People all around the world have been recounting their experiences with ‘long Covid’ a state of illness that lasts weeks or months longer than doctors expect.
In a recent BMJ webinar, specialists have discussed how best to support people in this situation. An increasing number of people around the world have reported lasting illness following confirmed or suspected infection with SARS-CoV-2, the virus that causes Covid -19.
The symptoms involved often extreme fatigue and fever, persist for many weeks or months after they are supposed to have disappeared.
This phenomenon is now often dubbed long Covid, and the people affected sometimes call themselves ìlong-haulers.î Besides explaining how the lingering symptoms have drastically reduced their quality of life, long-haulers also note that, more often than not, healthcare practitioners are at a loss as to how to provide support.
To begin to address this gap in primary care, some specialists have been drafting new guidelines for doctors. In a BMJ webinar that took place at the start of September, six specialists from the United Kingdom and Germany came together to discuss the best approaches to the diagnosis, management, and prognosis of long Covid. As Dr. Fiona Godlee, the editor-in-chief of BMJ and chair of the session, noted: ìWhile most people recover quickly and completely from Covid -19, growing numbers are finding that they havenít simply snapped back into their pre- Covid lives. Instead, after what may have been only a mild initial illness, they are experiencing a range of troubling and sometimes disabling symptoms.î
ìBreathlessness, cough, palpitations, exercise intolerance, mental and physical exhaustion, anxiety, depression, fatigue, inability to concentrate and brain fog are just some of the things being described,î she said. Yet despite living with such life-altering symptoms for months, many people are unable to convince their doctors that they have long Covid, having never received a positive Covid -19 test result. According to Prof. Greenhalgh ó who specializes in primary care and also works as a general practitioner ó the requirement for proof of an infection with SARS-CoV-2 is the first thing that has to change if patients with long Covid are to receive any support. In a BMJ article she co-authored in August, Prof. Greenhalgh and colleagues had already emphasized this point: ìSince many people were not tested, and false-negative tests are common, we suggest that a positive test for [Covid -19] is not a prerequisite for diagnosis.î
Highlighting that there is an ìabsence of agreed definitions,î she and her team suggested that a helpful approach might be to think of ìpost-acute Covid -19 as extending beyond 3 weeks from the onset of first symptoms.
