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Reflections of a COVID-19 Long Hauler (11 November 2020)
Patient Safety Learning posted an article in Blogs
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Damage to multiple organs recorded in 'long Covid' cases
Patient Safety Learning posted a news article in News
Young and previously healthy people with ongoing symptoms of COVID-19 are showing signs of damage to multiple organs four months after the initial infection, a study suggests. The findings are a step towards unpicking the physical underpinnings and developing treatments for some of the strange and extensive symptoms experienced by people with “long Covid”, which is thought to affect more than 60,000 people in the UK. Fatigue, brain fog, breathlessness and pain are among the most frequently reported effects. On Sunday, the NHS announced it would launch a network of more than 40 long Covid specialist clinics where doctors, nurses and therapists will assess patients’ physical and psychological symptoms. The Coverscan study aims to assess the long-term impact of COVID-19 on organ health in around 500 “low-risk” individuals – those who are relatively young and without any major underlying health complaints – with ongoing Covid symptoms, through a combination of MRI scans, blood tests, physical measurements and online questionnaires. Preliminary data from the first 200 patients to undergo screening suggests that almost 70% have impairments in one or more organs, including the heart, lungs, liver and pancreas, four months after their initial illness. “The good news is that the impairment is mild, but even with a conservative lens, there is some impairment, and in 25% of people it affects two or more organs,” said Amitava Banerjee, a cardiologist and associate professor of clinical data science at University College London. Read full story Source: The Guardian, 15 November 2020 -
Content ArticleLecture content How common is smell loss in COVID-19? Does it get better? How does it position relative to other symptoms of the pandemic? How is it different to typical smell loss seen with other viruses? What about taste? Why bother with smell loss?
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When the doctor Is a Covid ‘Long Hauler’
Patient Safety Learning posted an article in Blogs
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News ArticleIt has a plethora of symptoms, strikes the young and old, and lasts for months – maybe much longer. It’s also so new that scientists aren’t sure what they’re dealing with. For those whose lives have been deeply affected by long-term repercussions of Covid, the battle to be recognised is just the start. There are thousands of people in the UK dealing with the long-term effects of COVID-19, experiencing debilitating symptoms that last for weeks and months beyond the initial infection. One of the most commonly reported is fatigue, along with breathlessness, joint pain and muscle aches. Neurological issues are common, particularly brain ‘fog’ and a loss of memory and concentration. Some have chest pain or heart palpitations, skin rashes, diarrhoea, headaches, hearing or eyesight problems, or hair loss. Others have lost their senses of taste and smell. In online support groups, people are sharing stories of bone-crippling exhaustion, constant pain in their chest or heart, or the inability to remember a name or follow a conversation. These people don’t fit the binary model of the virus we thought we knew – that if you’re in the small minority who are seriously affected you might be hospitalised, end up in ICU or worse; otherwise you’ll likely be better after two weeks. Many only had mild cases originally and were not deemed to be in vulnerable categories. Widely varying symptoms have added to the confusion and fear surrounding the condition, which currently has no formal definition. For months, people with Long Covid had no one to turn to but each other. It’s only recently – through increasing research emerging, and sufferers publicly sharing their stories – that it has started to be taken more seriously. Earlier this month, NHS England announced a £10 million investment to set up one-stop services for physical and mental health issues caused by Covid alongside a Long Covid task force and, crucially, research on 10,000 patients. Not much is known about what causes Long Covid and there is little firm consensus. There are theories it occurs when a patient’s immune system overreacts to the infection, which can lead to widespread inflammation that theoretically affects any organ. Last week, a study by the National Institute for Health Research (NIHR) suggested Long Covid symptoms could actually be caused by four separate syndromes: post-intensive-care syndrome, post-viral fatigue syndrome, permanent organ damage to the lungs and heart, or lingering COVID-19 symptoms. Read full story Source: The Telegraph, 24 October 2020
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Women aged 50-60 at greatest risk of ‘long Covid’, experts suggest
Patient Safety Learning posted a news article in News
