Research has found that nearly 2% of the Uk are still experiencing long COVID symptoms.
Whilst the public interest and concern over COVID-19 has waned considerably over recent months, data released by the ONS earlier this year revealed that nearly 2% of the UK’s population (1.8%) are still experiencing symptoms compatible with long COVID/Post-COVID-19 syndrome, the latter being the term now used by the UK’s National Institute for Health and Clinical Excellence (UK NIHCE).
With the same ONS data reporting that 20 % of people with long COVID describe their symptoms as “severe”, its contribution to the record levels of people described as “inactive, not seeking work”, is a significant one (5.7%).
In this context, Professors Greenhalgh, Sivan et all have published in The Lancet (31 July 2024),
“Long COVID: a clinical update” which presents as an interdisciplinary review of the literature on epidemiology, pathophysiology, lived experience and the clinical investigation and management of long COVID.
Medical gaslighting
The authors note that with medical understanding and knowledge lacking during the early months of the pandemic, many people living with long COVID were undiagnosed, disbelieved, inadequately assessed or inappropriately treated. Some described their experiences as equivalent to “medical gaslighting”. This in turn led to the emergence of online communities with sufferers seeking support, reassurance and guidance.
Susceptibility to long COVID?
Whilst there is still no recognised international definition of what constitutes long COVID or “Post-COVID-19 syndrome”, UK NIHCE, currently defines this as:
“Ongoing symptoms not explainable by an alternative diagnosis persisting for 12 weeks or more after the acute stage of COVID-19 infection”.
The review notes that those most susceptible to long COVID share many of the following characteristics:
female: having pre-existing medical conditions; socioeconomically deprived; having an initial COVID illness which was multi-symptomatic; being under or unvaccinated and where no antiviral treatment was given during the initial illness.
The general tenor of the review is for further research to be evaluated in the following key areas.
Vaccination
On the basis that prevention is preferable to cure, the authors suggest that third generation vaccines may be the best and most harmless protection from re-infection, but also recognise that for long COVID sufferers, vaccination may cause an overstimulated immune response which may exacerbate or precipitate long COVID symptoms.
Separately, the review notes that between 50% and 85% of long COVID sufferers are estimated to have been unvaccinated and subsequently hospitalised by COVID-19 infection. Two doses of vaccination are believed to reduce the risk of developing long COVID by 36% — with three doses improving this to 68.7%.
Genetic susceptibility
From testing of human leukocyte antigen haplotypes, genetic susceptibility to acute and the long-term effects of COVID-19 have been hypothesised.
Preliminary studies have shown changes in gene expression persist one year after the acute stage of COVID-19 infection which require the use of AI to establish the changes and the implications.
Developing predictive bio-markers
One recently published study suggests distinct clinical patterns and trajectories of long COVID symptoms suggesting that treatment can be targeted during the acute COVID-19 illness and the first six months of long COVID.
Next generation clinical trials
The researchers recommend small, adaptive and pragmatically designed trials to rapidly test therapies combined with AI-supported deep molecular profiling to understand why a certain therapy is effective or ineffective.
Rehabilitation profiles
Rehabilitation currently comprises either graded exercise or symptom guided pacing. Noting the current absence of comparative data to determine which method works best, the recommendation is for benchmarking and comparison.
Commentary
Although “COVID fatigue” may be the understandable reaction of many – worn down by pandemic restrictions and constant media reporting for almost three years, this review places into sharp focus the high prevalence of long COVID within the population, the severity of ongoing symptomology for many sufferers and its impact on the economy.
Whilst a cure still eludes medical professionals, it is hoped that as the evidence base grows over time with increasing research and AI profiling, the treatment and management of long COVID sufferers will dramatically improve.
For more information on Long Covid, contact our occupational disease solicitors.
