Sick for the long haul: One third of COVID-19 patients have symptoms for eight months

One in three Australian COVID-19 patients is still battling symptoms eight months after being infected, and youth is no protection against the debilitating effects of ‘Long COVID’.

The landmark ADAPT study shows 32 per cent of 81 COVID-19 patients diagnosed at St Vincent’s Hospital’s testing clinics reported still feeling ill 240 days post-infection.

Derek Young, 55, is still feeling the effects of COVID-19 one year after he was infected with the virus. Credit:Nick Moir

An alarming one in five (19 per cent) still met the criteria for debilitating ‘Long COVID’ at the eight-month mark, experiencing fatigue, laboured breathing or tightness in their chest long after their infection had passed, the researchers at St Vincent’s and the Kirby Institute found.

Of the patients who met the criteria for ‘Long COVID’, almost half (46 per cent) said they had not fully recovered, the researchers reported in their paper published on Wednesday to the pre-print server medRxiv which is not yet peer-reviewed.

Dr David Darley, lead author and respiratory physician, said older age was not associated with an increased risk of Long COVID.

“Which means this syndrome can affect you at any age,” Dr Darley said.

Patients didn’t show any significant signs of improvements between their four-month and eight-month assessments.

“This is what really worried us … because this is not just any virus where normally people recover in two or three weeks. This has to be taken very seriously because not only does it have bad acute effects but there almost seems to be this considerable group of patients that have persistent symptoms we don’t understand,” Dr Darley said.

“Anecdotally, some patients are still symptomatic a year on,” Dr Darley said.

Derek Young, 55, still feels the brain fog of COVID-19 more than a year after he tested positive in mid-March 2020. The high fever, sweats, shivering and muscle aches had all passed within six weeks, but the “incredible fatigue” dragged on for eight months.

“At first I was sleeping 22 of 24 hours a day, but for months I would have a good run of three or four days, then have to take a day off to just sleep,” he said.

“Everyday functions – internet banking – I couldn’t do. To this day I’ll still forget something, or reach for a word I can’t find.”

His wife, Gabriela Domicelj, had far more pernicious symptoms.

“Gabriela was hospitalised three times with severe respiratory disorder. She had severe insomnia, headaches, loss of smell and taste, her hair started falling out,” Mr Young said.

“She decided to write down all her symptoms and came up with 37.”

Gabriela Domicelj and her husband Derek Young had remarkably different Long COVID experiences.Credit:Rhett Wyman

Dr Darley said women and people who had been hospitalised with the virus were more likely to develop Long COVID.

“It makes sense that if you were hospitalised initially you probably had severe infection and were more likely to have persistent problems,” he said.

“But the female gender finding is really interesting. One hypothesis is that women tend to have an increased risk of auto-immune and inflammatory conditions so it might be something about the female immune response that makes Long COVID worse.”

Women are also more likely than men to seek medical care while men tend to underplay symptoms and avoid getting help, Dr Darley said.

The most common symptom was fatigue (23 per cent) followed by shortness of breath (11 per cent).

Among the 97 patients who underwent a cognitive and mental health assessment eight months post-infection, 27 per cent reported poor memory and 33 per cent reported poor concentration.

The researchers’ conservative definition of Long COVID – limited to fatigue, laboured breathing or chest tightness – means the findings likely underestimate the true burden of the condition.

“This is a group of patients who need relatively close observation and much more research needs to be done to work out what is going on,” Dr Darley said.

Whether COVID-19 directly caused all patient-reported symptoms was the “million-dollar question”, Dr Darley said.

“These symptoms are probably a mixture of a whole range of things that happened to these people after [being infected with] the virus. Some people may have been traumatised by their COVID diagnoses and had predominantly mental health symptoms, some patients were really sick and needed ventilation and have lung injuries, middle-aged women may have an immune response,” he said.

Professor Jeremy Nicholson, of the Australian National Phenome Centre, said the mounting international evidence left little doubt that a significant proportion of people with even the mildest bouts of COVID-19 when first diagnosed would develop long-term health problems.

“We’ve had tens of millions of people infected worldwide and if you scale this through COVID-19 is far more serious as a global disease than viruses that have come before, both in terms of its long-term ill health effects and the massive economic cost of support [for] these people,” Professor Nicholson said.

With more than 29,000 confirmed infections in Australia over the course of the pandemic, “this study does indicate [Long COVID] is a potentially significant problem for thousands of Australians,” he said.

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