Long COVID - long term, lasting symptoms of coronavirus

People who have apparently made a full recovery following previous positive test results for COVID-19 are finding they are struggling to get back to normal even months after their recovery. This applies whether they have recovered from the coronavirus at home, in a hospital ward, or an intensive care unit. The long length of recovery from the virus attack is having a huge impact on their lives and the lives of those around them.

They call it 'Long COVID', or ‘Long-Haul COVID’ - it's not a medical term, but one used inside and outside the medical profession. It describes the long-term health impacts that affect people's recovery time. The lasting effect of the initial infection is having an impact on more than just respiratory and lung health. People could experience a mild illness with mild symptoms. Or their initial recovery could be just the start of long-term problems for the patient. 

Everyone's recovery is different, which is why we create a private rehabilitation plan and treatment plan at Circle Rehabilitation for people in the UK, which is individual to you. Our rehabilitation programmes are medically-led - your care and rehabilitation are overseen by one of our specialist rehabilitation consultants and physicians.

At Circle Rehabilitation, there is one common question we hear from Long COVID patients:

The answer is not straight forward. People suffering from Long COVID have varied experiences as the coronavirus seems to affect different people in different ways. We already know that people who have underlying health conditions, a long term illness or long term health condition, who are overweight, or from a Black and minority ethnic background, who are older or who are male seem to be at a greater risk of contracting COVID 19. The emerging evidence shows that there is as varied a range of people who are at risk of the longer-term effects of Long COVID.

The recovery time for the coronavirus is lasting longer than the original virus infection for thousands of people in the UK. A study by King's College, London, found that 1 in 10 people with the virus is experiencing symptoms of long term medical conditions for at least four weeks. Some people who contracted COVID-19 when it first started to take hold in the UK in March 2020 are still continuing to struggle now.

The research studies, backed by the COVID symptom study app, are starting to develop a picture of who is at risk of developing Long COVID. A team from King's College London, England, and led by Professor Tim Spector, has identified potentially six clusters of factors during the first week of illness which may be associated with increased risk of Long COVID: people having a persistent cough, a hoarse voice and sore throat, headache, diarrhoea, skipping meals or feeling shortness of breath during their first week of the illness appear more likely to get long term symptoms.

The National Institute for Health Research (NIHR) estimates there could be 60,000 people with lasting symptoms in the UK. The NIHR set up the PHOSP Covid study (Post-hospitalisation COVID-19) at Leicester University to track 10,000 patients who had been admitted to hospital with COVID-19, over the course of a year during which time they will carry out clinical assessments of the impact of the viral illness on the number of patients. The findings of this long term follow up study are now starting to emerge.

At Circle Rehabilitation, we can design a rehabilitation programme that is adaptive and tailored around your needs and those of your family. Our state-of-the-art COVID rehabilitation centre can assist in helping people experiencing the longer term effects of COVID to overcome chronic fatigue, regain their strength, come to terms psychologically with their experience and provide care for people with damaged lungs and respiratory systems.

There are now almost 30,000 members of the private Long COVID Facebook support group, with members describing chronic fatigue, viral fatigue, brain fog and memory loss, shortness of breath and other health problems. They talk about their experiences of the health service and the longer-term effects of them being in hospital, on themselves as well as on their family and friends.

ICU Steps is a support group for people who have been in a hospital intensive care unit. The group helps people with emotional and practical support to help them come to terms with what for many people is a traumatic experience.

The NHS in England has also recently established the Your COVID Recovery website to help people suffering from Long COVID to manage the effects and lasting symptoms of COVID-19. The advice, for General Practitioners and Long COVID patients, is sourced from medical professionals and those specialising in respiratory medicine.

The NIHR has now published the outcomes of the PHOSP themed review of people living with COVID-19, embracing the experiences of 10,000 people to better understand the condition and treatment for people.

At Circle Rehabilitation, we support the NIHR's findings that a holistic approach is needed to help people manage long term symptoms. It is this individual approach that is at the heart of Circle Rehabilitation. We appreciate that everyone's recovery is individual to them, and our specialist consultants design a rehabilitation programme specific to each patient.

We are all familiar with the symptoms of the coronavirus viral infection itself - COVID symptoms include shortness of breath, a persistent cough, fluctuating sense of smell and taste or a temperature as the virus attacks the body.

The ongoing debilitating Long COVID symptoms include chronic fatigue syndrome, mental health problems such as anxiety and stress, chronic illness, joint pain, lung damage, and chest pain.

People in the UK suffering from Long COVID who have been in an intensive care unit may experience longer term effects of nerve damage and shoulder damage from inactivity and being in a raised-arm position for an extended time.

Sometimes people describe 'floating' symptoms that move around the body - illnesses of the respiratory system, immune system, cardiovascular system, kidneys and gut, liver and skin can get better only for new and ongoing symptoms to arise in other parts of the body.

• Breathlessness - feeling like you need to stop to catch your breath more than you would normally do. or a tight feeling in your chest. It is associated with long term impact of lung damage, as well as anxiety. At Circle Rehabilitation, we can organise lung scans and appointments with respiratory specialist consultant doctors to assess the extent of lung issues
• Problems swallowing, especially if you are breathless. If you have had assisted breathing in hospital, your swallowing muscles may have 'deconditioned' or weakened
• Fatigue and severe fatigue - feeling more tired than you are usually or extreme fatigue you cannot otherwise explain. This is a common symptom often referenced by coronavirus patients. You may not feel like it, but some gentle exercise as part of a rehabilitation plan may help build your strength.
• The feeling your immune system is compromised - like your body's operating system is not working properly
• A dry cough that does not want to go away. An appointment with a respiratory physician at Circle Rehabilitation could assist in managing these symptoms
• Changes in taste and smell - these could be bland, salty, sweet or metallic, and could affect your appetite and the amount of food that you eat
• Joint and muscle problems, musculoskeletal shoulder, and back pain - people with Long COVID tend to move less, and this can cause aches and pains. At Circle Rehabilitation we provide a graded exercise plan to work on building strength gradually, with physiotherapist and occupational therapist colleagues
• Lasting organ damage or cardiovascular effects. At Circle Rehabilitation, our rehabilitation consultants and medical doctors can assess the extent of any visible damage or physiological damage to organs, arrange additional tests - including blood tests, MRI scans and CT scans - and devise a plan based on your goals.

• Feeling scared or anxious - knowing you have had COVID-19 can feel very frightening, especially when we see the effects on those around us. If you have been in hospital you may also associate the memory of struggling to breathe with the anxiety you felt, and remembering that may trigger new feelings of stress and anxiety
• Feeling sad, with low mood or frustration, a lack of motivation or not paying as much attention to yourself or things you used to enjoy
• 'Brain fog', problems with memory, or a lack of concentration. Having trouble focusing.

If you have recovered from COVID-19 but are experiencing any of the following symptoms then we recommend you contact your GP in the first instance. We expect the NHS and public health commissioners to make full use of all available resources and capacity across the health sector in England, Scotland and Wales to fulfil your needs and reduce the long term impact of chronic illness caused by the infectious disease. Circle Rehabilitation works positively with NHS partners to provide effective healthcare for people with Long COVID.

If your coronavirus test is positive it is important to take care of yourself and those around you, including those in your support bubble. The clinical guidelines about social distancing and shielding in times of the COVID-19 pandemic are changing all the time. It is important to minimise the spread of the disease among the general public. For up-to-date guidance about local measures see the Government's COVID advice pages.

If you have a life-threatening emergency, call 999