Long Covid

Long Covid, which often refers to Post Covid syndrome, describes a series of chronic symptoms, such as fatigue, that can occur after the acute illness. The term Long Covid refers to the prolonged persistence of symptoms for up to 12 weeks. If the symptoms are still present after 12 weeks, this is actually referred to as post-Covid syndrome. Nevertheless, the two terms long Covid and post-Covid syndrome are often used interchangeably.

Most sufferers report the following symptoms:

• prolonged fatigue (severe exhaustion)
• Breathing difficulties (dyspnoea)
• cognitive impairment (so-called brain fog)

The following can also occur

• Muscle pain
• joint pain
• palpitations/heart rhythm disturbances/circulatory problems
• Pain in the limbs
• Loss of sense of taste and smell
• Cough
• Headache
• Rash

You can find out more about Long Covid in here.

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ME/CFS

The above symptoms are very similar to those of another chronic illness - ME/CFS. ME/CFS is the abbreviation for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome. This is a neuroimmunological multisystem disease. One of the most common symptoms of ME/CFS is the so-called post-exertional malaise (PEM). This is an extreme form of fatigue (exhaustion) that can occur up to 48 hours after physical or mental exertion. Other symptoms in patients include

• Orthostasis intolerance (worsening of symptoms when changing to an upright posture: dizziness, weakness, palpitations or shortness of breath)
• Hypersensitivity to stimuli (e.g. light, odors, chemicals, food)

You can find out more about ME/CFS in here.

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Similarities in the symptoms

A review that systematically summarizes and evaluates the results of previous studies has shown that In 25 of 29 known ME/CFS symptoms, at least one study reported the same symptom in Long Covid patients.
This means an overlap of 86% between the two clinical pictures.

These include, among others :

• Fatigue
• Post-exertional malaise
• Concentration problems and difficulty finding words
• Sleep problems
• Pain (headaches, muscle pain)

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Medical similarities

Current studies on the similarities between post Covid and ME/CFS show some medical similarities, such as

• Reduced deformability of red blood cells
• Reduced blood flow to the brain.
• Reduced metabolism in the brain
• Dysfunction of the endothelium (innermost cell layer of the blood vessels) with impaired oxygen supply to the tissues

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Differences between Long Covid and ME/CFS

There were some symptoms that were described exclusively in ME/CFS or Long Covid within the above review. In Long Covid, these are loss of sense of taste and smell and rashes.

Symptoms that were only described in ME/CFS in the review were hypersensitivity to stimuli such as light and odors, lymph node swelling and pain, tinnitus and double vision. Problems with motor function were also only described in ME/CFS in the review. However, this can also be different in individual cases, as the clinical pictures overlap at many points.

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Treatment of Long Covid and ME/CFS

Due to the great similarity in the symptoms of the two diseases, the current guidelines also provide for similar, symptom-oriented treatment. This is primarily based on behavioral therapy and exercise therapy measures to alleviate symptoms and prevent chronification.

It can be helpful for those affected to engage in stress reduction measures and adequate coping behavior. Coping means using methods to deal with the symptoms, even if they cannot be completely eliminated. Roughly speaking, this means that those affected should neither do too much nor too little.

This includes pacing, for example, which involves better assessing your own energy reserves. During each activity, attention is then paid to the individual energy level in order to avoid overexertion. In addition, exercise therapy with dosed physical training can be helpful in slowly becoming more efficient again. Cognitive performance training can counteract memory and word-finding disorders.

Psychotherapeutic and drug therapies are used to treat other symptoms such as pain, circulatory problems, sleep problems or depressive moods.

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What's next?

Due to the large number of people affected, research into the treatment of Long Covid is in full swing. The media and interest groups have also taken up the issue and raised awareness of Long Covid and ME/CFS. On May 4, 2020, the Bundestag's scientific service published a statement on the need for care and research into ME/CFS. It calls for “immediate publicity campaigns, care structures including professional participation opportunities, research networks and systematic medical training and continuing education programs”.

As a result, the Bundestag Budget Committee has decided to release 5 million euros for research into treatment options for ME/CFS and Long Covid. This will be used to set up a National Clinical Study Group (NKSG) to conduct research into the two diseases across Germany.

Those affected are certainly watching the latest developments with interest. The funding of research projects and further studies on ME/CFS and post-Covid syndrome could provide new insights in the near future. In addition, doctors are becoming increasingly aware of the previously rather unknown disease ME/CFS. This suggests that a diagnosis can be made more quickly in the future and earlier treatment will be possible.

Follow-up studies of the previous SARS pandemic in 2002/2003 showed that 27.1% of 233 surviving patients subsequently suffered from ME/CFS. As the SARS virus also belongs to the coronavirus family, findings from the SARS pandemic could also be of interest to those affected by Long Covid.