Do people eventually recover from long COVID?

Written in association with: Dr Teresa Castiello
Published:
Edited by: Conor Lynch

In this article below, long COVID is discussed at length and in expert detail by esteemed leading cardiologist, Dr Teresa Castiello. She reveals how common long COVID is, and tells us what cardiac symptoms people with long COVID typically suffer from.

How common is long COVID?

We talk about post-COVID syndrome or long COVID when one or more symptoms persist for three weeks or more after the initial COVID-19 infection. Sequelae from COVID-19 are unfortunately significantly more common than long-term symptoms after flu. 

 

People with a minimum of two doses of the COVID-19 vaccination are reporting long COVID less frequently. However, long COVID remains very common, especially in women, obese people, in those with poor pre-COVID health, and also in patients who required hospitalisation prior to catching COVID-19.

 

On average, around six to 10 per cent of people who caught COVID-19 still experience chest pain or shortness of breath months after infection. Fatigue or brain fog sits at around five per cent, whilst it has been found that anxiety and depression is at roughly 15 per cent.

 

Additional symptoms such as adnominal disorders, headaches, or generalised pain have also been found to be present in up to eight to 10 per cent of patients. Tachycardia, including postural orthostatic tachycardia syndrome (POTS), is also frequently reported. Benign heart inflammation, renal damage, and diabetes have all also been found in patients suffering from long COVID symptoms.

 

What kind of cardiac symptoms are long COVID sufferers experiencing?

The main cardiac symptoms that derive from long COVID include chest pain, breathlessness, palpitations, fatigue, and alteration of both blood pressure and heart rate. 

 

Are people suffering from long COVID still contagious?

Most commonly, the PCR test becomes negative after a few days, and as such, the patient is no longer contagious, despite still being symptomatic. 

 

Do people eventually recover from long COVID?

As COVID-19 is a new virus, we do not have long-term data. Most of the long COVID cases tend to improve and then eventually recover, although this may take several months. Some damage remains irreversible, such as a large scar on the heart or on the lungs, and will require long-term follow-ups

 

How are chest pain and palpitations from long COVID treated?

First of all, it is important to understand the reason behind these symptoms occurring as the mechanisms related to COVID-19 causing chest pain and/or palpitations are different. Symptoms may in fact be caused by myocardial inflammation, and so a cardiac-specific inflammatory therapy is indicated in this case.

 

If chest pain is instead caused by damage to the small vessels in the heart, medication such as beta-blockers, calcium-antagonist, or nitrate are indicated.

 

Are elderly people more susceptible to long COVID?

We noticed quite early that the elderly were more endangered by acute COVID-19. However, long COVID is not just affecting those with severe acute COVID presentations, but also those with or who have had a mild dose of COVID-19. UK data shows that the highest risk age group is between 45 and 69, while elderly people (>80 years old) have a similar risk factor when compared to those aged between 18 and 24 years of age.

 

In fact, women and younger individuals commonly experience long COVID. Having said that, elderly patients hospitalised are more likely to experience fatigue and cognitive issues, while shortness of breath and chest pain are observed more commonly in younger individuals.

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Dr Teresa Castiello is an experienced cardiologist who specialises in chest pain and heart conditions. If you are noticing any long covid-related symptoms, be sure to book an appointment with her today via her Top Doctors profile.

By Dr Teresa Castiello
Cardiology

With over 20 years of medical experience, Dr Teresa Castiello is a leading cardiologist based in London. She specialises in acquired and inherited cardiomyopathyheart failurepreventive cardiology and family screeningsyncopehypertension, and cardiac magnetic resonance. Her decade-long career as a cardiologist has highlighted the importance of prevention and early diagnosis, balancing clinical experience and research. Dr Castiello has a holistic approach, taking into account her patients’ physical and mental well-being and their background, putting the person before his/her disease.

Dr Castiello graduated in medicine and surgery with honours from La Sapienza University, Rome in 2001, where she completed her medical and initial cardiology training (MD). In 2009 she specialised in cardiology at the University Campus Bio-Medico, Rome. Between 2009 and 2011 she dedicated her professional and personal time to three humanitarian missions, in Africa and East Jerusalem. Her longest mission was in Sudan where she worked at the Salam Center for Cardiac Surgery, on the outskirts of the Sudanese capital, Khartoum. Here she screened patients with suspected or documented cardiac diseases to select patients suitable for heart surgery. In Kenya, she tested the suitability to create a cardiac surgery unit and provided training to local staff. In East Jerusalem, she proudly collaborated with a children's NGO.

Following her time in Africa, she returned to Italy, where she earned a consultant cardiologist post at San Raffaele, Rome. Having gained almost ten years of medical experience, she then moved to England where she has since been working in all fields of cardiology with a specific focus on her areas of interest and expertise.

Dr Castiello practises at numerous London hospitals. Presently, she leads the heart failure and cardiomyopathy service at Croydon University Hospital as well as performing cardiac MRIs at St Thomas Hospital.

Thanks to her research commitment, she is leading several clinical trials at Croydon University Hospital, holding the position of a principal investigator. She also has a robust research network nationally and internationally. Since 2018 she has worked as heart failure educational lead (Royal Society of Medicine) for London, which involves organising and teachings for cardiology trainees. She has now been elected President of the Cardiology Section of the Royal Society of Medicine, a leading role for the education of future cardiologists.

Outside of her clinical duties, Dr Castiello is highly committed to national and international medical societies, namely the European Society of Cardiology, and holds many prestigious memberships and fellowships. Specifically, she has been Committee Member of the Patient care of the European Heart Failure Association (HFA) since 2018 and she is now Committee member of the newly formed Digital Health and Patient Care structural committee of  the HFA.   She has authored and co-authored peer-review papers and online educational resources.

Lately Dr Castiello is founder and director of M.I.A.L healthcare (Medici Italiani A Londra), the first Italian-speaking hospital based service in London. M.I.A.L’s model of care offers a patient-centres holistic approach for personalised medicine throughout the entire patient journey. M.I.A.L's long term plan is reinvesting part of the income in humanitarian projects focused on healthcare and education.

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