Long COVID: what helps?

After a COVID-19 infection, the course of the illness varies greatly. While some people don’t have any symptoms afterwards, others become seriously ill: they suffer from shortness of breath, pain or extreme tiredness – even though the acute stage of the COVID-19 infection was months ago. This is called long COVID.

For people suffering from long COVID or post-COVID syndrome, the situation can become desperate. People who were active can find it difficult to get back to their previous life, if they manage it at all. Currently, very little is known about the causes of this secondary disease and the treatment options.

Long COVID is an umbrella term for the long-term health effects following an acute COVID-19 infection. The virus can no longer be detected, but the body and organs are still being affected. Long COVID syndrome comprises symptoms that persist for more than four weeks after the onset of the COVID-19 illness, or ones that are new. Patients usually suffer from a number of different symptoms at the same time. They are no longer contagious, however.

Long COVID causes a wide variety of symptoms. This range of documented symptoms makes it difficult for doctors to create a clear picture of the disease.

The most common symptoms include:

• Fatigue
• Complaints after physical exertion
• Difficulty concentrating
• Shortness of breath and difficulty breathing
• Chest pain
• Headaches
• Loss of the sense of taste and smell
• Coughing
• Insomnia
• Muscle tiredness/muscle pain
• Recurring fever
• Skin rashes
• Hair loss
• Depression

Long COVID can affect anyone. Young, healthy people who had a mild case of COVID-19 report serious and long-lasting symptoms after getting over the initial infection.

Women suffer much more often than men from the long-term effects of COVID-19. According to Christian Clarenbach, head pulmonologist at University Hospital Zurich (USZ), 75% of patients at the long COVID clinic are women between the ages of 20 and 45.

It’s estimated that around 10% of adults suffer from long-term effects in the three months following the onset of COVID-19 symptoms. Two different patient groups are affected:

• Those that completed their isolation at home while infected with COVID-19. The course of the illness was often not as severe. They briefly felt better, but noticed that they couldn’t reach their previous levels of performance, and couldn’t get back to their daily lives properly. According to Christian Clarenbach, this accounts for most patients in the long COVID clinic.
• Those affected who were in hospital or even on an ICU ward because of COVID-19. They have other measurable symptoms, such as issues with lung function, and recovery is delayed. Many have problems from spending a long time in bed in the ICU, and are still psychologically affected. These patients were often already receiving medical care and went to a rehabilitation clinic after the acute treatment.

The reason why some people take longer to get better is unclear. It could be possible that acute infections cause an inflammatory response in the body or an autoimmune reaction. It has been observed that in those who had a seemingly harmless case of COVID-19, physical strain after the illness could play a role.

In most cases, symptoms go away within six weeks. If you are worried about your symptoms or they are affecting your daily life, contact your doctor to talk about the next steps. If required, the doctor will refer you to the appropriate specialist or therapist.

For further clarification, patients can also contact a long COVID clinic in their canton. Numerous clinics and hospitals in almost every canton now offer this kind of service. For long-term symptoms, an internal hospital network of specialists, such as pulmonologists, cardiologists, infectious disease specialists, neurologists and psychiatrists, is available.

Ultrasound or computer tomography (CT) can show if the organs have been damaged or are inflamed. Blood tests provide information on the inflammation values or organs that are not functioning normally. In the case of difficulty breathing, a lung function test is often carried out.

When making a diagnosis, it’s tricky to delineate it from other illnesses. In severe COVID-19 cases, the regular recovery process can take longer. Furthermore, a longer stay on the ICU ward or even on a ventilator can lead to complications that were not actually caused by the illness itself.

A targeted treatment for long COVID syndrome doesn’t exist yet. Treatments are therefore geared towards the symptoms and alleviating complaints. Different kinds of treatments can be used, including physiotherapy, occupational therapy and rehabilitation.

Because the long COVID diagnosis is relatively new, and there are various treatment methods available, pulmonologist Clarenbach says that patients are also experimenting with dubious methods. He warns about trying treatments that are not recognised and promise recovery: “Patients are sometimes at their wits’ end. This leads some of them to try expensive and useless treatments. But you should be very wary of treatments that are not recognised or are experimental.”

Physiotherapy

Targeted exercises can help to continually activate the body without overdoing it. Movement, massage and relaxation exercises help to alleviate pain. In the case of difficulty breathing, targeted exercises and breathing techniques are used.

Occupational therapy

Occupational therapy allows those affected by long COVID to cope better with their daily lives. The therapists focus on the activities and tasks that are important to each individual person.

Rehabilitation

Rehabilitation clinics have developed special programmes for long COVID patients. They address individual, structural and functional deficits.

Treatment costs

The costs of the medical treatment for the long-term effects of COVID-19 are covered by health insurance.

Your first point of contact is your GP. Further information on the long-term effects of COVID-19 can be found on the following websites:

• The Altea Network is aimed at those affected, relatives, doctors and researchers. The website gives tips on how to cope with symptoms, has a directory of clinics and therapy options, and also has a blog presenting the latest information from research, law and society.
  

• The Long Covid Switzerland association was founded by people affected by the illness, and supports others. The website provides links to long COVID clinics in each canton and gives tips on how to alleviate symptoms.