Women aged 50-60 are at greatest risk of developing “long Covid”, analysis suggests. Older age and experiencing five or more symptoms within the first week of illness were also associated with a heightened risk of lasting health problems. The study, led by Dr Claire Steves and Prof Tim Spector at King’s College London, analysed data from 4,182 COVID Symptom Study app users who had been consistently logging their health and had tested positive for the virus. In general, women were twice as likely to suffer from Covid symptoms that lasted longer than a month, compared with men – but only until around the age of 60, when their risk level became more similar. Covid vaccine tracker: when will a cor Increasing age was also associated with a heightened risk of long Covid, with about 22% of people aged over 70 suffering for four weeks or more, compared with 10% of people aged between 18 and 49. For women in the 50-60 age bracket, these two risk factors appeared to combine: They were eight times more likely to experience lasting symptoms of Covid-19 compared with 18- to 30-year-olds. However, the greatest difference between men and women was seen among those aged between 40 and 50, where women’s risk of developing long Covid was double that of men’s. “This is a similar pattern to what you see in autoimmune diseases,” said Spector. “Things like rheumatoid arthritis, thyroid disease and lupus are two to three times more common in women until just before menopause, and then it becomes more similar.” His guess is that gender differences in the way the immune system responds to coronavirus may account for this difference." Read full story Source: The Guardian, 21 September 2020 -
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News ArticleOld age and having a wide range of initial symptoms increase the risk of "long Covid", say scientists. The study estimates one in 20 people are sick for least eight weeks. The research at King's College London also showed being female, excess weight and asthma raised the risk. The aim is to develop an early warning signal that can identify patients who need extra care or who might benefit from early treatment. The findings come from an analysis of people entering their symptoms and test results into the COVID Symptom Study app. Scientists scoured the data for patterns that could predict who would get long-lasting illness. "Having more than five different symptoms in the first week was one of the key risk factors," Dr Claire Steves, from Kings College London, told BBC News. COVID-19 is more than just a cough - and the virus that causes it can affect organs throughout the body. Somebody who had a cough, fatigue, headache and diarrhoea, and lost their sense of smell, which are all potential symptoms,- would be at higher risk than somebody who had a cough alone. The risk also rises with age, particularly over 50, as did being female. Dr Steves said: "We've seen from the early data coming out that men were at much more risk of very severe disease and sadly of dying from Covid, it appears that women are more at risk of long Covid." No previous medical conditions were linked to long Covid except asthma and lung disease. Read full story Source: BBC News, 21 October 2020
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Content ArticleKey takeaways Presentation weeks and/or months after ICU discharge Physical and mental tolls of critical illness and care Beware of the possible warning signs, which may include: muscle weakness or problems with balance, problems with thinking and memory, severe anxiety, depression and nightmares The medical community expects to see a high number of PICS cases among COVID-19 survivors due to the increasing number of patients receiving critical care.
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Health Secretary warns of long-term effects of COVID-19 as new film released
Patient Safety Learning posted a news article in News
The Health Secretary is urging the public – and especially young people – to follow the rules and protect themselves and others from COVID-19, as new data and a new film released today reveal the potentially devastating long-term impact of the virus. The symptoms of ‘long COVID’, including fatigue, protracted loss of taste or smell, respiratory and cardiovascular symptoms and mental health problems, are described in a new film being released today as part of the wider national Hands, Face, Space campaign. The film calls on the public to continue to wash their hands, cover their face and make space to control the spread of the virus. The emotive film features the stories of Jade, 22, Jade, 32, Tom, 32 and John, 48, who explain how their lives have been affected – weeks and months after being diagnosed with COVID-19. They discuss symptoms such as breathlessness when walking up the stairs, intermittent fevers and chest pain. The film aims to raise awareness of the long-term impact of COVID-19 as we learn more about the virus. A new study from King’s College London, using data from the COVID Symptom Study App and ZOE, shows one in 20 people with COVID-19 are likely to have symptoms for 8 weeks or more. The study suggests long COVID affects around 10% of 18 to 49 year olds who become unwell with COVID-19. Read full story Source: Gov.uk, 21 October 2020 -
Content ArticleSudre et al. analysed data from 4182 incident cases of COVID-19 who logged their symptoms prospectively in the COVID Symptom Study app. 558 (13.3%) had symptoms lasting >28 days, 189 (4.5%) for >8 weeks and 95 (2.3%) for >12 weeks. Long-COVID was characterised by symptoms of fatigue, headache, dyspnoea and anosmia and was more likely with increasing age, BMI and female sex. Experiencing more than five symptoms during the first week of illness was associated with Long-COVID. This model could be used to identify individuals for clinical trials to reduce long-term symptoms and target education and rehabilitation services. *Note: this article is a preprint and has not been through the peer review process yet.
