6 TALKBACK INVESTIGATING THE INFLUENCE OF LONG COVID
Long Covid: is it making The pandemic has With Covid-19 increased back pain likely to linger incidence We have all experienced significant and abrupt for some time to routines both at work and home yet, PROFESSOR disruption because of Covid lockdown and restrictions FRANCES on freedoms. Those with low back pain have reduced seeking medical attention, management WILLIAMS from and support – but back pain cases have begun King’s College to escalate, perhaps because many are working from home in sub-optimal conditions and lack the London and her exercise of travelling to and around the workplace. team, ROGER Up to half of people responding to questionnaires COMPTE throughout the UK, Europe and the US have experienced new back pain episodes since the BOIXADER pandemic began. and ISABELLE The SARS-CoV-2 virus induces the illness Covid-19, which is associated with symptoms in GRANVILLE many different organ systems. At the beginning of SMITH, explain the pandemic, Covid-19 was thought to be mainly a respiratory disorder. However, nearly two years how the down the track it is recognised that it may affect pandemic has multiple body systems. affected rates of Myalgia or widespread muscle pain and unusual joint pain are commonly reported symptoms of low back pain and Covid-19. Such pain likely reflects the immune discuss whether response to viral infection, including production patients with long of cytokines and other inflammatory mediators. These have been well documented in Covid-19 Covid may be patients as well as multiple other infections more susceptible including flu. The production of autoantibodies has been detailed in some patients and is the to chronic low subject of current research efforts. back pain. How the body produces these antibodies is influenced by our genetic make-up, and our genes may be responsible for the type of response we have to a virus. Genetic diversity in Covid-19 patients has been associated with illness severity and outcome. But that is to be expected. In fact, it has long been recognised that our response to viral or bacterial infection is regulated through our host genetics. Individual differences and genetic predisposition are currently the core hypotheses of many studies aiming to decipher the response to SARS-CoV-2 and the development of long Covid.
Persistent symptoms Long Covid, or post-acute Covid syndrome, describes symptoms that persist past the usual infective period of two or three weeks. “Long” when referring to Covid-19 symptoms has differed between research groups, but now the National
TALKBACK l AUTUMN 2021
Our unfamiliarity with long Covid can heighten fears over how long symptoms might last Institute for Health and Care Excellence (NICE) has reasonably proposed symptoms lasting beyond 12 weeks from the first day of symptoms. This is because many viral infections have effects that last for several months as a normal part of the illness. The Covid Symptom Tracker app from King’s reports that around 5% of people logging symptoms on the app have gone on to become “long-haulers”. Other estimates are higher – a study from Imperial College London including half a million participants found as many as 37.7% of Covid-19 patients still experience one or more symptoms at 12 weeks. Different methods of data collection and interpretation of symptoms may explain the dissimilarity of these estimates. Nevertheless, with infection so common in the general population and new infections continuing, the number having long Covid in the UK is likely to increase. People experience long Covid in different ways, and there are currently no tests or biological markers for the condition. People tend to experience long Covid symptoms in waves or intermittently – some days patients seem to be recovering, and the next they are so sick they can barely get out of bed. An additional problem is that only around half of those who have been sick with Covid-19 display any immunity, meaning re-infection is possible, which may be confused with long Covid. Like the symptoms of Covid-19, long-haul symptoms are extremely varied. Below are the more commonly reported symptoms: l fatigue l myalgia
