It’s been seven months since Aparna Prakash, a 26-year-old Hyderabad-based content moderation professional, got Covid-19. She still faces difficulty sleeping, and when work pressure gets to her, she experiences palpitations.
For her, life is giving lemons, “but it is difficult to make lemonade as I am unable to get over the long-Covid symptoms”, says Prakash.
She told South First: “I tested positive in June 2022 and tested negative for it after a week, but my sleep cycle has deteriorated and not a day goes by when I don’t have anxiety. I get anxious about everything, from things related to work to personal stuff.”
There are hundreds of people like her who are suffering from Long Covid. Their testimonies can be read on multiple Facebook groups with the simple keyword search “Long Covid hauler”.
What is Long Covid?
Long Covid, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is a condition in which people experience persistent symptoms after recovering from acute Covid-19, which is caused by the virus SARS-CoV-2.
While most people with Covid-19 recover within a few weeks, some individuals continue to experience symptoms for several months after the initial infection.
These symptoms can vary widely and may include fatigue, shortness of breath, chest pain, joint pain, brain fog, difficulty sleeping, depression, and anxiety.
The World Health Organisation (WHO) defines Long Covid as the continuation or development of new symptoms three months after the initial SARS-CoV-2 infection, with these symptoms lasting for at least two months with no other explanation.
Long list of symptoms
“There is no single symptom that defines Long Covid. There is a long list, which includes fatigue, body pain, joint pain, shortness of breath, burning in the chest, and sleeping trouble,” National Covid Taskforce co-chairman Dr Rajeev Jayadevan told South First.
“Palpitations, insomnia, pacing heartbeat, abnormal pulmonary function tests, uncontrolled refractory headache, and PTSD are also rare symptoms seen in Long Covid patients,” Dr Dilip Gude, a senior consultant physician at Yashoda Hospitals in Hyderabad, told South First.
Jayadevan said many studies are exaggerated when they say one out of four persons suffers from Long Covid.
“But we have now come to the conclusion that it may affect one out of 20 people diagnosed with Covid-19,” he said.
The diagnosis of Long Covid
The exact causes of Long Covid are still being studied, but some theories suggest that it may be related to ongoing inflammation and damage to various organs in the body caused by the initial viral infection.
Experts suggest that there is no specific lab diagnosis for Long Covid. “It is clinical, and depends on what the patient tells the doctor,” said Jayadevan.
The diagnosis of Long Covid is based on a combination of factors, including:
A confirmed or suspected history of Covid-19 infection: To be diagnosed with Long Covid, a person must have previously tested positive for Covid-19 or experienced symptoms consistent with Covid-19, even if they did not get tested.
Persistence of symptoms: A person must continue to experience symptoms for a prolonged period, typically more than 12 weeks after the onset of the initial Covid-19 infection.
Symptoms that other conditions cannot explain: Doctors will typically perform a range of tests to rule out other medical conditions that could be causing the symptoms before diagnosing Long Covid.
A multidisciplinary approach: Because Long Covid can involve a wide range of symptoms affecting different parts of the body, doctors may work with specialists in different fields to develop a comprehensive treatment plan.
It’s worth noting that the specific symptoms of long Covid can vary widely, and some people may experience symptoms that are not typically associated with Covid-19.
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Long Covid also a risk for mental well-being
For Aparna Prakash, explaining Long Covid symptoms to coworkers and friends was another hell of a task.
“When I tell them about my symptoms, they are ignorant about it. They usually say, ‘You are making it up. It can’t be possible. You want a break from work that’s why you are making all these symptoms.’ They have even told me that I should stop making excuses based on Long Covid,” said Prakash.
Hyderabad-based psychologist Dr Kiran Nagpal told South First that the psychological impact of Long Covid can be attributed to a number of factors, including the physical symptoms of the illness, the uncertainty and unpredictability of the condition, the challenges of managing ongoing symptoms, and the social isolation and disruption of daily routines that can occur as a result of the illness.
“The experience of having Covid-19 and ongoing symptoms can also trigger feelings of fear, grief, and loss, particularly if individuals have experienced serious illness or have lost loved ones to Covid-19,” she told South First.
She added that when a person is afraid of expressing what they are feeling, they try to conceal it or express it in very unhealthy ways.
“For these patients, counselling therapy and relaxation techniques help, but the most important part is the social environment where the patient is living. People need to be mindful. Even if they have questions about Long Covid, they should ask with empathy and not doubt,” said Nagpal.
Addressing the psychological impact of Long Covid was an important part of managing the condition, she added.
Treatment options might include mental-health counselling or therapy, medication, mindfulness or relaxation techniques, and lifestyle changes such as exercise, social support, and stress management.
The treatment for Long Covid
The treatment of Long Covid-19 is focused on managing the symptoms and improving the quality of life.
There is currently no specific cure for Long Covid, and treatment options vary depending on the individual’s symptoms and medical history.
“Even a simple paracetamol can help, and sometimes simple regular exercise has helped the patient,” said Gude.
Some common treatments for Long Covid include:
- Medication: Depending on the symptoms, medications such as pain relievers, anti-inflammatory drugs, or antidepressants may be prescribed to manage pain, inflammation, or mental health conditions.
- Rehabilitation: Physical therapy, occupational therapy, or speech therapy may be recommended to improve mobility, strength, and coordination, and to address any breathing or swallowing difficulties.
- Psychological support: Mental-health counselling or support groups may be recommended to address anxiety, depression, or other mental health conditions that may be associated with Long Covid.
- Oxygen therapy: Some individuals with Long Covid may experience shortness of breath or low oxygen levels, and may require supplemental oxygen therapy to help them breathe better.
- Lifestyle changes: Eating a healthy diet, getting regular exercise, and managing stress can all help improve overall health and well-being, and may help alleviate some of the symptoms associated with Long Covid.
“Many people with Long Covid have reported that symptoms gradually get better — even in the absence of specific drug treatment. Most people who have had Covid-19 recovered completely,” said Jayadevan.
He added: “What we need at this hour is a cross-sectional study in India to measure the impact of Long Covid.”
He also said: “Through these studies, we can determine the treatment modalities which can be used for Long Covid patients, possibly in clinical trials.”