Most people who contract COVID-19 report feeling better within a few days or weeks, with a full recovery usually taking less than 12 weeks. However, for those who don’t recover in that time, they are suffering with long Covid – or post-Covid syndrome. Although many of us are aware of the common symptoms, as time goes on scientists are discovering even more complications.
In an update for medical practitioners published in the British Medical Journal in September this year, “Covid strangle” was listed as a symptom of long Covid.
This is classified as a “sore or dry throat with sensation of choking” and an “altered voice”.
Previously, just a sore throat has been associated with the condition.
The paper, which was compiled by a team from various UK universities, recommended referring the patient to a specialist if this side effect did not improve.
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It says: “If not improving, refer to ear, nose, and throat or speech and language therapist as appropriate.”
Researchers say “no clear explanation” exists for why an individual “develops long Covid while another recovers quickly”.
However, they say: “Long Covid is more common in those who had more severe acute
disease but may occur after mild or even asymptomatic disease.
It is more common in people who were hospitalised, aged 35 to 69, female, living in deprived areas, working in healthcare, social care, or education, with high body mass index, and with more than one pre-existing, activity limiting health condition.
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“The underlying cause of long Covid is not fully known, but several interacting mechanisms likely contribute.”
They add: “A chronic, low grade inflammatory response is correlated with the severity of ongoing symptoms in patients who were hospitalised.
“Some patients have evidence of multi-organ microvascular disease characterised by immunothrombosis and endothelial dysfunction, and some show an autoimmune response, where the body starts to recognise its own tissues and organs as foreign.
“Some patients have Covid induced neurological damage, particularly to the autonomic nervous system, which controls involuntary functions like heart rate.”
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Other symptoms listed in the update include:
- Fatigue, low exercise tolerance, deconditioning
- Exertional breathlessness – short of breath predominantly with physical activity
- Altered breathing/breathing pattern disorder
- Chest pain
- Autonomic dysfunction – palpitations, dizziness, orthostatic tachycardia, gastro-intestinal disturbance, generalised pain
- Brain fog and mental fatigue
- Dizziness and vertigo
- Loss of smell
- Skin rashes, conjunctivitis, abdominal bloating, regurgitation
- Poor sleep
- Anxiety, depression, post-traumatic stress disorder (PTSD), loss of identity and purpose
- Joint and muscle pain.
It also warns of post-exertional symptom exacerbation.
This is a: “‘Crash,’ ‘relapse’ worsening of symptoms (physical, cognitive, or emotional), or new symptoms, following exertion.”
If someone experiences this, the report recommends medical staff: “Monitor symptom severity and frequency and pattern of relapses.
“A patient activity diary can record triggers (for relapse).”
It concludes: “Long Covid affects patients in different ways and to different degrees. Because a key component of care is investigating and managing risk factors and comorbidities, no standard protocol exists for assessment.
“Ideally, every patient should have an in-person consultation including a full history, clinical examination, and review of comorbidities and social circumstances.”