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10:19am 03/06/2021
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​Long COVID: an undiscussed sequelae of COVID-19

By Professor Dr Moy Foong Ming

Most patients with COVID-19 experience mild symptoms or moderate illness.

Approximately 10-15% of patients progress to severe disease, and about 5% become critically ill.

Typically, patients recover from COVID-19 after two to six weeks1.

While most patients with COVID-19 recover and return to normal health, some patients can have symptoms that last for weeks or even months after recovery from COVID-19.

These patients are not infectious to others during this time. This persistent state of ill health is known as Long COVID or post-COVID condition.

Long COVID is a range of symptoms that continue for weeks or months beyond the initial illness. It can happen to any COVID-19 patients, even patients who are not hospitalized and who have mild illness can experience persistent or late symptoms.

Some patients develop medical complications that may have lasting health effects.

Patients with long COVID report experiencing different combinations of symptoms such as tiredness or fatigue, difficulty thinking or concentrating, headache, loss of smell or taste, dizziness on standing, palpitations or increased heartbeat, chest pain, difficulty breathing or shortness of breath, cough, joint or muscle pain, depression or anxiety, fever, symptoms that get worse after physical or mental activities etc.

These symptoms are caused by patients' body's response to the virus continuing beyond the initial illness.

Preliminary results from a national survey in the UK estimates that around one in ten COVID-19 patients exhibit symptoms for a period of 12 weeks or longer2.

Another study found that 30% of COVID-19 patients surveyed still had persistent symptoms after nine months3.

However, there is no such information available in Malaysia.

As our accumulated COVID-19 cases is more than half a million now (579,462 cases on 1 June 2021), there should be some observation on patients who recovered from COVID if they have Long COVID.

Information on the prevalence, seek treatment or not, ability to resume physical function as before illness, health related quality of life and proportion of returning to work should be monitored.

The COVID-19 patients who recovered and discharged, regardless of them having mild or moderate symptoms, should be well informed about Long COVID.

They should be advised to seek treatment if they experience any severe symptoms as mentioned above.

With over half a million accumulated cases of COVID-19 in the country, even a small percentage of patients experience long-term debility could have significant and lasting health and economic consequences for the country.

The best method to prevent Long COVID is to prevent COVID-19.

Practice all SOPs, avoid crowds and poorly ventilated indoor spaces, get vaccinated when available.

References:

1 WHO: Update on clinical long-term effects of COVID-19

2 UK Office for National Statistics: The prevalence of long COVID symptoms and COVID-19 complications 

3 JAMA Network: Sequelae in adults at 6 months after COVID-19 onfection

(Professor Dr Moy Foong Ming, Center of Clinical Epidemiology & Evidence Based Practice, Department of Social & Preventive Medicine, Faculty of Medicine, Universiti Malaya)

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