The Lesser-known Symptoms of Long Covid

• 10–20% of those who recover from a Covid-19 infection develop Long Covid, for which common symptoms include chest pains or palpitations, breathing difficulties or an inability to take a full breath, cough, headaches, loss of taste or smell, aches and pains in muscles and joints, stomach pain, diarrhea, and a sore throat.
• The Covid-19 virus could cause neurological symptoms including circulation issues, forgetfulness, dizziness, seizures, or even a stroke.
• There are no recognized treatments that specifically target Long Covid, so medical staff focus on treating its symptoms. Patients with Long Covid tend to experience the symptoms for approximately 4–6 months before they improve.

In addition to the more familiar respiratory symptoms of a Covid-19 infection, patients who experience hair loss, skin allergies, and forgetfulness should remain vigilant as they could be suffering with a condition known by the following names: Long COVID, Post-Covid Condition, Post-Covid Syndrome, or Long-Haul Covid-19.

Long Covid is a condition characterized by symptoms that present 4–12 weeks after the patient has already recovered from an initial Covid-19 infection, and which can last for up to 4–6 months. The symptoms and impact of Long Covid cannot yet be fully explained or diagnosed like other, better-known conditions. Indeed, this condition can develop during a Covid-19 infection or after the infection has gone away, with its symptoms also capable of making a return in the future.

Currently, the true causes of Long COVID remain unproven. However, it is thought that it may be caused by any of the following: remnants of the initial infection still being present in various bodily systems, immune system irregularities, or parts of the virus remaining in the patient's body. While such issues would not generally lead to an illness, it is believed that with regard to Covid-19, it could cause an immune system reaction capable of causing symptoms.

10–20% of those who recover from a Covid-19 infection develop Long Covid, However, some studies have found that up to half of all those infected with Covid-19 develop at least one symptom synonymous with this condition. Nevertheless, the following groups are deemed more at risk of developing Long Covid:

• Patients who required hospital treatment for their initial Covid-19 infection
• Women 
• The elderly
• Those with underlying health conditions, such as asthma, diabetes, immunodeficiencies, and the obese
• People with mental health disorders

The most common symptoms associated with Long Covid are as follows:

• Chest pains or palpitations
• Breathing difficulties or an inability to take a full breath
• A cough
• Headaches
• Loss of taste or smell
• Aches and pains
• Muscles soreness
• Joint pain
• Stomach pain
• Diarrhea
• A sore throat

1) Chronic fatigue

Causes: Chronic fatigue in Long Covid patients could be a result of the increased workload placed on the immune system during its fight against the Covid-19 virus, which can continue to have an impact on health even after the initial infection has been defeated.

Additionally, the Covid-19 virus directly impacts the musculoskeletal system, leading to inflammation and damage occurring in certain regions, which can leave the patient feeling exhausted. However, the lack of social interaction and exercise resulting from the pandemic can also be directly associated with a person feeling more fatigued than usual.

Symptoms: Up to half of patients who have recovered from their initial Covid-19 infection report feeling chronically fatigued, with many people tiring easily, feeling generally exhausted, experiencing muscle pains, being incapable of performing the simplest of daily tasks, or being unable to exert the same amount of energy as before their illness despite health tests not detecting any obvious issues.

Care and treatment: Patients should seek medical attention to undergo a thorough diagnosis and rule out other potential health conditions, such as a central nervous system infection, capable of causing muscular weakness or residual lesions in the respiratory and cardiovascular systems.

Unfortunately, there are no specific treatments available for fatigue, so patients are instead recommended to partake in some light exercise at a point in the day when they are feeling at their best. Nevertheless, patients should only do what they feel comfortable doing, and only gradually build up intensity over time to ensure their body has time to adapt to the illness and subsequent recovery.

2) Memory and concentration issues

Causes: The Covid-19 virus can impact the nervous and neurological systems. Indeed, the virus could cause damage to the blood brain barrier, resulting in neurotransmitters being released in greater numbers than usual and changes to blood properties which could lead to circulation issues. If this only affects a small area of the brain, patients may only experience certain symptoms, such as forgetfulness or concentration problems.

