As the novel coronavirus pandemic continues in its third year, hundreds of thousands survivors of the disease continue to suffer with lingering painful symptoms and conditions.

Technical consultant for incident management system for the Pan American Health Organization (PAHO) COVID-19 response, Dr Sasha Peiris, has pointed out that the most recent evidence from “long-COVID” studies and data from public health agencies are that the incidents of post-COVID symptoms range from 10 to 60 per cent or more, of people who had the disease.

“The varied percentages may be due to the heterogeneity of the studies; it may also be due to the definition that these studies have been using to recognise patients with post-COVID. Also, early on the studies did underestimate the incidents since this condition was not well-recognised and communities are now just starting to do the research,” Dr Peiris explained on Monday at a webinar titled ‘The many faces of Long-COVID-19’.

The webinar was held in collaboration with The University of the West Indies and focused on the medical long-term impact of COVID-19 including mental health, case management and rehabilitation.

Dr Peiris noted that since 2020 the medical community has raised concerns about the possible medium- to long-term effects of COVID-19 and now in the third year, these concerns are “very real”, with many published literature linking the long-term sequel conditions with SARS-CoV-2 infection, now termed post-COVID-19 conditions by the World Health Organization (WHO), also referred to as “long COVID”, “long haulers” and other names by the French Research Institutes.

The WHO has developed a standardised clinical case definition for long-COVID, based on global stakeholder consensus.

This is now defined as individuals with a history of probable or confirmed SARS-CoV-2 infection, usually three months from the onset of acute infection with symptoms that last for at least two months which cannot be explained by alternative diagnosis, Dr Peiris pointed out.

Presently, more than 200 symptoms have been associated with long COVID, ranging from mild to debilitating, affecting every major organ system. The most commonly recorded symptoms are fatigue, shortness of breath, and brain fog. In studies, people report that even two years post-COVID, these symptoms have prevented them from returning to normal functions, such as work and school.

The technical expert noted that post-COVID can affect individuals who were asymptomatic and those who had mild, moderate, or critical disease.

Dr Peiris said 200 studies with more than 120,000 participants found a 57 per cent incident of any post-COVID symptoms six months from the onset of the disease, not linked to the severity of a person’s illness.

She pointed to a study published in the Lancet this month — one of the longest longitudinal studies of COVID survivors — following more than 1,000 patients for two years.

It found that at six months, 68 per cent of survivors had at least one sequel, and that there was only a slight decrease — down to 55 per cent of at least one symptom, all the way through two years post-acute infection.

“What it shows you is that even two years down the line after acute infection, there is more than half of patients still having symptoms,” she noted, adding that this has been associated with decreased quality of life, for these sufferers.

At the same time, PAHO says there is evidence that the COVID-19 vaccine could have a protective effect against post-COVID conditions.

Dr Peiris stressed that as there is no single diagnostic tool for long-COVID, which means patients must undergo a comprehensive system of care to treat and manage their symptoms.

She noted that PAHO has been supporting countries in the region to implement care models for post-COVID-19 conditions which include a primary care pathway, access to multidisciplinary rehabilitation, and specialised medical services, focusing on both hospitalised and non-hospitalised patients.