The Long-Haulers of the Post-COVID Era

This article was exclusively written for The European Sting by Dr. Bayan Maged and Dr. Maryam Nabil, two dynamic and enthusiastic intern physicians at Ain Shams University Hospital, Cairo, Egypt . They are affiliated with the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

COVID-19, which quickly grew to cause the fifth largest deadly pandemic in human history, is estimated to have taken the lives of over 6 million people as of August 2023. However, statistics don’t reveal the full extent of its impact, as two major factors that cannot be accurately estimated are the number of long-COVID cases and the effect it continues to have on the healthcare system.

Many people with COVID-19 get better within weeks, yet some continue to experience symptoms that can last up to months. People with this condition, long covid, are called “long-haulers.”. Before the emergence of COVID many other viral outbreaks have produced long-term after effects, for instance the 1918 influenza pandemic had an elevated risk of developing Parkinson’s disease years later. There are likely multiple overlapping causes, most commonly discussed being the persisting reservoirs of SARS-CoV-2 in tissues and immune dysregulation. The leading symptom of many post-COVID sufferers is considerable fatigue. In addition, it can manifest as new-onset chronic multi-systemic affection. Long COVID is associated with all ages, most cases are in mild, acute, non-hospitalized cases.

Risk factors potentially include female sex, type-2-diabetes, lower socioeconomic class, and Hispanic or Latino heritage. At least 65 million individuals around the world have long COVID, which is estimated to be 10% of cases worldwide. However, the number is likely much higher due to many undocumented cases. With the significant proportions of cases unable to return to work and the unavailability of validated effective treatments. The scale of newly disabled individuals is contributing to labor shortage, hence negatively affecting the health care system .During the early stages of the pandemic, emergency departments were so overwhelmed that many hospitals retrained and shifted human and non-human resources to support areas of greatest need, leading to the delay or cancellation of many elective procedures. Adaptations to limit the spread of COVID was through the use of virtual and tele-medicine, which isn’t applicable in all cases as many require face-to-face consultations and interventions.

This reduced access to healthcare meant many COVID-unrelated conditions went undiagnosed and untreated causing many indirect deaths by COVID.These stressors revealed how underfunded and underprepared health sectors both in industrialized and developing countries are. And although the phrase “post-pandemic” may seem unrealistic to some, thanks to advances in the field of vaccines, we are closer to reaching that era. However, the previously mentioned effects it had on healthcare and the vulnerabilities it exposed remain a source of anxiety especially for individuals of lower socioeconomic status who were the most at risk, as quitting work for protective measures wasn’t an option for most.

Similarly to how the effect of COVID on the human body doesn’t always cease after a negative PCR test, the Impact of the pandemic on healthcare, the social unrest it exacerbated, as well as psychological impact caused both by both the lockdown and by financial loss due to the resulting economic crisis, will probably continue to be felt for years to come.

About the authors

Dr. Bayan Maged and Dr. Maryam Nabil are two dynamic and enthusiastic intern physicians at Ain Shams University Hospital, Cairo, Egypt .Currently, they are active members of the IFMSA Egypt . They are passionate about cultural exchange especially when it comes to the medical field and improving it in their home country through research and sharing ideas . With a sense of purpose to contribute to the  health-care sector in the future.

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