What are the Signs and Symptoms of Long COVID?

As a professional massage  practitioner I was  aware that I needed to spend some time researching many aspects of Long COVID in order to provide well-documented information for both myself and my patients.

Due to the relative newness of the topic and the ever-evolving subject matter, it has taken me quite some time. I am now pleased to have completed 4 Long COVID articles to posted on my website  even though at this point in time, I still feel I have only captured the tip of the iceberg.

One thing I can be sure of is that there is a wealth of evidence witnessed by myself and contemporaries within my profession indicating that we are seeing Long COVID patients in our practices whether this has been formally diagnosed, or individuals are simply showing signs and symptoms of Long COVID.

What we know so far about the symptoms of Long COVID

What we do know for sure is that some people who catch COVID 19 have long-term problems after recovering from the original infection even if they weren’t very ill with COVID 19 symptoms in the first place.

Long COVID isn’t fully understood, and there’s no internationally-agreed definition. Estimates of how common it is, or what the main symptoms are, vary.

Stats published on the 6th May 2022 the Office for National Statistics (ONS) estimate that 1.8 million people ( 2.8% of the population) in the UK have Long Covid. Long Covid ONS 

of which:

  • 65% report that their ability to undertake their day-to-day activities had been “limited a lot”.
  • 45% were experiencing symptoms for at least a year
  • The most common symptoms are
    • Fatigue 51%
    • Shortness of Breath 34%
    • Loss of smell 28%
    • Loss of taste 25%
    • Difficulty concentrating 25%
    • Muscle ache 24%

A further, comprehensive list of symptoms can be found at the end of the article.

Long COVID Symptoms are is most common in:

  • 35-49 year old women
  • Those living in deprived areas
  • Those working in teaching and education
  • Those working in health & social care

Guidance for UK health professionals from the National Institute for Health and Care Excellence (NICE) refers to Long COVID symptoms as continuing for more than 12 weeks and that cannot be explained by another cause. These Long COVID guidelines were last updated on the 1st March  2022.

NICE have very detailed information and I was interested to read that in the recommended assessment process for people with ongoing symptomatic COVID-19 or suspected post- COVID-19 syndrome is to use a holistic, person-centred approach to include a comprehensive clinical history and appropriate examination that involves assessing physical, cognitive, psychological and psychiatric symptoms, as well as functional abilities.

This approach is known as the biopsychosocial model of care. My clinical qualification ensures my consultation already includes a detailed clinical history and I have just added specific questions relating to COVID 19 and Long COVID.

It’s important to be aware of the wide ranging and fluctuating symptoms of Long COVID, which can change in nature over time. A list of the most commonly reported symptoms on the NICE & NHS websites can be found at the end of this document*

Since March 2020, along with over 4M others,  I have been recording my own, if any, symptoms and PCR/Lateral Flo test results daily on the ZOE COVID Study App and have followed their findings, watched their weekly updates and their regular webinars. In October they broadcasted a webinar on Long COVID. Professor Tim Spector, lead scientist at the ZOE COVID Study, was joined by his colleagues from King’s College London, Dr Claire Steves, Reader in ageing research, and Professor Alexander Hammers, who works in imaging and neuroscience and suffers from Long COVID.Living with Long COVID

They shared personal Long COVID experiences and answered questions. Questions including:

  • Who is getting Long COVID?
    What is it like to live with Long COVID?
    What help is available for people with Long COVID?

It is worth noting that at that time the World Health Organisation’s definition of Long COVID includes symptoms such as fatigue, shortness of breath, and cognitive dysfunction. However, is it evident that Long COVID experiences vary hugely from person to person.

Professor Tim stated that “Everyone experiences illness in their own way, and that is certainly no different in Long COVID,”

The World Health Organisation (WHO)’s latest Q&A information on Long COVID is dated 16th December 2021. Most people who develop COVID-19 fully recover, but current evidence suggests approximately 10%-20% of people experience a variety of mid- and long-term effects after they recover from their initial illness. These mid-and long-term effects are collectively known as post COVID-19 condition or “Long COVID”. They emphasised that it was important to remember that their understanding of post COVID-19 condition continues to evolve.  Researchers were working with patients who develop post COVID-19 condition to better understand more about its cause, symptoms and effects. WHO have not updated their article to date.

*The most commonly reported symptoms include (but are not limited to) the following:

Long  COVID Symptoms
NICE (National Institute for Health and Care Excellence)NHS ( National Health Service)
Updated March 22Updated April 2022
Respiratory symptoms

•             Breathlessness

•             Cough

Cardiovascular symptoms

•             Chest tightness

•             Chest pain

•             Palpitations

Generalised symptoms

•             Fatigue

•             Fever

•             Pain

Neurological symptoms

•             Cognitive impairment (‘brain fog’, loss of concentration or memory issues)

•             Headache

•             Sleep disturbance

•             Peripheral neuropathy symptoms (pins and needles and numbness)

•             Dizziness

•             Delirium (in older populations)

•             Mobility impairment

•             Visual disturbance

Gastrointestinal symptoms

•             Abdominal pain

•             Nausea and vomiting

•             Diarrhoea

•             Weight loss and reduced appetite

Musculoskeletal symptoms

•             Joint pain

•             Muscle pain

Ear, nose and throat symptoms

•             Tinnitus

•             Earache

•             Sore throat

•             Dizziness

•             Loss of taste and/or smell

•             Nasal congestion

·               Change of Voice

 

Dermatological symptoms **

•             Skin rashes

•             Hair loss

Psychological/psychiatric symptoms

•             Symptoms of depression

•             Symptoms of anxiety

•             Symptoms of post-traumatic stress disorder

** I have witnessed scalp sensitivity

Respiratory symptoms

·        Shortness of Breath

·        cough

Cardiovascular symptoms

•     Heart palpitations

·        Chest pain or tightness

Generalised symptoms

·        extreme tiredness (fatigue)

·        High temperature

Neurological symptoms

·              problems with memory and concentration  (“brain fog”)

•             difficulty sleeping (insomnia)

•             dizziness

•             pins and needles

·               Headaches

Gastrointestinal Symptoms

·        feeling sick, diarrhoea, stomach aches, loss of appetite

Musculoskeletal symptoms

·        joint pain

Ear, nose and throat symptoms

•             tinnitus, earaches

•             sore throat

•             changes to sense of smell or taste

Dermalogical Symptoms

·        skin rashes

 Psychological/psychiatric symptoms

·        depression and anxiety

 

 

 

https:// COVID.joinzoe.com/post/living-with-long- COVID-summary

[Accessed 24/03/22]

https://www.nice.org.uk/guidance/ng188/resources/covid19-rapid-guideline-managing-the-longterm-effects-of-covid19-pdf-51035515742

[Accessed 18/05/22]

https://www.nhs.uk/conditions/coronavirus-COVID-19/long-term-effects-of-coronavirus-long-COVID/

[Accessed 18/05/22]

https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/conditionsanddiseases/bulletins/prevalenceofongoingsymptomsfollowingcoronavirus COVID19infectionintheuk/3march2022

[Accessed 18/05/22]

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-answers-hub/q-a-detail/coronavirus-disease-( COVID-19)-post- COVID-19-condition

[Accessed 24/03/22]

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