Long Covid: scientists and doctors grapple with unanswered questions


Gillian Duncan
  • English
  • Arabic

The first cases of long Covid emerged in late spring last year, just as lockdowns were beginning to bring the initial wave of the virus under control.

People who should have fully recovered were still suffering weeks later.

Some continued to have shortness of breath, or issues such as a loss of taste or smell, palpitations, chest pain, brain fog, or a host of other issues.

12 months on, exhaustion is the most common symptom, sometimes accompanied with tingling or numbness in hands and feet.

Most had only had a mild case of the virus, and the vast majority of sufferers were women.

They also tended to be younger, between the ages of 20 and 50.

As new cases mounted, others continued to stall in their recovery.

Now, more than one year since the pandemic was declared, millions of people are believed to still be suffering from the condition.

We don't really know right now how many patients will develop these long Covid symptoms after they have had this infection

Studies from the UK have shown that up to a quarter of people there experience long Covid.

But doctors say the condition could affect considerably more.

“We don’t really know right now how many patients will develop these long Covid symptoms after they have had this infection,” said Kristin Englund, a doctor at Cleveland Clinic, in an online explainer on the topic.

“Studies look at anything between 10 per cent and 80 per cent," she said.

“So there could be a large number of people experiencing symptoms well after that four week time period when we would expect people to normally recover.”

Zijian Chen, an endocrinologist at Mount Sinai, who was appointed as medical director at the hospital’s Center for Post-Covid Care, was shocked when he realised the full scope of patients in its database who suffered lingering effects of the virus during the first wave.

"I looked at the number of patients that were in the database and it was, I think, 1,800 patients," he told The Atlantic in a recent interview.

“I freaked out a little bit. Oh my God, there’s so many patients telling us that they still have symptoms.

“We didn’t expect this from a virus.

“We expect that with viral infections as a whole, with few exceptions, you get better.”

Those with evident issues were sorted into groups to see specialists.

Some had fibrosis or lung scarring, others developed heart problems.

But in 90 per cent of people there was no obvious cause of their ongoing health issues.

"We couldn’t see what was wrong," Dr Chen said.

The condition largely remains a mystery, but studies are beginning to reveal answers.

Long Covid recently received an official name - Post Acute Sequelae of SARS-CoV2, or PASC.

The condition is the subject of studies across the world, where clinics have been established to treat sufferers.

At least 10 long Covid clinics have been established in London alone, where doctors are struggling to see everyone who needs help.

“The referrals at the clinics are twice the number we can cope with.” Melissa Heightman, a respiratory physician at University College London Hospital’s clinic for post-Covid treatment told Bloomberg.

Dubai resident Eman Jamal has seen her fair share of doctors since she caught the virus last April.

She was pretty sick at the time, with a racking cough and pounding headaches, but was one of the lucky ones, or so she thought after she was discharged following an 18-day stay at Mediclinic Parkview Hospital in Al Barsha.

Almost a year on she still suffers from chest tightness, pain, muscle spasms and fatigue.

Ms Jamal has seen countless doctors, and although she has been diagnosed with asthma, it cannot explain the extent of her systemic health problems.

After a “terrible January”, she had herself retested for the virus - it was negative.

By that point she had no antibodies left, so reinfection was a real possibility given the prevalence of the virus at the time.

“The first time I tested for antibodies was in September of 2020. They were on the high side. I got tested again at the end of December and they were completely gone,” said the Palestinian American, 36.

“It’s different numbers in different countries, but if you have 1.4 and above you are considered to have antibodies. I had 7.6. I was really comfortable with that number. I felt I could do things and I could go out and be a little bit more social. I was still being super careful. By December I had nothing.”

Vaccine's positive impact

Ms Jamal rode out the start of the year and in February things returned to her “new normal” of bad days and good days. Then towards the end of the month she got her Covid-19 vaccine.

She was diagnosed with asthma after suffering from the virus, so qualified for Pfizer under Dubai’s priority system.

“I was in bed for 72 hours. I had a fever of 39.5C. I was weak. I was shivering,” she said.

