Long COVID part 2

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Joined: 24 Mar 2013 01:28
Full Name: Govind Mohan
Name of Your College/Medical School: Madras Medical College

Long COVID part 2

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What is long covid?
Although long covid is widely acknowledged to exist, diagnostic criteria vary, with different authorities acknowledging a diversity of symptoms and severity levels. Symptoms include fatigue, cognitive symptoms such as difficulty concentrating and impaired memory, and sensory changes like permanent loss of smell or taste.10 Physiologically, long covid may cause damage to extremities, in some cases requiring amputation1112; multiorgan injury such as chronic kidney disease requiring dialysis or transplant1314; or respiratory complications and persistent post-exertional symptoms. These symptoms may exist in isolation or in clusters, and though they range in severity, many greatly affect people’s wellbeing and life plans.

The exact prevalence of long covid is unknown because the wide range of presentations overlap numerous other conditions, there is no definitive diagnostic test, some people with long covid may struggle to access care (and thereby be counted), and covid-19 testing was difficult to access in many settings at the beginning of the pandemic. In the UK, the Coronavirus Infection Survey conducted from April 2020 to August 2021 estimated between 3% and 11% of 15 061 participants with covid-19 infection experienced symptoms for more than 12 weeks.15 The US Centers for Disease Control and Prevention found up to 20% of 353 000 patients aged 18-64 years had one symptom attributable to covid-19 more than four weeks after infection.16 At its lower bound, at least 16.5 million of the 562 million people infected with covid-19 worldwide as of 20 July 202217 may have long covid, but at its higher estimates, the number could extend to over 100 million people.

Symptoms of long covid can persist for over a year and potentially be permanent. One international online survey in 2020 of 3762 people in 56 countries with confirmed or suspected covid-19 who had illness lasting over 28 days found 45% of respondents had required a reduced work schedule, and another 23% had left the workforce because of suspected long covid.18 Long covid in children and young people could similarly jeopardise educational attainment.

Long covid and disability
Long covid itself may not be a disability but given its potentially debilitating effects on people’s lives, it can be disabling. Long covid symptoms may also constitute disabilities because of loss of human function or because of a persistent impairment that undermines a person’s quality of life.19

Another way in which long covid symptoms may be disabling is if a person experiences social discrimination or social subordination, wherein they lose status in society as a result of perceived “defective bodily functioning.”1920 Some evidence suggests that people with long covid already experience discrimination. For example, in a cross sectional survey of 127 patients with long covid symptoms conducted between August 2020 and March 2021 in Japan, 55 people had experienced at least one form of discrimination and stigma, including being treated as if still contagious or being the subject of harmful rumours or verbal harassment.21 Subsequent research does not suggest attitudes have changed.22 People with long covid can also experience social isolation, stigma, and loss of social identity because of their inability to perform at work, maintain their relationships, care for their families, exercise, and so on.

part 3 to follow

G Mohan.
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