The one — and fortunately only — time I got Covid, I felt absolutely awful. I was exhausted, coughing, had a sore throat, and all my muscles ached. After a few days and receiving a negative test result, I felt well enough to go back to work. However, my recovery was slow and I didn’t feel “normal” for weeks. My shifts at work left me more tired than usual and even my daily 5K run felt like a marathon. Was I experiencing long Covid?
According to the Royal College of GPs, long Covid refers to signs and symptoms that persist for more than 12 weeks after an infection consistent with Covid-19 and cannot be explained by any other diagnosis. It often presents with a range of overlapping symptoms that can fluctuate and affect any system in the body.
I didn’t reach the 12-week mark, so it wasn’t long Covid. Instead, it was just a slow recovery from a severe viral infection. As a doctor managing Covid cases, I’ve had mixed opinions about long Covid. While I do believe it exists, I’ve been frustrated by the number of patients labeled with it without any convincing reason beyond ongoing symptoms. This label not only impacts their mental well-being but also prevents clinicians from exploring other potential causes.
I once saw a patient, George Garton, who had been diagnosed with long Covid and believed his cricket career was over. However, upon analyzing his symptoms and seeking input from a haematologist, we discovered that he actually had a lung clot from a long flight. Knowing that his condition was reversible changed his outlook, and he was able to resume training and perform well in his matches.
For some patients, the label of long Covid is self-diagnosed without adequate medical reasons. Their symptoms, such as fatigue and muscle aches, may stem from underlying psychological issues. In these cases, the label is unhelpful as it leads to a sense of helplessness without addressing the root problems.
On the other hand, I’ve witnessed severe cases of long Covid that are truly debilitating. These individuals were previously healthy and active, but now struggle with even basic daily activities. According to recent data from the Office for National Statistics, 1.9 million people in the UK are self-reporting long Covid. However, it’s important to question the accuracy of this number, as it influences how people with symptoms are treated and can cause unnecessary anxiety.
A recent paper published in BMJ Evidence-Based Medicine raised doubts about the prevalence of long Covid. The authors highlighted flaws in previous studies and emphasized the need to compare symptoms in those who did not have Covid. They also pointed out that the data often came from hospitalized patients or those who volunteered for studies, which can distort the overall picture.
While these doubts exist, two other studies published recently confirm the existence of long Covid. MRI scans revealed abnormalities in organs like the lungs and brain, which were more common in those who had Covid compared to those who did not. Changes in brain volume may explain symptoms like brain fog, providing physical evidence of the illness. Additionally, blood test results showed significant differences between those with long Covid and those who had recovered completely, including lower levels of cortisol linked to symptoms like fainting.
These studies, along with previous research demonstrating long-term effects on blood vessels and the benefits of vaccination in reducing long Covid incidence and severity, prove that long Covid is a genuine physical illness. However, it is crucial to acknowledge that poor studies and misdiagnoses have inflated the numbers.
As we continue to learn more about Covid, my approach to managing patients and the advice I offer will evolve based on the best available evidence. It is essential to provide the best possible care to those who truly have long Covid and address the underlying causes. Building a healthier society that is less susceptible to Covid and its long-term effects is key, emphasizing the importance of vaccination and potentially expanding eligibility for annual vaccines.
There is still much we do not understand about Covid, but by staying informed and adapting our strategies, we can minimize the impact of long Covid collectively and individually.
– Dr. Rob Galloway
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