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Content ArticleThis article in the Nursing Times Long Covid series discusses how nurses are at high occupational risk of Long Covid and how best to support them.
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Content ArticleToday may be the most difficult day the NHS has ever experienced. The headlines will focus on the pressures created by the heatwave and that most visible sign of healthcare failure – ambulances queuing outside hospitals. But, as we know all too well, this brutal situation is the culmination of many factors, which include but are not limited to prolonged periods of underfunding in the past decade, lack of an adequate workforce plan, and a cowardly and short-sighted failure to undertake social care reform, writes Dr Kamran Abbasi, editor of the BMJ, and HSJ editor, Alastair McLellan, in this joint editorial.
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Content ArticleCOVID-19 is more likely to lead to Long COVID among persons of working age. In this paper, Darja Reuschke and Donald Houston outline the first estimates of the impact of Long Covid on employment in the UK. Using estimates of cumulative prevalence of Long Covid, activity-limiting Long COVID in the working-age population and of economic inactivity and job loss resulting from Long COVID, they provide evidence of the profound impact of Long COVID on national labour supply. Since the start of the pandemic, cumulatively 2.9 million people of working age (7% of the total) in the UK have had, or still have, Long ovid. This figure will continue to rise due to very high infection rates in the Omicron wave. Since the beginning of the pandemic, economic inactivity due to long-term sickness has risen by 120,900 among the working-age population, fuelling the UK’s current labour shortage. An estimated 80,000 people have left employment due to Long COVID. The authors argue that governments need to tackle the twin challenges to public health and labour supply and provide employment protection and financial support for individuals and firms affected by Long COVID.
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Content ArticleAn analysis of data from nearly 154 000 US veterans with SARS-CoV-2 infection provides a grim preliminary answer to the question: What are COVID-19’s long-term cardiovascular outcomes? The study, published in Nature Medicine by researchers at the Veterans Affairs (VA) St Louis Health Care System, found that in the year after recovering from the illness’s acute phase, patients had increased risks of an array of cardiovascular problems, including abnormal heart rhythms, heart muscle inflammation, blood clots, strokes, myocardial infarction, and heart failure. What’s more, the heightened risks were evident even among those who weren’t hospitalised with acute COVID-19.
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Content ArticleThis blog by doctors Clare Rayner and Amali Lokugamage argues that Long Covid rehabilitation needs a wider focus that goes beyond a purely biomedical paradigm to include complementary therapies and methods. The authors—who have both lived with Long Covid for more than two years—argue that although patients were the first to raise concerns about Long Covid, describe its symptoms and patterns and even research the condition, their narratives and voices are not being included in approaches to treatment. While the biomedical evidence surrounding Long Covid is currently limited, they highlight that there is much valuable lived-experience to be found in patient support and campaign groups, and that patients' knowledge should be drawn on to shape policy and guidance about the condition.
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Content ArticleDr Harsha Master, Dr Ashish Chaudhry, Dr Nicholas Gall, Dr Louise Newson, Dr Sarah Glynne, and Dr Paul Glynne present their experiences of diagnosing, managing, and referring patients with long COVID and associated conditions. Read this article to learn more about: the definition, prevalence, and symptoms of long COVID exclusion of alternative diagnoses, and identification of red-flag symptoms the authors’ experiences of managing long COVID and its complications.
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Content ArticlePoster from World Physiotherapy for World Physiotherapy Day 2021 highlighting the symptoms of Long Covid similar to ME/chronic fatigue syndrome which can worsen with exertion.
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Content ArticleThe National Institute for Health and Care Research (NIHR) is funding a portfolio of research to improve our understanding of, and find treatments for, Long Covid. The NIHR’s 19 studies are trying to answer some of the most urgent questions.
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Content ArticleMore must be done to avoid harm to patients while waiting for treatment. The backlog for planned care is one of the biggest challenges for the NHS in Wales. Waiting times targets have not been met for many years. This backlog has been made much worse due to the pandemic. In February 2022, there were nearly 700,000 patients waiting for planned care, a 50% increase since February 2020. Over half of the people currently waiting have yet to receive their first outpatient appointment which means that they may not know what they’re suffering from and their care cannot be effectively prioritised. Modelling shows it could take up to seven years or more to return waiting lists to pre-pandemic levels. This report makes five recommendations based on what the Welsh Government needs to do as it implements its national plan.
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Content ArticleReturning to work as a nurse with Long Covid is thwart with difficulties in part due to its relapsing-remitting nature. Many nurses with Long Covid experience post-exertional malaise and symptom exacerbation if they push themselves and this may trigger a major relapse. This means that a return to work needs to be planned carefully. Dr Alison Twycross, Editor in Chief of Evidence-Based Nursing, speaks to two freelance consultants from Long Covid Work: Dr Clare Rayner, a consultant occupational physician, and Kirsty Stanley, Director, Occupational Therapist & Writer at Occupation4Life Ltd, about best practice in this context. They provide guidance for both employers and employees. Alison, Clare and Kirsty are also members of the Long Covid Support Employment Group.
