Is long-COVID a problem for me?
A proportion of people who had an apparently mild COVID-19 infection continue to suffer with persistent and cyclical symptoms, including chest pain and palpitations, shortness of breath, muscle and joint aches and pains, headaches, cognitive impairment (‘brain fog’) and fatigue. This is called ‘long-COVID’, and seems to be a multisystem disease that sometimes occurs after a mild acute illness. Some people struggling with these persistent symptoms refer to themselves as ‘long haulers’. The image below illustrates the range and complexity of symptoms reported by people with long-COVID.
As a General Practitioner, I became aware of this problem in late Spring 2020, after a number of female patients presented with ongoing COVID-19 symptoms that impacted themselves, their families, and their ability to work. At the same time, people were publicising their problems through the media, and many individuals with ongoing problems described difficulties in getting help for their symptoms.1,2,3
I was concerned that this phenomenon of long-COVID was not being recognised as a condition that needed attention. I conducted a study4, interviewing people with persistent symptoms following coronavirus infection in Spring 2020. A summary of the findings (below) was shared with participants to check out the analysis and meaning of the data.
Study participants were recruited using advertisements on social media. Out of 30 people interviewed, only 6 were male. This disparity in response got me thinking: is long-COVID affecting men less than women? Or are men more reluctant to come forward and take part in research? Perhaps men are affected by long-COVID but they are not seeking the help they need from the health service?
I spoke with Ashish Chaudhry, a general practitioner (GP) who has been affected by long-COVID to get his take on why men may not be coming forwards with symptoms or seeking help. Ashish reflected that the epidemiology of long-COVID is not known – there isn’t yet a code that GPs can use to record a diagnosis of long-COVID in a person’s records. As a result, we simply don’t know if women are more affected by ‘long-COVID’ than men. Perhaps men with persistent symptoms might be less likely to access healthcare – women are accustomed to seeking help, for example, participating in screening programmes – or if men feel there is a stigma is associated to seeking help with non-specific or poorly defined symptoms. Alternatively, a man presenting to a GP with chest pain or shortness of breath may be referred for investigations not linked with a COVID-19 infection. We already know that women with chest pain, which represents heart disease, are less likely to be investigated and managed appropriately than men.5
Ashish wonders whether men more than women might struggle with the identity of being ill, and whether fear of job loss might lead men not to present to their GP with symptoms that may be due to long-COVID. If so, then what is needed? There needs to be further research to determine whether men are less affected by long-COVID than women, and we need to encourage men who think they have persistent symptoms following COVID-19 infection to seek help from the NHS.
- Harding L. “It feels endless”: four women struggling to recover from Covid-19. Guardian 2020 Jun 7 (https://www.theguardian.com/world/2020/jun/07/it-feels-endless-four-women-struggling-to-recover-from-covid-19-coronavirus-symptoms; accessed August 2020).
- Garner P. Covid-19 and fatigue—a game of snakes and ladders. BMJ Opinion 2020 (https://blogs.bmj.com/bmj/2020/05/19/paul-garner-covid-19-and-fatigue-a-game-of-snakes-and-ladders/; accessed August 2020.
- Campbell J. Fears over thousands of “long haul” Covid-19 sufferers. Scotsman 2020 (https://www.scotsman.com/regions/fears-over-thousands-long-haul-covid-19-sufferers-2884703; accessed August 2020).
- Kingstone T, Taylor AK, O’Donnell C, et al. “Finding the right GP’: a qualitative study of the experiences of people with Long-COVID. Not yet published.
- British Heart Foundation. Women get half the number of heart attack treatments as men: New blood test diagnoses more women with heart attack but gender gap in treatment remains. ScienceDaily, 2019 (https://www.sciencedaily.com/releases/2019/10/191015115352.htm; accessed 7 October 2020).