Update on long COVID

COVID-19 is a disease whose symptoms usually disappear within 2 to 3 weeks. However, some patients may still be experiencing symptoms beyond 4 weeks after infection: this is what we call long COVID. Improvement is generally slow, fluctuating or even incomplete, and can sometimes take years. According to the available data, at least 10% of people who contract COVID-19 are likely to develop long COVID, which can occur equally in people who initially had mild or severe forms of the disease. Risk factors for long COVID after initial infection include: weak immunity at the time of the initial infection, some variants which seem to be more likely to cause long COVID or a history of multiple previous infections.

Long COVID: persistent symptoms and risk factors

COVID is often seen as a respiratory illness, and the best known symptoms are a persistent cough and breathlessness. However, the disease can affect all organs. Long COVID causes lowered immunity (which makes infections and reactivations of latent virus more likely), chronic inflammation and, frequently, the production of autoimmune antibodies.

Impact of COVID on the intestines, microbiota and chronic fatigue syndrome

The intestines have been confirmed to be a reservoir for COVID19. As a result, the disease often includes a variety of digestive symptoms. The presence of the virus in the intestines often leads to a change in the composition of gut microbiota, which play a key role in the onset of chronic fatigue syndrome. This is defined by a persistent feeling of tiredness , and may produce daily discomfort at work and with everyday activities, post-exercise aches and pains, unrefreshing sleep, orthostatic intolerance or even cognitive impairment. The immune response to COVID also has an effect on blood clotting, which can increase the risk of cardiovascular disease in the long term.

Neurological impact and cognitive impairment associated with long COVID

In neurological terms, the chronic inflammation associated with long COVID can result in reduced sensitivity and motor functions or tingling sensations. In elderly people, loss of memory and even cognitive decline have been noted. In these circumstances, it is sometimes difficult to separate these from possible psychiatric conditions, which can themselves be caused by the experience of long COVID.

ENT symptoms of long COVID

With regard to ENT conditions, the symptoms of long COVID may include vertigo, loss of hearing, tinnitus or long-term loss of taste or smell. Long COVID can affect the eyes: damage to retinal microcirculation and the risk of haemorrhage or occlusion of the retinal central vein have been described.

Does COVID impact reproductive health?

In women, irregular periods are sometimes noted, along with more severe premenstrual syndrome, reduced ovarian reserve or hormonal disorders. In men, risks of impotence or changes in fertility have been noted.

Is there a treatment for long COVID?

To date, no treatment has been officially approved, but clinical trials are currently underway to test treatments which act on the mechanisms of viral persistence, neuroinflammation, blood clotting disorders and autoimmunity.