Long Covid and the toll on those with this condition.

Latest research

A new study out this week from the REACT Study has been tracking responses from 276,840 adults in England. Of these, 59% reported developing Covid (with positive test). Analysis shows the average duration of symptoms of those with Covid varied. For most folks symptoms lasted around 10 days and this has been around my typical infection time. But, 1 in 10 people had more long-lasting with symptoms for more than 4 weeks with 1 in 13 having symptoms persisting for more than 12 weeks and 1 in 20 for more than a year.

Its not all bad news as almost a third of people reporting symptoms at 12 weeks will have recovered within a year but this still leaves 2/3 people with ongoing and life-altering symptoms.

What are the typical symptoms of Long Covid?

Around 65 million individuals worldwide are estimated to have Long Covid. Long Covid is a condition comprising often severe symptoms that can affect many different organs causing cardiovascular, respiratory and/or neurological symptoms.

Who is most at risk?

Studies have shown that some groups of people seem to have a higher likelihood of developing the condition- it is more likely if you are female, have a pre-existing health condition and live in conditions of higher deprivation. Although the condition can develop after mild infection, its more frequently associated with more severe infection. Most cases are linked with the time when the original Wild-type variant was dominant . The good news is that vaccination and prior infection have created some immunity- BUT there is still a risk. e.g. In UK, the risk of long COVID dropped after 2nd infections compared to 1st infections (4% → 2.4%). Similarly the REACT study showed that people infected in the Omicron wave of the pandemic were 88% less likely to experience symptoms longer than 4 weeks post-infection, compared to earlier waves. This is likely due to a combination of vaccination and hybrid-immunity (Infection post-vaccination). Nonetheless data from the REACT study and ONS show that approximately 700,000 in the UK alone developed the condition in the so-called “mild” era of Omicron.

We are learning more about Long Covid but although we don’t yet know WHY it is happening, there is clear underlying biology and immunology. For example some individuals have latent viral reservoirs, some have immune abnormalities causing autoimmunity and some have clotting abnormalities.

A recent study by Prof Akiko Iwasaki and colleagues has used a combination of computational and long term immunology profiling of blood cells. The study showed marked differences in immune cells compared with healthy controls. Many had more exaggerated antibody responses against SARS-CoV-2 and there was evidence of reactivity to latent viruses too. The stress hormone cortisol was typically lower among participants with long Covid. These findings may help to guide future studies into the biology of long Covid, help with developing relevant biomarkers and help define better treatments.

Long Covid has economic implications.

Data shows that people with Long Covid have their lives affected significantly. The rate in which symptoms affected daily life decreased from 45% → 25% over 7 months. That’s a LONG time for ANYONE to suffer. In the UK, since the beginning of the pandemic, economic inactivity due to long-term sickness has risen by 120,900 among the working-age population and this is fuelling the UK’s labour shortage. An estimated 80,000 people have left employment due to Long Covid.

Another important study recently out in Lancet revealed the cost of Long Covid for healthcare. The health journeys of >280000 people with Long Covid were tracked between 2020-23 and compared with controls. Healthcare provision was greater/month and increased over time which is a huge cost for NHS.

Despite this abundant evidence of economic costs in UK alone (and this will be reflected in other countries) and that for many the symptoms of Long Covid often get worse if people are re-infected, long Covid was not factored into UK decisions re vaccine access! I have written about this previously.

Why am I writing this? Despite the costs of Long Covid on people’s well being, health and wealth, it is still is SO rarely mentioned in media or policy. We are told to live with Covid but that should also mean considering the needs of those still suffering from Long Covid. We should be protecting EVERYONE. Funding care and research to understand the condition in order to predict, diagnose, monitor AND treat Long Covid is vital.