Long Covid
Everything you need to know about Long COVID - symptoms, causes, treatment options available in Australia, and when to see a doctor. Evidence-based medical information.
What You Need to Know - The Basics
Long COVID is when people still feel unwell weeks or months after having COVID-19.
The main things to know:
- Common symptoms include feeling very tired, having trouble breathing, and problems with memory or concentration.
- It mostly affects people who had a severe case of COVID-19, but anyone can get it.
- It can be serious but many people get better with time and care.
- In Australia, fewer people are getting Long COVID now, thanks to vaccines.
When to see a doctor immediately: If you have chest pain, trouble breathing, or feel very confused, see a doctor right away.
Doctors and health workers can help manage symptoms and support your recovery.
Overview
Long COVID refers to the persistence of symptoms following the acute phase of a COVID-19 infection. It is characterised by a complex interplay of pathophysiological mechanisms, including immune dysregulation, endothelial dysfunction, and persistent viral reservoirs, which contribute to a wide array of systemic effects [1]. The condition can affect multiple organ systems, leading to complications such as chronic fatigue, respiratory issues, and neurological symptoms [2]. In Australia, the prevalence of post-COVID conditions has been decreasing, attributed to high vaccination rates and the circulation of less virulent variants [3].
Statistics and Prevalence in Australia
In 2024, the Australian Institute of Health and Welfare (AIHW) reported that while the overall health of Australians is robust, a significant minority continue to experience post-COVID conditions [1]. The prevalence of Long COVID has been decreasing over time, correlating with increased vaccination coverage and the emergence of less severe virus strains [2]. As of October 2024, there were 3,177 recorded deaths due to COVID-19, a decrease from previous years, indicating a downward trend in severe outcomes [4].
Symptoms and Clinical Presentation
Long COVID manifests with a diverse range of symptoms that can vary in severity and duration. Early signs often include fatigue, breathlessness, and cognitive disturbances, commonly referred to as "brain fog" [5]. As the condition progresses, patients may experience more advanced symptoms such as chest pain, joint pain, and sleep disturbances [6]. Red flag symptoms, such as severe chest pain or neurological deficits, require immediate medical attention [7]. The clinical presentation can vary significantly among different populations, necessitating a tailored approach to diagnosis and management [8].
Causes and Risk Factors
The pathophysiology of Long COVID is complex, involving persistent inflammation, immune system dysregulation, and potential viral persistence in certain tissues [9]. Risk factors for developing Long COVID include severe initial infection, older age, female gender, and pre-existing health conditions such as asthma or diabetes [10]. Understanding these mechanisms is crucial for developing effective treatment strategies and mitigating long-term health impacts [11].
Diagnosis
Diagnosing Long COVID in Australia involves a comprehensive clinical assessment, guided by national guidelines developed by the NHMRC and RACGP [12]. Diagnostic protocols include detailed patient history, symptom evaluation, and exclusion of alternative diagnoses [13]. Laboratory investigations may involve blood tests to assess inflammatory markers, while imaging studies such as chest X-rays or CT scans are utilised to evaluate organ-specific complications [14]. The development of formal diagnostic criteria is ongoing, with a focus on evidence-based approaches to improve accuracy and consistency [15].
Treatment Options in Australia
Treatment for Long COVID is multidisciplinary, involving both pharmacological and non-pharmacological strategies. First-line therapeutic interventions include symptomatic relief with medications such as analgesics and anti-inflammatory drugs [16]. Non-pharmacological treatments focus on rehabilitation, including physiotherapy and cognitive behavioural therapy, to address physical and psychological symptoms [17]. The NHMRC is actively developing national guidelines to standardise care, ensuring access to effective treatments across different regions [18]. Medicare and the Pharmaceutical Benefits Scheme (PBS) provide support for many of these interventions, although access may vary based on location and specific health needs [19].
Living with Long COVID
Managing Long COVID requires a holistic approach, emphasising patient education, self-management strategies, and regular monitoring [20]. Patients are encouraged to engage in lifestyle modifications, such as graded exercise and stress management techniques, to improve quality of life [21]. Psychosocial support is also essential, addressing mental health concerns and facilitating social reintegration [22]. Coordinated care involving general practitioners, specialists, and allied health professionals is crucial for optimising outcomes and preventing disease progression [23].
Managing this condition is an ongoing process, but many people learn to live well with proper support and care.
Daily management:
- Follow your treatment plan as prescribed
- Keep track of your symptoms and how you're feeling
- Stay in regular contact with your healthcare team
- Learn about your condition so you can make informed decisions
Building your support network:
- Talk to family and friends about your condition
- Consider joining support groups
- Work with healthcare professionals who understand your needs
- Don't hesitate to ask for help when you need it
Self-care strategies:
- Maintain healthy lifestyle habits where possible
- Manage stress and get adequate rest
- Stay as active as your condition allows
- Focus on activities and relationships that bring you joy
Important: With proper management and support, many people with this condition live full and active lives.
Prevention
Preventing Long COVID primarily involves reducing the risk of initial COVID-19 infection through vaccination and public health measures [24].
High vaccination rates in Australia have been instrumental in decreasing the new cases of severe COVID-19 and subsequent long-term complications [25].
Ongoing research into booster vaccinations and emerging variants continues to inform prevention strategies, ensuring that the population remains protected against future outbreaks [26].
Key Takeaways
• Long COVID is a medical condition that can be effectively managed with proper diagnosis and treatment from healthcare professionals. • Treatment options are available in Australia through Medicare and PBS, making care accessible and affordable for most people. • Early detection and appropriate management can significantly improve outcomes and quality of life for people with this condition.
References
- AIHW Australia’s Health 2024 (overview/press release)
- AIHW Australia’s Health 2024 (full report)
- AIHW Australia’s Health 2024 (PDF/data insights)
- ABS COVID-19, influenza and RSV deaths 2024
- Long COVID/stratified random health survey (Medical Journal of Australia)
- Clinical guidelines and resources (Queensland Health)
- National Post-Acute Sequelae of COVID-19 (PASC) Plan PDF (Department of Health)
- Weekly updates of national living evidence-based guidelines (Australian National COVID-19 Clinical Evidence Taskforce)
- RACGP news on long COVID guideline development