But after a rough few days, she started to feel better. Her long Covid symptoms began to subside.

“There was a noticeable improvement about 11 or 12 days after I took it,” she said.

Other sufferers have also reported a vast improvement in their symptoms after they got vaccinated.

Scientists do not fully understand it yet, but they have some theories.

Covid-19 may be able to hide in the brain, with one possible route in being through the nose. AP
Covid-19 may be able to hide in the brain, with one possible route in being through the nose. AP

One explanation could be that Covid long haulers are still harbouring the virus somewhere in their bodies, where it is sheltered from the immune system, like the brain, and it is replicating slowly.

Studies have shown the virus can indeed infect the brain, where it is believed to enter via the nose.

This is what an autopsy study concluded last November, when researchers discovered coronavirus particles intact in cells located at the roof of the nose, along with evidence of "active replication in the tissue". 

They said from there the virus could access the olfactory bulb – the neural structure in the front of the brain involved in the sense of smell – and travel via specific cranial nerves deep into the brain where it still replicates.

If symptoms are indeed caused by a “viral ghost,” antibodies produced in response to a vaccine may be able to "eliminate the reservoir", Akiko Iwasaki, an immunologist at Yale University, wrote on Twitter.

Alternatively, long Covid symptoms could also be caused due to an autoimmune response to the initial infection, she said.

If symptoms are due to an autoimmune reaction, the vaccine may “divert the autoimmune cells,” said Ms Iwasaki.

Ms Jamal does not know whether the improvement is related to the vaccine, or even if it will last, but she is hopeful.

“I can’t confidently say it was the vaccine only. But something is getting better.

“My next dose is this coming Sunday,” she said.

“I am hoping the improvement continues.”

England's all-time record goalscorers:
Wayne Rooney 53
Bobby Charlton 49
Gary Lineker 48
Jimmy Greaves 44
Michael Owen 40
Tom Finney 30
Nat Lofthouse 30
Alan Shearer 30
Viv Woodward 29
Frank Lampard 29

Copa del Rey

Semi-final, first leg

Barcelona 1 (Malcom 57')
Real Madrid (Vazquez 6')

Second leg, February 27

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  • Specialist robotics and science laboratories
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The specs: McLaren 600LT

Price, base: Dh914,000

Engine: 3.8-litre twin-turbo V8

Transmission: Seven-speed automatic

Power: 600hp @ 7,500rpm

Torque: 620Nm @ 5,500rpm

Fuel economy 12.2.L / 100km

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Safety 'top priority' for rival hyperloop company

The chief operating officer of Hyperloop Transportation Technologies, Andres de Leon, said his company's hyperloop technology is “ready” and safe.

He said the company prioritised safety throughout its development and, last year, Munich Re, one of the world's largest reinsurance companies, announced it was ready to insure their technology.

“Our levitation, propulsion, and vacuum technology have all been developed [...] over several decades and have been deployed and tested at full scale,” he said in a statement to The National.

“Only once the system has been certified and approved will it move people,” he said.

HyperloopTT has begun designing and engineering processes for its Abu Dhabi projects and hopes to break ground soon. 

With no delivery date yet announced, Mr de Leon said timelines had to be considered carefully, as government approval, permits, and regulations could create necessary delays.

THE SPECS

Engine: 3.5-litre V6
Transmission: six-speed manual
Power: 325bhp
Torque: 370Nm
Speed: 0-100km/h 3.9 seconds
Price: Dh230,000
On sale: now

Essentials

The flights
Whether you trek after mountain gorillas in Rwanda, Uganda or the Congo, the most convenient international airport is in Rwanda’s capital city, Kigali. There are direct flights from Dubai a couple of days a week with RwandAir. Otherwise, an indirect route is available via Nairobi with Kenya Airways. Flydubai flies to Kinshasa in the Democratic Republic of Congo, via Entebbe in Uganda. Expect to pay from US$350 (Dh1,286) return, including taxes.
The tours
Superb ape-watching tours that take in all three gorilla countries mentioned above are run by Natural World Safaris. In September, the company will be operating a unique Ugandan ape safari guided by well-known primatologist Ben Garrod.
In the Democratic Republic of Congo, local operator Kivu Travel can organise pretty much any kind of safari throughout the Virunga National Park and elsewhere in eastern Congo.

