This will allow you to have a good source of energy, vitamins and minerals to allow your immune system to function effectively and help your recovery. Try to stop smoking as this can adversely affect your recovery and even increase your risk of picking up more infections. Gently increase your activity and stay positive to keep your spirits high on your road to recovery.

References:

https://cks.nice.org.uk/topics/coronavirus-covid-19/ https://www.nice.org.uk/guidance/ng188/chapter/5-Management https://www.bmj.com/content/370/bmj.m3026 https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1.full https://www.rcn.org.uk/magazines/bulletin/2020/nov/long-covid-need-to-know-guide https://selondonccg.nhs.uk/wp-content/uploads/2020/09/Long-COVID-Pathway-September-2020.pdf https://www.guysandstthomas.nhs.uk/resources/patient-information/therapies/physiotherapy/recovery-after-coronavirus.pdf https://www.yourcovidrecovery.nhs.uk/your-wellbeing/family-friends-and-carers/


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