Sly Saint
Senior Member (Voting Rights)
Long Covid has been puzzling doctors almost since the start of the pandemic.
The condition is defined as when people have persistent ill health lasting at least three months after their initial infection. But five years after the first Covid case, we still don’t know the cause, there are no diagnostic tests, and there are no approved medicines.
Into that void have sprouted many competing hypotheses about the biology of long Covid, as well as connected ideas about potential treatments. But most theories are still at an early scientific stage.
Doctors are warning that some desperate patients are getting stuck in a quagmire of pseudoscience that has developed around the condition. So what do and don’t we know about the best treatments for long Covid?
One reason for the range of different experiences may be the label of long Covid is being used as an umbrella term for several syndromes with different causes, a report from the UK’s National Institute for Health and Care Research has said.
These syndromes include people whose initial infection was so severe they needed weeks of intensive care in hospital, as well as the more puzzling outcome of people getting lasting symptoms when they had a mild initial illness.
For the latter group, there seem to be similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), another mysterious syndrome of persistent tiredness and other symptoms that often seems to be triggered by a virus. Some people think that, in this group, long Covid is essentially the same as ME/CFS – but this theory has not been proven.
The NHS website can only offer general health advice. It says people should try to eat a balanced diet, stick to regular sleep patterns, and stay active if they can, for instance, by taking short walks – although, confusingly, they should also “listen to their body” and not do too much.
The popularity of unproven high-tech remedies for long Covid is ironic because over time, doctors at NHS clinics have found that more commonplace therapies can give some benefit. Professor Busse’s recent review found that physical and mental health rehabilitation programmes raise the chances of patients experiencing meaningful improvement or recovery.
The long Covid ‘treatments’ to avoidBut other long Covid patient representatives say rehab techniques have helped them get better. One such person is Professor Paul Garner, an infectious diseases specialist at the Liverpool School of Tropical Medicine, who caught Covid in March 2020 and was ill with fatigue, “blinding” headaches and muscular pains until November. He made a complete recovery after gradually increasing his activity levels.
Professor Garner believes that his symptoms were caused by an overactive stress response, which disappeared when he stopped expecting that physical activity would make him worse. “It’s incredibly exciting that we’ve got some evidence that these approaches seem to help,” said Professor Garner, who was a co-author on Professor Busse’s paper.