Best Foreign Language Film nominees

Capernaum (Lebanon)

Cold War (Poland)

Never Look Away (Germany)

Roma (Mexico)

Shoplifters (Japan)

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Hobbies: Off-roading, scuba diving, playing squash and going to the gym.

 

Tips to avoid getting scammed

1) Beware of cheques presented late on Thursday

2) Visit an RTA centre to change registration only after receiving payment

3) Be aware of people asking to test drive the car alone

4) Try not to close the sale at night

5) Don't be rushed into a sale 

6) Call 901 if you see any suspicious behaviour

Company Profile:

Name: The Protein Bakeshop

Date of start: 2013

Founders: Rashi Chowdhary and Saad Umerani

Based: Dubai

Size, number of employees: 12

Funding/investors:  $400,000 (2018) 

Fighting with My Family

Director: Stephen Merchant 

Stars: Dwayne Johnson, Nick Frost, Lena Headey, Florence Pugh, Thomas Whilley, Tori Ellen Ross, Jack Lowden, Olivia Bernstone, Elroy Powell        

Four stars

Have you been targeted?

Tuan Phan of SimplyFI.org lists five signs you have been mis-sold to:

1. Your pension fund has been placed inside an offshore insurance wrapper with a hefty upfront commission.

2. The money has been transferred into a structured note. These products have high upfront, recurring commission and should never be in a pension account.

3. You have also been sold investment funds with an upfront initial charge of around 5 per cent. ETFs, for example, have no upfront charges.

4. The adviser charges a 1 per cent charge for managing your assets. They are being paid for doing nothing. They have already claimed massive amounts in hidden upfront commission.

5. Total annual management cost for your pension account is 2 per cent or more, including platform, underlying fund and advice charges.

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The Great Derangement: Climate Change and the Unthinkable
Amitav Ghosh, University of Chicago Press

Our legal consultant

Name: Dr Hassan Mohsen Elhais

Position: legal consultant with Al Rowaad Advocates and Legal Consultants.

What is graphene?

Graphene is a single layer of carbon atoms arranged like honeycomb.

It was discovered in 2004, when Russian-born Manchester scientists Andrei Geim and Kostya Novoselov were "playing about" with sticky tape and graphite - the material used as "lead" in pencils.

Placing the tape on the graphite and peeling it, they managed to rip off thin flakes of carbon. In the beginning they got flakes consisting of many layers of graphene. But as they repeated the process many times, the flakes got thinner.

By separating the graphite fragments repeatedly, they managed to create flakes that were just one atom thick. Their experiment had led to graphene being isolated for the very first time.

At the time, many believed it was impossible for such thin crystalline materials to be stable. But examined under a microscope, the material remained stable, and when tested was found to have incredible properties.

It is many times times stronger than steel, yet incredibly lightweight and flexible. It is electrically and thermally conductive but also transparent. The world's first 2D material, it is one million times thinner than the diameter of a single human hair.

But the 'sticky tape' method would not work on an industrial scale. Since then, scientists have been working on manufacturing graphene, to make use of its incredible properties.

In 2010, Geim and Novoselov were awarded the Nobel Prize for Physics. Their discovery meant physicists could study a new class of two-dimensional materials with unique properties. 

 

Our family matters legal consultant

Name: Hassan Mohsen Elhais

Position: legal consultant with Al Rowaad Advocates and Legal Consultants.

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The line up

Friday: Giggs, Sho Madjozi and Masego  

Saturday: Nas, Lion Bbae, Roxanne Shante and DaniLeigh  

Sole DXB runs from December 6 to 8 at Dubai Design District. Weekend pass is Dh295 while a one day pass is Dh195. Tickets are available from www.soledxb.com

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How do Sim card scams work?

Sim swap frauds are a form of identity theft.

