Confusion over long Covid symptoms could result in conditions including cancer – particularly in children and young people – being missed, a member of the Government’s vaccine advisory board has warned.
Dr Maggie Wearmouth, a GP and member of the Joint Committee on Vaccination and Immunisation (JCVI), told i that working out which patients definitely have long Covid “will take up the next 10 years of the NHS”.
Doctors are reporting an increase in the number of patients with apparent symptoms of the disease, she added, but a too-loose medical definition means that they may instead be suffering from something else.
“One of the diagnostic dilemmas is about other diseases such as newly presenting cancer that may be overlooked if a patient already has a diagnosis of long Covid,” Dr Wearmouth said.
“This is particularly worrying in children and young people.”
Long Covid is a term used to describe symptoms that persist four weeks after patients are infected with coronavirus.
The NHS recognises symptoms including extreme tiredness, problems with memory and concentration — also known as “brain fog” — difficulty sleeping and shortness of breath as coming under the umbrella term of long Covid.
But there is no one set definition of the disease. Others symptoms noted include: headaches, a cough that won’t go away, low grade fever, muscle aches, hearing and eyesight problems, loss of smell and taste, gastrointestinal upset, rashes and hair loss.
The World Health Organization (WHO) has insisted that scientists’ understanding of long Covid may change over time as new evidence emerges, and that a separate definition may be needed for children.
“A lot of people I’ve spoken to who think they’ve got long Covid actually have perfectly good reasons for those symptoms after 40 years of smoking, pre-existing depression etc,” said Dr Wearmouth. “I don’t think they’ve got long Covid, but that doesn’t mean to say they don’t need help.”
She added that efforts to determine which patients have long Covid and which patients are suffering from other illnesses with similar symptoms would be “immensely difficult”.
One study published by the Mayo Clinic in August found that nearly half of long Covid patients have the same symptoms and meet the criteria for a myalgic encephalomyelitis diagnosis — also known as chronic fatigue.
Meanwhile, researchers at the universities of Manchester and Warwick, writing an opinion piece in The Lancet Regional Health, Europe on Tuesday, noted that “any symptoms of long Covid have a significant overlap with the perimenopause and menopause, both of which affect women of all ages.”
Brain fog, which is a persistent symptom of long Covid, is also common among women going through the menopause.
Dr Wearmouth suggested that long Covid is a “new evolving multi-system disease that is going to pose a significant challenge to health services for years to come”.
“I can see there are going to be people specialising in the many aspects of long Covid for decades. The more they study, the more they’re going to find out about it,” she said.
“Sorting out what is long Covid and what isn’t long Covid is going to take up the next 10 years of the NHS as far as I can see… How the NHS and social care cope with this demand remains to be seen.”
Medical attention is increasingly turning to the long-term effects of coronavirus as countries around the world emerge from the pandemic, leaving the spectre of long Covid hanging over health services around the world.
However, efforts to determine the true scale of the problem have proved difficult so far.
Around 1.1m people in the UK reported experiencing long Covid as of early September, according to the latest data from the Office for National Statistics (ONS) — equivalent to around one in 40 people in Britain.
But other research has suggested the disease could be far wider-ranging.
A study published in September estimated that one in three people infected with coronavirus will experience at least one symptom of long Covid.
Researchers at the University of Oxford, the National Institute for Health Research (NIHR) and the Oxford Health Biomedical Research Centre (BRC) studied more than 270,000 people recovering from coronavirus in the US.
They found that 37 per cent of patients had at least one long Covid symptom diagnosed three to six months after infection.
Scientists have also voiced concerns that high infection rates could have a knock-on effect on long Covid rates, after WHO warned in March that long-term symptoms may be experienced with people who suffered only mild symptoms while infected with coronavirus.
“Long Covid is not necessarily related to the severity of the initial infection, so if more people are infected, more risk developing long Covid,” said Dr Wearmouth. “Vaccination can significantly reduce this risk.”
Covid infection rates have settled in the UK over the past week, though they remain relatively high, with a further 33,865 cases reported on Wednesday.
Ravi Gupta, a professor of clinical microbiology at the University of Cambridge, said on Tuesday that high infection rates could cause long-term problems for children.
“I’m worried about the lack of appreciation of the negative impacts of mass infection in children, such as Long Covid and the risks of new variants emerging,” he told The Guardian.
The NHS announced over the summer that it would plug £100m into 15 specialist long Covid clinics for children and young people, while the Government has pledged an extra £20m to support new studies into the disease.
There are currently 90 specialist long Covid clinics across England — though there are zero in Scotland and Wales, and just one in Northern Ireland.
