Article: Why some people still have long Covid – and others never did at all

[Sly Saint]

from Telegraph 3 months ago.

Five years on from when the pandemic began, vast numbers of people remain desperately unwell, some two, three or even four years after first contracting the virus.

“The planet has acquired a huge new medical specialty of chronically unwell people,” says Danny Altmann, an immunology professor from Imperial College London. “Estimates range from between 65 million to 200 million people who still have Covid. It’s enough to fill hospital departments in every city in the world.”
The latest report from the Office of National Statistics showed that an estimated 3.3 per cent of people in England and Scotland are living with long Covid, of whom 71 per cent have had symptoms for one year, 51 per cent for at least two years, and 31 per cent for at least three years.

A clinical review published in The Lancet in August 2024 found that people aged 35 to 65 and those who were economically inactive were most affected by long Covid, confirming findings from studies that this condition is having a substantial effect on people’s ability to work.

Is long Covid sometimes mistaken for something else?​

Numerous patients have experienced gaslighting from doctors and other medical professionals, many of whom are convinced that their illness is psychological in origin.

Manoj Sivan, a consultant in rehabilitation medicine and professor at the University of Leeds who lead a long Covid study called Locomotion from 2022 to 2024, says that many end up being misdiagnosed with depression, anxiety or chronic pain.


“There is still a disbelief about the condition, and healthcare professionals don’t always refer these patients on to long Covid clinics,” he says. “So these patients end up being told, ‘Well, this is just a worsening of your anxiety, it’s a reaction to what’s happening in your life.’”

Wendy Crawford, 47, a finance officer, had Covid five years ago and never recovered. “I have easily spent thousands on consultations, tests and treatments trying to find solutions.”

While the majority of studies suggest that taking antivirals during an acute Covid infection provides some protection against the later development of long Covid, many people struggle to obtain these medications on the NHS. Crawford says that despite her prolonged illness, she has been unable to get antivirals to try and prevent further relapses.

“My last reinfection put me in bed for over a year, but when I tried to try to get access to antivirals after I tested positive, I was told that this wasn’t possible as I wasn’t classed as vulnerable,” she says.


David Putrino, an associate professor at New York’s Mount Sinai Health System, who researches long Covid, is hopeful that new diagnostic tools based on AI can eventually reach clinics, making it easier for confused doctors to separate long Covid cases from psychiatric illnesses – and also providing indications of possible therapies which might work.

In 2023, he published a new model which was able to correctly classify long Covid patients from people with other conditions, using the levels of various hormones and immune cells. “For each patient that receives a diagnosis using the algorithm, the features which led to their individual diagnosis can then go on to guide treatment,” he says.

Is there a cure for long Covid?​

Because of the complexities, Prof Putrino says that finding a single cure for long Covid is unrealistic. Instead, he says there needs to be more of a focus on identifying patient subgroups who are likely to respond best to various therapies.

This is particularly important because while studies have indicated that the antihistamine famotidine can improve brain fog in some patients, and others have found that a combination of L-arginine and vitamin C improved exercise tolerance, we still have little idea as to why certain patients respond to these interventions and others do not.

As an example, Prof Putrino points to another study which found that taking a combination of coenzyme Q10 and alpha lipoic acid for two months led to complete resolution of fatigue in half of the points. “The best we can do is tell people there’s a 50:50 chance that it will work,” he says. “That’s not really a financial risk that a lot of these patients are able to take, given that supplements are expensive and not available on the NHS.”


While trials around the world are examining the efficacy of more intensive medications such as immunotherapies and broad-spectrum antivirals, Prof Putrino says that we need better ways of screening patients to identify who will be likely to benefit and who might even be at risk from these treatments.

MSN