They involve criminals conning mobile phone operators into issuing them with replacement Sim cards by claiming to be the victim, often pretending their phone has been lost or stolen in order to secure a new Sim.

They use the victim's personal details - obtained through criminal methods - to convince such companies of their identity.

The criminal can then access any online service that requires security codes to be sent to a user's mobile phone, such as banking services.

Five famous companies founded by teens

There are numerous success stories of teen businesses that were created in college dorm rooms and other modest circumstances. Below are some of the most recognisable names in the industry:

  1. Facebook: Mark Zuckerberg and his friends started Facebook when he was a 19-year-old Harvard undergraduate. 
  2. Dell: When Michael Dell was an undergraduate student at Texas University in 1984, he started upgrading computers for profit. He starting working full-time on his business when he was 19. Eventually, his company became the Dell Computer Corporation and then Dell Inc. 
  3. Subway: Fred DeLuca opened the first Subway restaurant when he was 17. In 1965, Mr DeLuca needed extra money for college, so he decided to open his own business. Peter Buck, a family friend, lent him $1,000 and together, they opened Pete’s Super Submarines. A few years later, the company was rebranded and called Subway. 
  4. Mashable: In 2005, Pete Cashmore created Mashable in Scotland when he was a teenager. The site was then a technology blog. Over the next few decades, Mr Cashmore has turned Mashable into a global media company.
  5. Oculus VR: Palmer Luckey founded Oculus VR in June 2012, when he was 19. In August that year, Oculus launched its Kickstarter campaign and raised more than $1 million in three days. Facebook bought Oculus for $2 billion two years later.
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Squads

Sri Lanka Tharanga (c), Mathews, Dickwella (wk), Gunathilaka, Mendis, Kapugedera, Siriwardana, Pushpakumara, Dananjaya, Sandakan, Perera, Hasaranga, Malinga, Chameera, Fernando.

India Kohli (c), Dhawan, Rohit, Rahul, Pandey, Rahane, Jadhav, Dhoni (wk), Pandya, Axar, Kuldeep, Chahal, Bumrah, Bhuvneshwar, Thakur.

F1 The Movie

Starring: Brad Pitt, Damson Idris, Kerry Condon, Javier Bardem

Director: Joseph Kosinski

Rating: 4/5

The specs

Engine: 2-litre 4-cylinder and 3.6-litre 6-cylinder

Power: 220 and 280 horsepower

Torque: 350 and 360Nm

Transmission: eight-speed automatic

Price: from Dh136,521 VAT and Dh166,464 VAT 

On sale: now

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It Was Just an Accident

Director: Jafar Panahi

Stars: Vahid Mobasseri, Mariam Afshari, Ebrahim Azizi, Hadis Pakbaten, Majid Panahi, Mohamad Ali Elyasmehr

Rating: 4/5

The specs

Engine: four-litre V6 and 3.5-litre V6 twin-turbo

Transmission: six-speed and 10-speed

Power: 271 and 409 horsepower

Torque: 385 and 650Nm

Price: from Dh229,900 to Dh355,000

HOSTS

T20 WORLD CUP 

2024: US and West Indies; 2026: India and Sri Lanka; 2028: Australia and New Zealand; 2030: England, Ireland and Scotland 

ODI WORLD CUP 

2027: South Africa, Zimbabwe and Namibia; 2031: India and
Bangladesh 

CHAMPIONS TROPHY 

2025: Pakistan; 2029: India  

Moon Music

Artist: Coldplay

Label: Parlophone/Atlantic

Number of tracks: 10

Rating: 3/5

Walls

Louis Tomlinson

3 out of 5 stars

(Syco Music/Arista Records)

While you're here
The specs

Engine: Direct injection 4-cylinder 1.4-litre
Power: 150hp
Torque: 250Nm
Price: From Dh139,000
On sale: Now

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World Cup League Two

Results

Oman beat Nepal by 18 runs

Oman beat United States by six wickets

Nepal beat United States by 35 runs

Oman beat Nepal by eight wickets

 

Fixtures

Tuesday, Oman v United States

Wednesday, Nepal v United States

 

UAE currency: the story behind the money in your pockets