Additionally, spending prolonged periods recovering in hospital, especially in ICU, could result in reduced contact with society or prolonged exposure to unfamiliar surroundings, both of which can be causes of post-traumatic stress disorder, which affects thought processes and memory function, leading to increased forgetfulness, particularly in older patients.

Symptoms: Patients may experience trouble formulating thoughts, memory problems, brain fog, forgetfulness, issues concentrating, and an inability to remember how to perform previously familiar tasks, while some may also experience sleep issues, such as insomnia.

Care and treatment: Patients can consult with their doctor regarding treatment as well as attend appointments with psychiatrists and psychotherapists. Furthermore, studies carried out abroad have found that patients experience an improvement in their symptoms after undergoing low-frequency transcranial magnetic stimulation therapy.

3) Post-Covid hair loss

Causes: Post-Covid hair loss could potentially be a direct result of the virus because the body’s reaction to Covid-19 involves the release of chemicals responsible for causing increased inflammation, resulting in a physical response that can cause hair to fall out. Alternatively, this symptom could be caused by other, associated factors, such as stress experienced while recovering in hospital both during and after the initial infection, side effects of medication, or nutrient deficiencies owing to a bad diet during the initial infection.

Symptoms: Hair loss from all over the head but no scarring. The rate of hair loss could vary from 100 strands a day up to 1,000 strands per day.

Care and treatment: A healthy diet consisting of the 5 main food groups in moderation is essential, as is reducing exposure to stress, and getting plenty of rest. Patients may also wish to consult a specialist doctor regarding medicated treatment, such as the use of Minoxidil.

4) Skin rashes or skin sensitivity issues

Symptoms: The skin may feel sensitive, with some patients reporting feelings of pins and needles, numbness, and itching that is most prevalent in areas that are prone to prolonged pressure as well as in the fingers and toes. A red rash may also appear that looks like a tight mesh or a net, with swelling, blistering, or hive-like itching possible, again most prevalent in the hands and feet.

Care and treatment: Patients with these symptoms should be careful to maintain good personal hygiene, washing hands regularly alongside the regular application of moisturizers. They should also consult with a doctor, who can rule out other nerve system or dermatological disorders, including underlying health conditions that may be the cause, such as diabetes, or look into symptoms that are present alongside being unable to take a full breath and chest tightness.

Children are at risk of developing Long Covid, although their level of risk is lower than in adults. The most common symptoms among these groups are fatigue, headaches, problems sleeping, concentration issues, muscular pains, aching joints, or a cough. However, some cases cause multisystem inflammatory syndrome associated with Covid-19 (MIS-C) in children, which can lead to inflammation throughout the body as well as symptoms similar to those associated with Kawasaki syndrome, such as a high fever, rashes all over the body, red eyes, and reddening of the lips. Another condition that parents should be aware of is myocarditis, with child, including adolescent, athletes advised to undergo thorough heart screening following a Covid-19 infection before they make a return to their training.

The rates of recovery and time necessary to recover from Long Covid are still being studied as there are some patients with the condition who have not sought out medical attention. Nevertheless, from the cases studied, most patients tend to make a full recovery within 4–6 months of living with the condition.

The current lack of specific treatment for Long Covid means medical staff instead focus on managing the symptoms and working together with a multidisciplinary team, including physiotherapists, occupational therapists, and psychotherapists to diagnose disorders effectively, or rule out other potential causes. Moreover, some studies have reported that people with Long Covid saw their symptoms improve when they received a Covid-19 vaccine during their illness.

The most effective way to prevent Long Covid is to protect oneself from contracting Covid-19. This can be achieved through getting vaccinated, wearing a mask when outside the home, practicing social distancing, avoiding built up areas, and generally taking good care of personal hygiene.

If a patient has just recovered from a Covid-19 infection and is developing symptoms they suspect could be caused by Long Covid, they are advised to consult a doctor to undergo screening, diagnostics, and treatment for those symptoms.