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May 2022, Volume 72, Issue 5

Student's Corner

The COVID long-haulers: A letter to the Editor

Anousheh Awais Paracha  ( 1st Year MBBS Student, Dow Medical College, Dow University of Health Sciences, Karachi, )
Muhammad Sameer Arshad  ( 2nd Year MBBS Student, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan. )
Muhammad Azam  ( Allama Iqbal Medical College, Lahore,Pakistan. )



Madam, corona virus disease 2019 (COVID-19) is a global pandemic that has affected over 174 million people and claimed over 4 million lives as of July 2021.1 However, an aspect often overlooked is long COVID which includes signs and symptoms that develop or continue to persist in patients after acute COVID-19.2 This has multi-organ system effects including cardiovascular, neurologic, pulmonary, psychiatric, and dermatologic manifestations.3 In a recent study conducted by H.E. Davis et al., Davis and colleagues surveyed 3762 patients with confirmed or suspected long COVID-19. The results showed the prevalence of 203 symptoms spanning over 10 organ systems.4

The current guidelines place great emphasis on controlling the spread of this infection. While this is imperative, the long-term effects are often over-looked. Evidence shows that patients exhibit higher rates of morbidity and mortality in the six months following diagnosis of acute COVID-19 infection.4 Long Covid has affected a significant number of health-care workers having a direct impact on the health system. Individuals who were physically fit and active prior to the infection find it increasingly challenging to perform basic daily tasks owing to brain fog.5 The paucity of evidence across online databases regarding management of long COVID shows the lack of attention given to this factor.

Keeping in view the urgency of the situation, multidisciplinary research is required to understand this widespread disease so further action can be taken. Governments must ensure that patients are provided with rehabilitation facilities post-acute infection. Measures including designated paid leaves and rebalancing of workload are required in workplaces to reduce the burden on patients. A multidisciplinary approach should be adopted when dealing with patients with acute infection whereby healthcare professionals keep long-term risks in mind. Special care should be taken while administering drugs at the time of acute infection in order to improve the long-term prognosis in COVID-19 patients. An approach utilizing telemedicine will help provide monitoring facilities including guidance on management of the symptoms. Awareness campaigns must be put into place in order to educate the population about the effects of long COVID. Keeping in view the psychiatric and mental effects, long-term rehabilitation is required. All patients who recover from COVID-19 must undergo evaluation and be provided with the required treatment. In conclusion, the emerging evidence of long COVID merits for urgent and effective public health measures to reduce the burden on the already struggling health system.


Acknowledgement: None to declare.

Disclaimer: None to declare.

Conflict of Interest: None to declare.

Funding Sources: None to declare.




1.       COVID Live Update: 191,230,672 Cases and 4,105,847 Deaths from the Coronavirus - Worldometer. [Online]. [Cited 2021 Jul 19]. Available from: URL:

2.       Overview. COVID-19 rapid guideline: managing the long-term effects of COVID-19. Guidance NICE. [Online] [Cited 2021 Nov 24]. Available from: URL:

 3.      Post-COVID Conditions: Information for Healthcare Providers [Online] [Cited 2021 Jul 19]. Available from: URL:

4.       Davis HE, Assaf GS, McCorkell L, Wei H, Low RJ, Re'em Y, et al. Characterizing long COVID in an international cohort: 7 months of symptoms and their impact. EClinicalMedicine 2021; 38: 101019.

5.       Ladds E, Rushforth A, Wieringa S, Taylor S, Rayner C, Husain L, et al. Persistent symptoms after Covid-19: qualitative study of 114 "long Covid" patients and draft quality principles for services. BMC Health Serv Res 2020; 20: 1144.

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: