In addition to the potentially lethal short-term effects of COVID-19 that have now taken the lives of more than two million across the globe, there is increasing evidence that the disease has the potential to cause long-term effects.
Deemed “long COVID” by some, its effects are only now being adequately studied due to the rapid timeframe in which COVID-19 took hold across the globe. Many are still reporting detrimental health effects more than six months following the initial COVID-19 infection.
As Health Issues India recently reported regarding a study conducted on COVID-19 patients published in The Lancet, “76 percent of patients reported at least one ongoing symptom. Fatigue or muscle weakness was reported by 63 percent; 26 percent reported sleep difficulties; and 23 percent experienced anxiety or depression.”
A Lancet commentary published in May last year presented initial results that indicated the potential for severe long-term implications in those affected by COVID-19. Chest CT scans — from individuals from China’s city of Wuhan — showed bilateral ground glass opacities following recovery from the virus. Ground glass opacities refers to unspecified murky areas within CT scans of the lungs, often corresponding to fluid secretion or damaged tissue.
Long COVID has thus far been defined by the following symptoms, presenting themselves often many months following infection: fatigue, myalgia or inflammation, insomnia, and mental health impacts including anxiety. Commentators have warned of the dangers of post-traumatic stress disorder among those who have contracted COVID-19.
Fatigue may be related to the aforementioned tissue damage to the lungs. It is speculated that this potentially lasting damage relating to scarring of the lungs results in a chronic decrease in lung capacity. Such a decrease could cause otherwise normal activities, such as carrying objects or walking up stairs, to have a much more significant impact on the individual, resulting in fatigue. This is of particular concern, as the scarring of lung tissue could result in an elevated risk factor for a number of lung diseases as the affected individual ages.
Myalgia, or chronic inflammation, can result from an infection and causes healthy tissue to experience the effects of inflammation, resulting in issues such as muscle weakness and joint pain. This, combined with potential scarring of the lungs, would explain the mechanisms by which severe fatigue is occurring in those with long COVID.
The final three symptoms involve the mental wellness impacts of the condition. Some accounts suggest that, in some with more severe infections, mental faculties may be impaired for some time following infection. As such, symptoms such as depression and anxiety may be directly related to the COVID-19 infection or may simply be reactive, brought about by the period of infection or the prevailing physical symptoms.
Many of these issues form a positive reinforcement cycle which inevitably brings about worsening symptoms. Fatigue, combined with insomnia, can result in an individual’s mental health deteriorating, experiencing symptoms and conditions such as depression and anxiety. Stress related to these mental health issues can result in higher levels of inflammation in the body, causing issues such as myalgia to worsen, and in turn begin the vicious circle again.
As noted in a recent article on Health Issues India, “the vicious circle of mental health issues among the population being amplified while treatment remains a distant prospect (if not more so compared to the pre-pandemic world) is one that portends to engender elevated rates of substance misuse, self-harm, and suicide unless the relevant authorities act. Addressing the mental health concerns of those affected by COVID-19 in tandem with any lasting physical effects is an imperative at all stages of the healthcare delivery system.”
Indeed, with regards to mental health, India is all but unprepared to deal with the fallout of the pandemic. As a previous article mentioned, “even under normal circumstances, these individuals would be unlikely to avail treatment. Mental healthcare accounts for just 0.16 percent of the government budget for health. In addition, there is an acute shortage of psychiatric professionals in the country. Data indicates that there are 0.3 psychiatrists, 0.12 psychologists and 0.07 social workers for every 100,000 Indians.”
With so many across both India and the world affected by COVID-19, the prospect of potentially permanent effects of long COVID becomes a disconcerting situation. Efforts must be made to roll out vaccines as hastily as possible to prevent an ever growing number of people suffering both the physical and psychological side effects of the condition.
Contact details for mental health support in India can be accessed here.
If you are suicidal or experiencing suicidal thoughts, visit your nearest hospital or contact AASRA on 91-22-27546669 or Sneha India on 91 44 24640050 helpline. A list of other suicide helplines can be accessed here.