December 2019 saw the emergence of a novel coronavirus (SARS-CoV-2) which caused a pandemic of a severe coronavirus disease (COVID-19).

Long Covid (post COVID syndrome), as now defined by the NHS, consists of “signs and symptoms that develop during or following an infection consistent with COVID-19 which continue for more than 12 weeks and are not explained by an alternative diagnosis”. Interestingly, ‘Long Covid’ is a patient-created term. It emerged in the Spring of 2020 as people took to social media in response to a lack of medical knowledge to explain their ongoing Covid-19 symptoms in the absence of a positive test. Through social media people were reassured that they were not alone in their experience. Long Covid got its own Twitter hashtag in May 2020 and was first discussed by the British Medical Association in September 2020.

ISARIC Conference

The International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) is a global federation of clinical research networks, whose purpose is to prevent illness and deaths from infectious disease outbreaks. On 9-10 December 2020, ISARIC hosted an online conference on the topic of Long Covid, which was organised by PMG’s partners, Conference Collective Ltd.  Speakers included researchers, clinicians, and Long Covid survivors from around the world (including Hong Kong, India, Italy, Japan, South Korea, and the UK).

In early January 2021, I had the opportunity to watch some of the recordings of the event to see what, if any, implications there might be for PMG members in relation to Long Covid. The conference starkly demonstrated the enormous variation around the world in how the COVID-19 virus is being dealt with, and how much the level of research and knowledge differs.

What is known about Long Covid?

There are three factors currently understood to increase the risk of Long Covid: older age, female gender, and higher body mass index.

A small Japanese study identified the main symptoms (in order of frequency) after 120 days as:

• dyspnoea
• fatigue
• loss of smell
• cough
• loss of taste
• alopecia

A slightly larger Italian study indicated that 3-4% of their hospital admission sample showed severe symptoms. Ongoing outcomes included respiratory issues (as measured by carbon monoxide diffusion capacity), and post-traumatic stress disorder. However, most patients who survived intensive care made a functional recovery.

What is still to learn?

There is much still to learn, and the ISARIC conference helped to define the topics. Some pertinent questions include:

• How should Long Covid be defined?
• How common is Long Covid?
• How should recovery be defined considering a negative test and fluctuating symptoms?
• How might people access sick pay and benefits in this extended recuperation period?
• What is the long-term prognosis for health and mortality?
• Why do people get it? How can it be treated?
• Is it one condition, or several distinct post-viral conditions?
• Can symptom pattern help predict treatment and recovery?
• Can certain interventions in the acute phase prevent Long Covid?
• What is the impact on marginalised and some ethnic minority groups?
• Can people with Long Covid get reinfected?
• Do they need a vaccine? Should they be prioritised for vaccination?
• What does Long Covid look like in children?

As the world’s scientists continue to look for answers, the evidence to date shows that Long Covid has had little, if any, impact on posture and mobility services.  However, if you'd like to watch the ISARIC Conference for your own general information, it's now available to view via YouTube.

Image by Gerd Altmann from Pixabay