dr sana mohammed

Dr Sana Mohammed, , COVID-19 Consultant at the Couva Hospital and Multi-Training Facility.

Persons affected with the COVID-19 virus stand a good chance of developing what is termed Long COVID complications.

Speaking at the Ministry of Health’s virtual COVID-19 update on Wednesday, Dr Sana Mohammed, COVID-19 Consultant at the Couva Hospital and Multi-Training Facility, said it has become increasingly clear that for some patients there are on-going effects of the COVID-19 virus.

Mohammed said Long COVID refers to the signs and symptoms that occur during or following COVID-19 infection, which persist for more than four weeks and are not explained by another medical condition.

She noted that symptoms of Long COVID are very variable with the most reported being fatigue, profound fatigue and shortness of breath.

Among the symptoms linked with Long COVID are respiratory, dermatological, musculoskeletal, gastrointestinal, cardiovascular, neurological, psychological/psychiatric, generalised, as well as ear, nose and throat symptoms.

“Many patients express a waxing and waning nature of the illness, where you feel as though one minute you’ve recovered, but then it hits you back. One patient described this as a constant cycle of disappointment, not just to you, but to those around you who really want you to recover.

She said patients may at times feel isolated and that they are the only one experiencing on-going symptoms following COVID-19 infection. But as they go along on their journey they begin to realise that there are other patients experiencing the same symptoms.

Sharing data from a COVID-19 study that surveyed over 4,000 patients in three different countries, Mohammed stressed that while the study has not yet been peer reviewed, it contains a large body of data that has shown some trends as it relates to Long COVID, and added that as the data grows they will be able to identify at-risk groups of patients.

According to the data presented, persons reporting more than any five symptoms in the week of onset increases their chances of developing Long COVID.

Additionally, 13.3% of the sample population had symptoms lasting more than 28 days, while 4.5% displaying symptoms for a period of eight weeks or more, and 2.3% had symptoms for longer than 12 weeks.

Mohammed noted that while the elderly population was more at risk to contracting Long COVID, with the over 70 age group representing 21.9% of the patients tested, there was a significant finding of 10% in the 18-49 age group.

And while women (14.9%) were more susceptible than men (9.5%), this did not hold true for older age groups as Long COVID affected all socio-economic groups.

“Asthma was the only pre-existing condition which was associated with Long COVID and individuals with Long COVID were more likely to have required hospital assessments.

“So what is important for us to note is that cases of Long COVID can occur in young, previously well individuals who were not admitted to hospital. The common perception that it is an old person disease is unrealistic, and young persons can certainly go on to experience Long COVID,” Mohammed said.

She stated that aside from the numerous health consequences of Long COVID, there are also psychological, social, financial and economic burden on some patients.

“Some patients may be unable to work, and have much difficulty returning to work following infection with COVID-19. Some of our patients have difficulty returning to their normal day-to-day function following infection.”

However, she noted that complications following infections with viruses are not new, and drew reference to the neurological complications associated with Zika as well as the long-term effects experienced by persons afflicted with the Chikungunya virus.

“So the concept of long-term symptoms or complications of viral infections should be widely accepted. And although COVID-19 is caused by coronavirus, which is a different virus, it is important for us to acknowledge the long-term health consequences of COVID-19 infection.”

Mohammed said this was especially important for those who believe that if they contract COVID-19 they will simply recover, and that their chances of dying is low, especially for those who are young with no pre-existing medical conditions.

“And although this may be true, I want to emphasise that even in this group it is certainly possible to experience Long COVID and long-term health consequences of COVID-19 infection.”

She said in managing Long COVID, patients benefit from a holistic approach in which education is key to both patients and healthcare professionals looking after patients in terms of what services are available for assessment and management of this challenging group of patients.

Mohammed said in realisation of the holistic approach, two Executive Wellness Centre, located at the Arima General Hospital and at the Couva Hospital and Multi-Training Facility, were conceptualised to look after patients infected with COVID-19, some of whom have Long COVID.

“These clinics are specialist clinics and use a multi-disciplinary team approach which is the standard of care for management of these patients.

“So given the multitude of symptoms of Long COVID and the long-term health consequences of COVID-19 infection, it is likely that large numbers of patients will experience complications of COVID-19. This will have a significant impact on our healthcare systems for years to come.

“So it is extremely important for us the population, to follow all the public health guidelines constantly advised by the Ministry of Health. The only way to prevent Long COVID is to prevent COVID-19 infection,” Mohammed said.