CHEARS

What is long COVID?

Long COVID is a term used to describe post-COVID conditions, that continue for several weeks or months after the diagnosis of COVID infection. The long-term effects of COVID-19 seem to occur in multiple systems of the body and can have a significant impact on quality of life.

Although details of how many people are affected by long COVID are still emerging, a study suggests that around one in five people who tested positive for COVID-19 show symptoms for five weeks or more.

Some of the lasting symptoms of COVID include:

· Tiredness or fatigue

· Breathlessness or shortness of breath

· Cough

· Muscle and body pain

· Chest pain

· Dizziness on standing (light-headedness)

· Sleep problems

· Heart palpitations

· Anxiety and depression

· ‘Brain fog’ (inability to concentrate or focus)

· Mood changes

· Changes in sense of smell and/or taste

How to self-manage long COVID?

· Breathing techniques to manage cough:

The patient should sit in a supported position, breathe in through the nose and out through the mouth while relaxing the chest and shoulders but allowing the tummy to rise. This technique can be used in 5–10-minute bursts, frequently throughout the day.

· Daily monitoring of breathlessness using pulse oximeter:

Although breathlessness tends to improve with breathing exercises, it is important to assess oxygen saturation levels (amount of oxygen carried by the blood) using a pulse oximeter. This non-intrusive device is commercially available at pharmacy stores, with detailed guidelines for usage. Smartphone apps that claim to measure oxygen saturation using the phone camera or torch should not be used.

The target range for oxygen saturation should be 94-98% and a level of 92% or below requires supplementary oxygen.

· Rest and relaxation to counter fatigue:

Recovering patients are advised not to over-exert themselves, and start with small and simple activities. Frequent short rests are advised so that the body gets enough rest instead of facing exhaustion.

· Self-pacing and gradual increase in physical activity, if tolerated:

The patient should understand themselves and try to gradually increase the amount of exercise they do. They can try going for short walks or do simple exercises, then build up from there. However, it must be noted that they should stop doing things that make them feel breathless. The targets that are set must be achievable, not forced.

Before starting any exercise plan, the patient must seek advice from a doctor.

· Diet:

Most healthcare professionals recommend a protein-rich diet intake to patients recovering from COVID. Foods like egg, milk, meat, and pulses must be included in the daily diet, according to the preferences of the patient. Good, nutritious, and healthy food is necessary to build appetite as well as regain the sense of taste and smell.

Indian cuisine is naturally replete with anti-oxidants and anti-viral ingredients such as turmeric, pepper, garlic, ginger, etc. that work wonders to aid in recovery. Apart from these, the intake of fluids, like water, natural fruit juices, milk, etc. is equally important.

· Attention to general health:

It is advisable to quit smoking as well as limit alcohol and caffeine intake.

· Sleep:

COVID seems to have affected the sleep pattern of the infected, especially the patients who had to be hospitalized. During recovery, it is of prime importance to regain a proper sleep schedule.

Patients must go to bed at regular timings and ensure that they get enough sleep to feel rejuvenated after waking up.

When to see a doctor?

For patients who had been hospitalized for COVID, it is advisable to follow up with a cardiologist, about any heart issues, such as chest pain. Patients must seek medical help if their condition worsens post-COVID or if they develop any new symptoms.

Since there is still a lot unknown about long COVID, patients who have lingering concerns or feel that something is bothering them must see a doctor post-COVID.

Ongoing Research

Long COVID is a burning topic and several research groups are focused on understanding the extent and persistence of damage to the heart and other organs due to COVID-19 infection. Studies are also looking for existing medicines that can help relieve long-term effects. There is also a need for more research on long-term effects on children and adolescents. We hope that all the sincere efforts will pay off, and soon, we will be better equipped to combat long COVID.