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Women over 40 (symbolic image) are more likely to develop Long Covid

Photo: Fabio Teixeira / ZUMA Wire / IMAGO

"There were phases of illness," says Claudia Ehlert in an interview with SPIEGEL, "when my limit was reached after half an hour's walk." Ehlert is a surgeon. She did not recover properly even months after being infected with the coronavirus and is now trying to help other people affected by Long Covid. (You can read the entire interview here.)

The problem is that much about the disease is still unexplained. The World Health Organization (WHO) estimates that up to 36 million people in Europe suffer from Long Covid.

According to a study from Germany, at least 6.5 percent of infected adults could still have symptoms six to twelve months after infection with the coronavirus. More than a third of those affected reported exhaustion, another third neurocognitive impairment, others headaches and dizziness.

After all, scientists have now compiled initial indications of how long patients suffer, what risk factors there are and how Long Covid can be avoided.

The disaster begins with the infection

The exact causes of Long Covid are still unknown. It is possible that the virus continues to circulate in the body of those affected or that tissue has been damaged by the infection. (You can read more about this here.) It is also possible that the virus misdirects the body's immune system and in this way causes the body to attack itself.

The WHO defines Long Covid as a disease whose symptoms appear within three months of infection with the coronavirus and last for at least two months. Fatigue syndrome is one of the most common symptoms. But sufferers also report chest pain, insomnia, joint pain, anxiety, loss of appetite, tinnitus, persistent changes in the sense of smell and taste. Some say that a kind of fog is gathering in their brains.

In the video: First Corona, then Long-Covid: The pandemic after the pandemic

The symptoms are varied, there is no clear test. The diagnosis is therefore usually carried out in the exclusion procedure. The WHO also only speaks of Long Covid when no other diagnosis can be found for the symptoms.

Who falls ill

According to an analysis, there are several factors that favor Long Covid:

  • According to the study, obesity and smoking, for example, increase the risk.

  • Women and everyone over the age of 40 are more likely to be affected.

  • Patients who had to be hospitalized with Covid-19 were also more likely to be diagnosed with Long Covid later on. However, people whose infection was asymptomatic are also affected.

  • Diseases such as asthma, diabetes or depression were also more frequently associated with Long Covid.

Even children and adolescents can contract Long Covid, albeit much less frequently than adults. According to a Danish study, the symptoms of Long Covid in most children and adolescents disappear within one to five months.

How long do the symptoms persist in adults?

In a study published in May with more than 1000,23 adult participants, almost 18 percent still had symptoms six months after infection. After one year, it was still 5.17 percent, after two years 2.<> percent. The subjects had been infected before vaccinations were available.

"In the first year, you have a higher chance of recovery," says the study's co-author, Tala Ballouz, according to Nature News. After a year, it becomes more of a chronic disease." Ballouz is an epidemiologist at the University of Zurich in Switzerland.

Neurological complaints subside only slowly compared to physical ones, further studies suggest. How seriously ill someone apparently also plays a role. In one analysis, people who had only mild symptoms after infection with the coronavirus recovered from Long Covid after a median of four months. In the case of seriously ill patients who had to be treated in hospital, the figure was nine months, more than twice as high.

After all, the risk of contracting Long Covid is apparently lower after the second infection with the coronavirus. At least that's what an initial study published in April suggests. However, it has not yet been independently audited.

What can be done about Long Covid?

In the meantime, as with other diseases, there is now a guideline for the diagnosis and treatment of Long Covid for physicians in Germany. But even this offers at best "orientation on the ground of a still limited data situation", it says.

Corona vaccinations could reduce the risk of Long Covid by 40 percent, according to an analysis. And the antiviral drug Paxlovid may also protect, a recent study shows. However, it was mainly men who took part in the study, and it is unclear whether the effect will be seen in all patients.

What is still missing is an effective therapy against Long Covid. For example, immunoabsorption, lipid apheresis and hyperbaric oxygen therapy are being tested. But as long as the clinical tests have not been completed, the guideline for physicians in Germany states: "is currently strongly discouraged from general use."