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Content ArticleFollowing the the COVID-19 virus, a new condition known as Long Covid has emerged. Find out what people told Healthwatch about their experiences of getting treatment for this new condition. Healthwatch looked at a sample of 122 people’s experiences, shared with them between September 2020 and March 2022, to explore what it is like for people seeking help with symptoms of Long Covid.
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Content ArticleThe Covid-19 pandemic has had a profound impact on patient safety, revealing a range of challenges across all healthcare systems, at all levels and in all settings. At the Health Plus Care conference on the 18 May 2022, Patient Safety Learning's CEO Helen Hughes, in a keynote speech, reflected on the impact of the pandemic on patient safety and work being undertaken by the World Health Organization to assess this. See attached her presentation slides.
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Content ArticleWith the ongoing COVID-19 pandemic, growing evidence shows that a considerable proportion of people who have recovered from COVID-19 have long-term effects on multiple organs and systems. A few longitudinal studies have reported on the persistent health effects of COVID-19, but the follow-up was limited to 1 year after acute infection. The aim of this study from Huang et al., published in Lancet Respiratory Medicine, was to characterise the longitudinal evolution of health outcomes in hospital survivors with different initial disease severity throughout 2 years after acute COVID-19 infection and to determine their recovery status. The study found thategardless of initial disease severity, COVID-19 survivors had longitudinal improvements in physical and mental health, with most returning to their original work within 2 years; however, the burden of symptomatic sequelae remained fairly high. COVID-19 survivors had a remarkably lower health status than the general population at 2 years. The study findings indicate that there is an urgent need to explore the pathogenesis of long COVID and develop effective interventions to reduce the risk of long COVID.
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Content ArticleBritain’s next public health crisis is already looming: Long Covid. The numbers are stark. According to the Office for National Statistics, 1.5 million people in the UK have long Covid, 281,000 of whom are so ill that their ability to undertake day-to-day activities has been limited “a lot”. Ravi Veriah Jacques knows first hand how debilitating Long Covid can be. He is only 23. Before Covid struck, Ravi had just graduated from Stanford University and was halfway through a master’s degree at Tsinghua University, Beijing, as a Schwarzman scholar. However, he has been seriously ill for a full year. Hisy main symptom has been an intense fatigue that has forced me to spend up to 16 hours a day in bed and, when I do get up, I can’t do any strenuous activity without my symptoms worsening. Long Covid has put my life almost completely on hold. Yet Ravi has received no effective medical treatment. He is being seen in London at University College hospital’s Long Covid clinic, where he has been prescribed antihistamines and given advice on how to manage his symptoms. Neither measure has made a dent on his fatigue. Ravi's experience is far from unique. None of the more than 80 specialist NHS Long Covid clinics can offer longhaulers effective treatments. But the clinics aren’t the primary issue. The fundamental problem is that we lack treatments because research isn’t progressing fast enough.
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Content Article
Covid-19: Long term brain injury (14 March 2022)
Patient Safety Learning posted an article in Blogs
SARS-CoV-2 infection can damage many organs other than the lungs. The most troubling is damage to the brain. A series of recent studies document long term brain-damage in as many as one quarter of all those infected regardless of the severity of the initial disease. Those numbers are daunting considering that an estimated 140 million Americans have been infected by SARS-CoV-2. Symptoms, such as brain fog, fatigue, depression and a host of other maladies, may be mild or incapacitating. Several studies warn that treatment of those with long term brain injury will strain the healthcare care system for years to come. Understanding the origin and treatment of Covid-19 related brain injury is a high priority for medical science. -
Content ArticleThis study in the International Journal of Environmental Research and Public Health aimed to investigate physical activity patterns in people with Long Covid, and the relationship between physical activity and Long Covid symptoms. It also aimed to find out the type of physical activity that people with Long Covid were being recommended, and what they were actually doing. The authors found that 75% of participants reported Long Covid symptoms worsening after physical activity. They also found that many participants received contradictory advice on whether or not to exercise with Long Covid.
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Content ArticleEndurance athletes have been left using wheelchairs or barely able to walk. But the government acts like Covid is beaten, writes Rose George in this Guardian article.
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Content ArticleThis study in BMC Infectious Diseases aimed to determine whether there is an association between Covid-19 infection and acute appendicitis. The authors performed a single institution retrospective review of pre-procedure Covid-19 testing and indications for surgical intervention. They found a high prevalence of Covid-19 in both all testing and pre-procedure testing during the enrolment period and observed a high prevalence of acute appendicitis among patients identified to be Covid-positive during pre-procedure testing and without recognised symptoms of Covid-19.
