A Year Into The Pandemic: What Is Long Covid? — Nur Qamarina Mohaizi, et al.

Post-Covid patients require a holistic approach for their follow-up care and well-being.

Do you feel that you are still experiencing symptoms after recovering from Covid-19? Have you heard of long Covid?

Long Covid, also known as post-Covid syndrome is a long-term effect after Covid-19 infection. According to the National Institute for Health and Care Excellence (NICE), long Covid comprises symptoms developed during or after Covid-19 infection that continue for more than 12 weeks, and are not explained by an alternative diagnosis.

In Malaysia, a tele­consultation service conducted by the Ministry of Health (MOH) after 1,004 Categories Four and Five patients were diagnosed found that 65.9 per cent continue to experience ongoing Covid-19 symptoms.

Based on data analyses at Hospital Sungai Buloh’s Covid-­19 Rehabilitation Out­patient Specialised Services (CROSS) database, Covid-19 patients Categories Four and Five are more likely to develop long Covid. All patients from these categories must be monitored after discharge.

Long Covid usually presents itself with a cluster of symptoms rather than a single symptom, often overlapping, and can affect any part of the body.

The five most common symptoms experienced are fatigue (excessive tiredness or lack of energy), exertional dyspnoea (difficulty breathing following activities), insomnia (difficulty sleeping at nights), coughing and anxiety.

Other symptoms include abdominal pain, joint and muscle pain, chest pain, headache, nausea, diarrhoea and reduced appetite. Psychologically, long Covid can lead to depression and post-traumatic stress disorder (PTSD).

Picture yourself having to return to work while dealing with the symptoms mentioned above. Long Covid symptoms will cause a significant reduction in the quality of life. You won’t be able to function as well as you did before getting infected with Covid-19.

Some employees would even go to the extent of taking leave from work because they aren’t able to complete tasks while experiencing such symptoms.

In addition, they will also feel concerned about how long their symptoms will persist, and when they will be able to get back to their normal daily routine. As a result, they will start to feel anxious and depressed.

The persistent worries caused by long Covid can have a huge impact on individuals. These feelings may also be worsened by chornic fatigue often associated with long Covid. 

Post-Covid rehabilitation involves a multidisciplinary team, comprising physiotherapists, occupational therapists, speech and language therapists, psychologists, dieticians and pharmacists, via a biopsychosocial approach.

Comprehensive assessments will be done beforehand in order to develop a personalised rehabilitation programme and appropriate prescriptions under close monitoring to address the symptoms.

Physiotherapists may start strengthening and breathing exercises for cardiopulmonary and musculoskeletal rehabilitation. Occupational therapists will focus on activities of daily living (ADL), which include dressing, grooming, toileting and hand functions, to regain patients’ lost skills and independence.

Psychologists will address cognitive impairment seen in anxiety and depression with neuro-stimulation activities and relaxation therapies.

This programme is currently available at several hospitals nationwide, including the University of Malaya Medical Centre, Universiti Teknologi Mara Medical Centre, Cheras Rehabilitation Hospital, Kuala Lumpur Hospital, Sungai Buloh Hospital, as well as private facilities such as ReGen Hospital, Daehan Sunway, Prince Court and others.

Post-Covid syndrome is common and has a wide range of symptoms. The diverse range of symptoms is tied to patient demographics and illness severity factors.

Therefore, all post-Covid patients require a holistic approach for their follow-up care and well-being. The Malaysian government and the public should work hand in hand to keep the epidemic under control and subsequently reduce the incidences of post-Covid syndrome.

Our government should also play their role by adhering to all the SOPs. If the government and the public can cooperate, our country will be able to overcome the epidemic.

Prepared by Nur Qamarina Mohaizi, Muhammad Luqmanul Hakim, Melvin Liew, Mashitah Hasan, Darshinidevi Ratnam, Choong Huey Yee, Vincent Tan and Wong Win Yi, who are final year medical students of Group 4A Community Posting, supervised by Prof Dr Victor Hoe Chee Wai Abdullah and Dr Lim Yin Cheng from the Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya.

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