An academic, suddenly struggling to prepare a simple meal. A half-marathon hopeful, now relying on a wheelchair. More than three years into the pandemic, scientists are still trying to unravel the mysteries of long COVID.
now sits at a staggering 200-plus. They include chest pain, joint pain, loss of smell or taste, skin disorders, gut disorders, hair loss, heart palpitations, headache, internal tremors, sore throat, sleep apnoea, nausea, diarrhoea, vomiting, allergies, fever, anorexia, “difficulty articulating self” , and most commonly, cognitive impairment or “brain fog”, and immense fatigue.
Either way, the kind of long COVID symptoms people are presenting with has broadened over time, says Anne Holland, professor of physiotherapy and head of respiratory research at Melbourne’s Alfred Health and Monash University.“In the early days, we were expecting persistent respiratory symptoms and people with symptoms similar to post-ICU [syndrome],” says Holland, “and we did see that then – impaired exercise tolerance, weakness of muscle mass, breathlessness.
It just made him worse. He finally went to a neuro-psychologist. “After more than three hours of cognitive tests, they found that there was a severe deficit of working memory. My sense had been that I was probably a couple per cent off my A-game, not quite capable anymore of performing at the level needed to be an academic in Australia, but the testing revealed I’d actually dropped into the bottom 10 per cent of the population.
Before Abercrombie caught COVID, in April last year, she was a bookkeeper, a half-marathon hopeful and a gym regular. Now she can barely speak. Her voice is so croaky, slow and breathless, she sounds like a badly programmed bot. She has been crushed by the condition. “Family and friends all drop off because your tests come back as normal so they say, ‘Well, she must be faking it.’ ”
They end up “crashing” with what’s known as post-exertional malaise, exhausted for hours or sometimes days. Payton Jacobs, the 18-year-old, says her fatigue is still extreme and her “crashes” are like a collapse, leaving her feeling paralysed, her limbs leaden. She struggled through her HSC exams last year, with a bed set up for her so she could sleep when necessary.
“The other issue it causes is over-investigation, with test after test, and that’s anxiety-provoking. You know, ‘We’re going to do an MRI.’ ‘Shit, I hope you don’t find a brain tumour.’ ” Just as Brew and his team have been studying those pathways in relation to the brain, and others have been looking at the heart and respiratory systems, Gail Matthews and a group of immunologists at the Kirby Institute have been looking for answers in the blood. “Something is triggering elevated levels of interferons but we don’t know what,” she says. “It’s the sort of picture you’d see if someone was fighting off an acute infection, when the body’s immune system goes into overdrive.
Infectious diseases expert Gail Matthews has been looking for possible long COVID answers in blood: “Something is triggering elevated levels of interferons but we don’t know what.”progress has been made with treatments for long COVID, although that’s the case with many other post-viral conditions, too, whether they follow glandular fever or chickenpox, polio or Ebola. Still, the global impact of long COVID means the research effort has been more intense – and scattergun.
On the other hand, he agrees with Newsome about the urgency. “In the Long COVID clinic, we have people who can no longer work, can’t function and so we have to deliver the treatments, the best we can cobble together from the research and the evidence around.”
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