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Content ArticleOnly 1 in 3 people were fully recovered from COVID-19 a year after they left hospital. Being female, having obesity or being on a ventilator were each linked with ongoing symptoms, months after people were discharged (Long-COVID). Nearly 1 million people in the UK have so far been admitted to hospital because of COVID-19. The long-term effects of the infection in this group are only just coming to light. Researchers explored the impact of being hospitalised for COVID-19 on people’s mental and physical health, and on their employment. They looked at characteristics such as age and sex to see which were associated with worse recovery. They also assessed whether inflammation in the blood may be a potential target for treatment. This study described, for the first time, four different patterns of COVID-19 recovery. It found, for example, that some people with long-COVID had higher levels of inflammation. The researchers say that targeting treatment to specific clinical problems, such as treating inflammation in people with higher levels of inflammation, are promising approaches to aid recovery.
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Content ArticleAs of May 31, 2022, there were 6·9 million reported deaths and 17.2 million estimated deaths from COVID-19, as reported by the Institute for Health Metrics and Evaluation. The Lancet COVID-19 Commission was established in July 2020, with four main themes: developing recommendations on how to best suppress the epidemic; addressing the humanitarian crises arising from the pandemic; addressing the financial and economic crises resulting from the pandemic; and rebuilding an inclusive, fair, and sustainable world. It has now published it's key findings and recommendations.
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Content ArticleOn 25 March 2020, Hannah Davis was texting with two friends when she realized that she couldn’t understand one of their messages. In hindsight, that was the first sign that she had COVID-19. It was also her first experience with the phenomenon known as “brain fog,” and the moment when her old life contracted into her current one. She once worked in artificial intelligence and analysed complex systems without hesitation, but now “runs into a mental wall” when faced with tasks as simple as filling out forms. Her memory, once vivid, feels frayed and fleeting. Former mundanities—buying food, making meals, cleaning up—can be agonisingly difficult. For more than 900 days, while other long-COVID symptoms have waxed and waned, her brain fog has never really lifted.
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Content ArticleThere are rising reports of profound cognitive impairment on par with clinical dementia as a result of Long Covid. By researchers’ best estimates, more than 1 in 8 people with Covid-19 will have some array of the 200 odd symptoms reported in this disease for months to years. Long Covid is quickly emerging as the next public health challenge. What are these land mines left behind by the SARS-CoV-2 virus? Are you at risk for them to explode even if you never get very sick from Covid? A study released earlier this month suggests that people suffering from long COVID end up with reservoirs of active SARS-CoV-2 virus — documented in our lungs, brain, and GI tract — which produce ongoing levels of viral spike protein in the blood. A year after becoming infected, patients’ levels can sometimes remain as high as were found during early infection.
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Content ArticleCOVID-19 is associated with increased risks of neurological and psychiatric sequelae in the weeks and months thereafter. How long these risks remain, whether they affect children and adults similarly, and whether SARS-CoV-2 variants differ in their risk profiles remains unclear. This study from Taquet et al. looked at the risks of 14 different disorders in 1.25 million patients two years on from Covid, mostly in the US. It then compared them with a closely-matched group of 1.25 million people who had a different respiratory infection. In the group who had Covid, after two years, there were more new cases of dementia, stroke and brain fog in adults aged over 65; brain fog in adults aged 18-64; and epilepsy and psychotic disorders in children, although the overall risks were small. Some disorders became less common two years after Covid, including anxiety and depression in children and adults and psychotic disorders in adults. The increased risk of depression and anxiety in adults lasts less than two months before returning to normal levels, the research found.
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Content ArticlePatients often report various symptoms after recovery from acute COVID-19. Ballering et al. aimed to analyse the nature, prevalence, and severity of long-term symptoms related to COVID-19, while correcting for symptoms present before SARS-CoV-2 infection and controlling for the symptom dynamics in the population without infection. They found persistent symptoms in COVID-19-positive participants at 90–150 days after COVID-19 compared with before COVID-19 and compared with matched controls included chest pain, difficulties with breathing, pain when breathing, painful muscles, ageusia or anosmia, tingling extremities, lump in throat, feeling hot and cold alternately, heavy arms or legs, and general tiredness.
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Content ArticleCOVID-19 has been associated with new-onset cardiovascular disease (CVD) and diabetes mellitus (DM), but it is not known whether COVID-19 has long-term impacts on cardiometabolic outcomes. This study from Rezell-Potts et al. aimed to determine whether the incidence of new DM and CVDs are increased over 12 months after COVID-19 compared with matched controls. The study found that CVD was increased early after COVID-19 mainly from pulmonary embolism, atrial arrhythmias, and venous thromboses. DM incidence remained elevated for at least 12 weeks following COVID-19 before declining. People without preexisting CVD or DM who suffer from COVID-19 do not appear to have a long-term increase in incidence of these conditions.
