Inside scientists’ battle against long Covid

As Covid-19 hospitalisations and related deaths stabilise across the UK, experts’ attention is turning to one of the pandemic’s most damaging legacies.

Almost a million people in the UK - including an estimated 34,000 children - are currently suffering from the effects of long Covid, according to latest figures from the Office for National Statistics (ONS). Around 40% say they have had the debilitating condition since first being infected with the coronavirus at least a year ago.

Defined as symptoms of Covid that last for longer than 12 weeks, the syndrome “is shaping up to be the next major threat to the health service and the economy”, says the Daily Mail. And “there is currently no cure”.

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‘I couldn’t function’

Long Covid researcher Professor Brendan Delaney has been waging a personal battle against the condition since being infected with Covid in March last year.

Delaney, chair in medical informatics at Imperial College London (ICL), told the Daily Mail that he has suffered “intense fatigue” along with “difficulty breathing, muscle pains, brain fog and a recurring fever”. Even after returning to work part-time following three months of recuperation, “I couldn’t function at my normal level,” he said. “I wasn’t seeing the connection between things.”

Other long Covid sufferers have described similar symptoms. A 19-year-old university student identified only as Niamh told The Guardian that she felt like she had been “hit by a train or run a marathon” even after recovering from her initial infection.

“I didn’t have the energy to move my arms,” she said. “When I stand up, even slowly, it feels like I might collapse. I ask myself, why can’t I be like everyone else? Why did this happen to me?”

According to the latest ONS research, fatigue is the most common complaint among suspected sufferers of long Covid. This symptom was reported by 528,000 people, followed by shortness of breath (388,000), muscle aches (296,000) and loss of smell (285,000).

There is no medically agreed definition of the condition, however. Professor Delaney told the Mail that part of the problem was that some diagnostic clinics lack “the resources to spot red flags such as low oxygen levels in the blood or a neurological problem such as vision issues”.

And while a growing number of experts are working on “devising diagnostic criteria” and treatments for the condition, says Wired, the process has been “complicated by the sheer number and diversity of symptoms that sufferers report”.

‘Multisystem disorder’

A study published in The Lancet last month identified up to 200 possible symptoms of long Covid, ranging from fatigue and blurred vision to memory loss, menstrual cycle disruptions and hallucinations.

As part of efforts to more accurately specify the condition’s hallmarks, a National Institute for Health Research’s (NIHR) review has suggested that the condition be “subdivided into at least four different syndromes”, Wired reports. These comprise “post-intensive care syndrome, long-term organ damage, post-viral fatigue syndrome and a novel one: a long-term syndrome caused by a continuation of Covid-19 symptoms”.

All the same, “defining exactly what long Covid is a tough undertaking”, adds the magazine, which notes that even the name for the condition “differs from country to country”.

Elizabeth Murray, a professor of primary care at University College London, defines long Covid as “a multisystem disorder that can affect the brain and the body”. Murray, who runs a long Covid clinic, told the Mail that while “we don’t yet have treatments” for many of the sydrome’s effects, “we do know how to help patients with common symptoms such as fatigue, brain fog, breathlessness and anxiety”.

“They need such rehab specialists as occupational therapists, physiotherapists, dietitians and psychologists,” she said.

The difficulty of launching clinics aimed at treating Covid patients has been evidenced in Scotland, however. Health Secretary Humza Yousaf has warned that infections are likely to rise following the easing of coronavirus restrictions, yet has ruled out “setting up specialist clinics to deal with the long-term effects of the pandemic”, The Times reports.

In an interview on The Sunday Show on BBC Radio Scotland, Yousaf cautioned that funding such clinics would soak up “precious” resources needed in other areas of the health service, and that the country could ill-afford to “take a whole group of specialists away from the NHS”.

On a positive note, says Wired, “new variants and mass vaccination will inevitably have some effect on the condition”. And the National Institute for Health and Care Excellence has earmarked £30m for research on the effectiveness of drugs, rehabilitation, dietary changes and weight-loss management in treating long Covid.

One “surprise” option being considered is “to use drug treatments in combination with complementary therapies”, says the Mail. “For instance, the treatment of symptoms such as breathing difficulties might combine yogic breathing (put simply, a form of deep inhalation techniques), meditation, supplements and acupuncture with established drugs, including the heart medications beta-blockers and ivabradine, which reduces the heart rate and so may help with fatigue.”

Other treatments being researched include “antihistamine medication combined with a low-histamine diet”, the paper adds, as well as “a very low-carb ‘keto’ diet”, which reduces “levels of inflammation and breathing disorders”.

In a bid to speed up the process of finding successful treatments, ICL’s Delaney has got together with around 35 fellow experts to share and discuss their experiences in treating long Covid patients.

“I quickly realised that no one knew anything about what was happening,” he told the Mail. “So I started linking up with other doctors.”

However, while their joint efforts are beginning to yield results, Delaney warns that there is “no magic bullet” in the fight to tackle long Covid.