Long COVID:  Symptoms, risk factors, and treatment options explained

What is Long COVID?

What are the common symptoms of long COVID?

• Respiratory: 
  • Shortness of breath 
  • Persistent cough 
  • Chest pain 
• Neurological 
  • Brain fog 
  • Difficulty speaking 
  • Memory loss 
  • Headache 
• Musculoskeletal: 
  • Joint and muscle pain 
• Gastrointestinal: 
  • Diarrhoea 
  • Constipation 
• Psychological: 
  • Anxiety and depression 
• Other: 
  • Fatigue 
  • Sleep disturbances 
  • Loss of taste and smell 
  • Fever 
  • Rash 

How is long COVID diagnosed?

1. Medical history evaluation: The doctor will conduct a thorough review of the patient's COVID-19 history, which includes assessing the severity of the infection, the symptoms experienced, and the treatments administered. It is important to note that long COVID may occur even following mild or asymptomatic infections.
2. Assessment of symptoms: The presence of symptoms such as fatigue, cognitive impairment, shortness of breath, joint pain, or palpitations,  will be carefully evaluated.
3. Physical examination and diagnostic testing: Based on the reported symptoms, the doctor may recommend various tests, including blood analyses, imaging studies (such as X-rays or MRIs), or evaluations of lung function, to identify any underlying complications.
4. Exclusion of alternative conditions: Since many symptoms associated with long-term COVID can overlap with those of other medical conditions, including thyroid disorders, chronic fatigue syndrome, or anxiety disorders, a significant part of the diagnostic process involves ruling out these possibilities.

Risk factors for long COVID

1. Severity of initial infection: Individuals who experience hospitalisation or severe manifestations of COVID-19 are at a heightened risk for long-term COVID.
2. Underlying health conditions: The presence of health issues such as diabetes, obesity, and cardiovascular diseases elevates the risk of long COVID.
3. Gender: Research indicates that women are more susceptible to long COVID symptoms compared to men.
4. Age: Long COVID is observed more frequently in middle-aged and older adults, although it may also affect younger individuals.
5. Multiple symptoms during acute infection: The occurrence of a diverse array of symptoms, encompassing respiratory and systemic manifestations during the initial infection, is associated with an increased risk.
6. Pre-existing mental health conditions: Individuals with anxiety or depression before contracting COVID-19 may experience a greater vulnerability to long-term COVID.
7. Delayed vaccination: Individuals who remain unvaccinated or receive vaccination post-infection may face elevated risks compared to those vaccinated before infection.

What treatment is available for long COVID?

Primary care management:

COVID-19 antivirals:

Symptom-specific treatments:

• Fatigue: Strategies such as energy-conservation methods, progressive exercise regimens, and physical therapy are recommended. 
• Breathing problems: Options include pulmonary rehabilitation and specific breathing exercises. 
• Cognitive issues: Interventions consist of cognitive rehabilitation and memory enhancement exercises. 
• Pain or muscle weakness: Treatments may involve physiotherapy and pain management techniques. 

Mental health support:

Medications:

Lifestyle adjustments:

What to do if I have long COVID symptoms?

1. Consult a healthcare professional: If you suspect you are experiencing long COVID, it is imperative to consult a healthcare professional without delay. It is essential to communicate all symptoms you are experiencing, even those that may not appear directly related, to facilitate an accurate evaluation. Furthermore, it is advisable to maintain a detailed record of your symptoms, including their intensity and any identifiable triggers. 
2. Seek specialised medical support: If your symptoms significantly impact your daily life, it might be helpful to consider seeking care from long COVID clinics or multidisciplinary programs. These facilities provide customised care solutions for ongoing challenges, such as fatigue, shortness of breath, or cognitive impairments. 
3. Adopt a healthy lifestyle: To bolster the recovery process, prioritise a balanced diet, ensure adequate hydration, maintain quality sleep, and engage in light physical activity, while refraining from excessive exertion. Additionally, it is important to manage stress levels through practices such as mindfulness or psychotherapy, particularly in the presence of mental health issues such as anxiety or depression. 
4. Stay informed and maintain regular follow-up: Remain informed about new treatments and rehabilitation strategies as they become available. Adhere to your healthcare provider’s recommendations and attend all scheduled follow-up appointments to ensure ongoing evaluation and necessary adjustments to your treatment plan. Timely intervention and careful management can contribute to improved recovery outcomes. 

Self-care at home

1. Prioritisation of rest and activity management Fatigue represents a prevalent symptom associated with Long COVID. It is essential to prioritise rest and remain attuned to the body's signals. Individuals should engage in activity management by balancing their tasks with sufficient rest intervals to prevent overexertion. 
2. Adherence to a nutritious diet: Emphasis should be placed on the consumption of nutrient-dense foods, including but not limited to fruits, vegetables, whole grains, lean proteins, and healthy fats. It is imperative to maintain hydration throughout the day to promote overall health. 
3. Incorporation of gentle physical activity: Participation in light physical activities, such as walking or stretching, can aid in maintaining mobility and enhancing circulation. Individuals are advised to refrain from engaging in strenuous workouts that may exacerbate fatigue. 
4. Support for mental health: The practice of relaxation techniques, including meditation, deep breathing exercises, or yoga, is recommended. Maintaining connections with friends and family is important, and individuals should consider seeking bulk-billed mental health plan if they experience anxiety, depression, or stress. 
5. Documentation of symptoms: The maintenance of a journal for recording symptoms, potential triggers, and improvements is advisable. Such documentation can assist healthcare providers in customising treatment plans based on the individual's experiences. 
6. Management of specific symptoms: For breathing difficulties, it is recommended to engage in breathing exercises or consult a respiratory therapist. To address cognitive challenges associated with brain fog, individuals should utilise organisational tools such as lists and reminders. To mitigate sleep disturbances, the establishment of a consistent bedtime routine and the creation of a conducive sleep environment are necessary. 

Can an online doctor help?

• Telehealth consultations: Patients can consult with Australian registered medical practitioners 24/7 via video calls, often within 15 minutes. 
• Medical Certificates: Users can obtain valid medical certificates for work, school, or carer responsibilities online, with approval from accredited practitioners typically within 15 minutes. 
• Online Prescriptions: Patients can receive online prescriptions and have medications delivered directly to their homes, often within two hours. 
• Referrals: Hola Health facilitates referrals to specialists as needed during consultations. 
• COVID Antivirals: The service provides access to COVID-19 antiviral medications through online consultations. 
• Mental Health Care Plans: Patients can receive tailored mental health care plans from qualified GPs as part of their telehealth services. 

Preparing for a telehealth appointment

• It is advisable to document symptoms comprehensively. This includes maintaining a detailed log of the symptoms experienced, their duration, and any identifiable triggers. It is important to compile a list of one's medical history. This list should encompass any pre-existing conditions, previous COVID-19 diagnoses, and treatments that have been administered. 
• Individuals should provide information regarding medications. This involves sharing details about any medications or supplements currently being taken. 
• Prepare a set of questions in advance. These may pertain to symptom management, potential referrals, or necessary diagnostic tests. One should ensure a stable setup for the appointment. This entails creating a quiet environment equipped with a reliable internet connection. 
• Have all relevant records readily accessible. This includes medical reports, test results, and vaccination records. Organising these aspects facilitates the healthcare provider in delivering customised advice and formulating an appropriate care plan.