While most people who contract COVID-19 fully recover within a few months, there is a small percentage who continue to experience symptoms months after they first became sick. They have become known as “COVID long haulers,” and Dr. Nick Daneman, division head of infectious diseases at Sunnybrook, shares some insight into what he has seen in regards to “long COVID,” and some advice on how patients can approach recovery.
Long COVID and Sunnybrook’s COVIDEO
COVIDEO, funded in part by Ontario Health, is a program at Sunnybrook that has helped patients with mild to moderate cases of COVID recover at home with consultations over video or phone. Dr. Daneman is the co-lead of COVIDEO, along with Drs. Philip Lam, Nisha Andany and Adrienne Chan.
The doctors have now seen 9,000 patients through COVIDEO, and they are beginning to analyze some of the data. Patients diagnosed with COVID-19 at Sunnybrook are offered a 90-day in-person follow-up visit. Of the first 995 patients, 506 didn’t respond to the invitation, 266 responded and declined, saying they were back to health, and there were 206 patients who came in for the 90-day follow up. From that data, Dr. Daneman says they have been able to look at which symptoms are most persistent and how common they are.
He did caution these numbers are likely overestimates, and also says these are symptoms seen in individuals who were not hospitalized with COVID-19; hospitalized and critically ill patients would have a different recovery than people who had a mild to moderate case of the virus.
“Generally, if you read about long COVID in the news, people are going to be worried that everyone is left with terrible after effects, but the vast majority of people are back to normal health way before the three-month mark.”
Most common “long COVID” symptoms
Dr. Daneman says the most common symptoms seen in COVIDEO patients are similar to what is being seen elsewhere.
“Fatigue, number one,” he says. “Some kind of anxiety, depression, insomnia [is] pretty common. Headache.”
He also says some patients still experience loss of smell at 90 days and temporary hair loss, known as telogen effluvium, was common, although it’s a condition known to happen sometimes after an acute illness.
Some patients still had a cough or some muscle and joint aches.
Recovery from long COVID
For people still battling COVID-19 symptoms months after their initial infection, they may understandably wonder when they will feel well again, and what they can do to help the process.
“One of the biggest things is time,” says Dr. Daneman. “We see this after almost any type of infection. That some people, a minority of people, can end up with some residual symptoms.”
He gives the example of a chronic cough following influenza or chronic fatigue after a bout of mono. And he says while it may be tempting to hunt for an “active, ongoing infection,” most often there is no infection remaining; the body simply needs time to recover.
“The trigger’s already gone and the body just hasn’t turned off the light switch that’s been turned on,” Dr. Daneman says.
Adopt healthy coping strategies
While Dr. Daneman is not a rehabilitation specialist, he says it’s important for people to find ways of coping and to find a “happy medium where they’re getting energizing activity, but not overdoing it.”
The COVIDEO program has some multi-disciplinary collaborations with the physiatry and rehabilitation departments to provide rehabilitation for Sunnybrook patients who are experiencing long COVID symptoms.
It might be difficult, but Dr. Daneman also recommends people don’t withdraw from their family, friends, work or hobbies because that could make mood or anxiety symptoms, or even physical symptoms, worse.
“It’s important to try as best as possible to find coping strategies and work toward the recovery because it will come with time,” he says.