PROFESSOR ROB GALLOWAY: Yes, long Covid DOES exist, but too many people have wrongly been told they have it

The one – and thankfully only – time I got Covid, I felt terrible: exhausted, coughing, sore throat and all my muscles ached. A few days later, and with a negative test result, I felt well enough to return to work.

Yet I didn’t feel ‘normal’ for weeks; Shifts at work made me more tired than usual and my daily 5K felt like a marathon.

Did I suffer from long Covid? The Royal College of GPs describes this as ‘signs and symptoms that develop during or after an infection consistent with Covid-19, persist for more than twelve weeks and are not explained by an alternative diagnosis.

“It usually presents with clusters of symptoms, often overlapping, which can fluctuate and change over time and affect every system in the body,” it says.

I didn’t reach the 12 week mark. It didn’t last long because of Covid, but a slow recovery from a nasty viral infection.

And I have to admit that over the last two and a half years of dealing with the coronavirus as a doctor, I have had mixed opinions about long Covid. This isn’t to say I don’t think it exists – it absolutely does (more on that later).

But part of me is frustrated by the number of patients labeled with it, often for no convincing reason other than a collection of persistent symptoms.

And the implications of this label can be significant and impact their mental well-being. Many of the people I have treated seem defeated by the assumption that they are unlikely to get better.

But also because it means that doctors may not look for other causes of their symptoms.

One such patient I saw was George Garton, an international cricketer from Sussex and England. After his long Covid diagnosis, he thought his career was over.

After talking to him about his symptoms and experiences, I felt like he wasn’t bothered by Covid for long – and with the help of an expert hematologist, we quickly realized that he had indeed had a lung clot after a long flight.

Knowing he had a reversible condition changed his mental outlook. He returned to training and was soon taking wickets and scoring runs for Sussex.

George was one of the lucky ones who managed to shake off his long Covid label and get better.

However, in some of the patients I see, their ‘long Covid’ is a self-diagnosis, given without any good medical reason.

Their very real symptoms, such as muscle pain and fatigue, can be physical manifestations of psychological problems.

For these patients, the long Covid label does not help, as they fall into a spiral of helplessness without addressing the underlying problems.

But on the other hand, I see terrible cases of long Covid. It exists and it can be terrible.

Previously fit, healthy, happy and hardworking people, who before they got Covid were running marathons – but who now struggle to even get out of bed in the morning, their lives ruined.

According to the latest data from the Office for National Statistics, 1.9 million people in Britain are experiencing self-reported long Covid-19 epidemics.

But how many people really have it? This question is important because of the way people with symptoms are treated – and also because these are the kinds of figures that could frighten many who worry about contracting a long Covid-19 epidemic and thus avoiding social interactions, with all the major damage that entails. that does something for people’s well-being.

There was skepticism about the figures, fueled last week by a newspaper that made headlines everywhere.

The paper, written by three leading statisticians and published in the highly respected journal BMJ Evidence-Based Medicine, highlighted data showing that only 1.6 percent of people with Covid had persistent symptoms attributable to Covid after 16 weeks.

The authors suggested that not only was Long Covid not as widespread as many of us feared – but that much of the original data on Long Covid was flawed.

Firstly, they revealed that many studies purporting to show how common Covid was did not compare the prevalence of symptoms in people who had not had Covid for long.

For example, if a study shows that 20 percent of people are tired after Covid, how do we know if this is due to the Covid infection if you don’t know what proportion of the population that has never had Covid is also tired? Another problem is that the long Covid data often comes from those who have been hospitalized or who have chosen to participate in the studies – and these patients do not represent the average person with Covid, who is often not as ill is. And so incorrect conclusions are drawn.

But if the data is overestimated, two other studies – which also came out this past week but didn’t make headlines – have confirmed the existence of long Covid.

In the first, MRI scans taken six months after patients were admitted to hospital for Covid, were compared with scans of people who did not have Covid.

The results showed that abnormalities in organs such as the lungs and brain were twice as common in those who had had Covid (61 percent compared to 27 percent in the non-Covid group).

The changes in the brain, including a reduction in brain volume, are significant because this is a disease that was not initially thought to affect the brain.

Furthermore, the people who were the unhealthiest when they contracted Covid had the greatest MRI changes, according to the British study published in The Lancet Respiratory Medicine.

Could this explain the long Covid-19 period and symptoms such as brain fog, demonstrating the physical nature of the disease?

The other study compared 273 patients with a long Covid-19 period with people who had never been infected, and with people who had had Covid but recovered afterwards.

The US researchers reported in the journal Nature that the long Covid group had significant differences in several blood test results – including having much lower levels of cortisol, a hormone that helps regulate the body’s stress response, controls blood sugar levels and regulates blood sugar levels keeps under control. blood pressure healthy.

This could explain many of their symptoms, such as fainting.

For any skeptics not long convinced that Covid is a real physical illness, these two studies provide a robust rebuttal (adding to a growing body of evidence on its long-term effects, such as on the blood vessels, with increased stroke rates and heart attacks).

Let me throw in another study. This appeared in the BMJ earlier this year and showed that vaccination significantly reduced the incidence and severity of long Covid-19. More evidence of the physical causes of long Covid.

So what is the upshot of all this? Bad studies have certainly resulted in the exaggerated numbers for long Covid. In addition, there are some self- or doctor-diagnosed cases of long Covid-19 that, frankly, are misdiagnosed.

But for those who have had Covid for a really long time, there is a physical cause for their symptoms.

We must do everything we can to reduce its impact on us collectively and individually. That means we need to focus on building a healthier society of people who are less likely to get sick from Covid, and especially from long Covid.

It also shows how important it is to get vaccinated – even if this means offering annual vaccines to everyone, not restricting them as we are now doing in Britain (autumn boosters are being offered to people aged 65 and over this year , and not to anyone) from age 50, just like in 2022), because the benefits of the vaccine in preventing long Covid are so great.

As always with Covid, there is so much more we don’t yet understand.

The way I interact with my patients and the advice I give them will change over time – based on the best available evidence.

Only by doing this can we provide the best possible care to patients – those who have truly had Covid for a long time and those who have been misdiagnosed.

@drrobgalloway