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Covid survivors say ‘brain fog’ has impaired their ability to function normally
Patient Safety Learning posted a news article in News
After contracting COVID-19 in March, Michael Reagan lost all memory of his 12-day vacation in Paris even though the trip was just a few weeks earlier. Several weeks after Erica Taylor recovered from her coronavirus symptoms of nausea and cough, she became confused and forgetful, failing to even recognise her own car, the only Toyota Prius in her apartment complex’s parking lot. Lisa Mizelle, a veteran nurse practitioner at an urgent care clinic who fell ill with the virus in July, finds herself forgetting routine treatments and lab tests, and has to ask colleagues about terminology she used to know automatically. It is becoming known as Covid “brain fog”: troubling cognitive symptoms that can include memory loss, confusion, difficulty focusing, dizziness and grasping for everyday words. Increasingly Covid survivors say brain fog is impairing their ability to work and function normally. “There are thousands of people who have that,” said Dr Igor Koralnik, chief of neuro-infectious disease at Northwestern Medicine in Chicago, who has already seen hundreds of survivors at a post-Covid clinic he leads. The effect on the workforce that is affected is going to be significant, he added. Read full story Source: The Irish Times, 18 October 2020 -
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News Article"Long Covid" – the long-lasting impact of coronavirus infection – may be affecting people in four different ways, according to a review, and this could explain why some of those with continuing symptoms are not being believed or treated. There could be a huge psychological impact on people living with long-term COVID-19, the National Institute for Health Research report says. They need more support – and healthcare staff require better information. Most people are told they will recover from mild coronavirus infections within two weeks and from more serious disease within three. But the report says thousands could be living with "ongoing Covid". Based on interviews with 14 members of a long-Covid support group on Facebook and the most recent published research, the review found recurring symptoms affecting everything from breathing, the brain, the heart and cardiovascular system to the kidneys, the gut, the liver and the skin. These symptoms may be due to four different syndromes: permanent organ damage to the lungs and heart post-intensive-care syndrome post-viral fatigue syndrome continuing COVID-19 symptoms Some of those affected have had a long stay in hospital with severe Covid-19 - but others, who have had a mild infection, have never even been tested or diagnosed. The review says coming up with a "working diagnosis for ongoing COVID-19" would help people access support. Read full story Source: BBC News, 15 October 2020
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Content ArticleAnalysis revealed a confusing illness with many, varied and often relapsing-remitting symptoms and uncertain prognosis; a heavy sense of loss and stigma; difficulty accessing and navigating services; difficulty being taken seriously and achieving a diagnosis; disjointed and siloed care (including inability to access specialist services); variation in standards (e.g. inconsistent criteria for seeing, investigating and referring patients); variable quality of the therapeutic relationship (some participants felt well supported while others described feeling fobbed off); and possible critical events (e.g. deterioration after being unable to access services). The authors conclude that quality principles for a long Covid service should include ensuring access to care, reducing burden of illness, taking clinical responsibility and providing continuity of care, multi-disciplinary rehabilitation, evidence-based investigation and management, and further development of the knowledge base and clinical services. *Note, this article is in preprint and has not undergone peer review yet.
