New long COVID deep dive

With around 5% of COVID-19 patients estimated to develop long COVID, it remains a global health issue.
 
In response, a team of GPs, public health experts and rehabilitation physicians with expertise in long COVID has launched a new podcast investigation into the condition, designed to arm healthcare professionals with the most up-to-date and detailed information.
 
Combining emerging research findings with practical, hands-on tips and advice, the series was designed to deliver accessible education and information, with its creators keen to ensure the disease stays on the radar for health funders and policymakers.
 
The podcast will be hosted by Dr David Lim, a GP and medical educator, and includes infectious disease researcher and CEO of the Burnet Institute Professor Brendan Crabb, GP and public health physician Associate Professor John Litt, and Professor Steven Faux, a rehabilitation and pain physician.
 
Professor Crabb uses his podcast to speak about current research on long COVID’s risk factors, pathophysiology, and emerging treatments
 
He explains the proposed mechanisms driving the condition, the role of antivirals in reducing its duration, severity, and what should be in a GPs’ toolkit of prevention.
 
‘There is the perception that COVID-19 is simply an acute respiratory disease, but it is really a systemic and chronic illness,’ Professor Crabb told newsGP.
 
‘There have been breakthrough developments in the last couple of years, such as defining the role of viral persistence and unusual thrombotic mechanisms underlying long COVID pathology, but the rate of translating that into treatments lacks the urgency that existed in the emergency phase of the pandemic.
 
‘Diagnosis is especially tough – a finger-prick blood test for long COVID would be a complete game-changer. There are many options for diagnostics on the horizon, but it will be a hard road.’
 
The series will also include long COVID definitions, incidence and symptoms, describe clusters of presentations and useful investigations for GPs to utilise, and evidence and tips around approaches to rehabilitation, including paced return to exercise, and liaising with workplaces.
 
Associate Professor Litt, who is also former RACGP Expert Committee – Quality Care Deputy Chair, said many of the current long COVID standard approaches ‘don’t really cut it’.
 
He has been involved with the development of an evidence-based long COVID risk calculator, CoRiCal, which, developed by a consortium of Australian universities, can be used to calculate an individualised estimate of the risk of developing long COVID.
 
Associate Professor Litt told newsGP the developing team hopes the calculator can enhance shared decision making and inform the decisions patients make in consultation with their GPs.
 
‘You put in your age and gender, if you’ve got any comorbidities, how many COVID vaccines you’ve had, and when the last one was, and any COVID infections you’ve had, it quantifies your risk of having long COVID symptoms,’ he said.
 
‘It divides long COVID symptoms into each of the systems, brain, cardiovascular, respiratory, gut, and it gives an estimate as a chance of one in X number of cases per million.
 
‘We can contrast your [current] state compared with if you have another booster, or you’ve got access to antivirals, or Metformin, and use that to reduce your risk of long COVID.’
 
With the podcasts now available to listen to, Professor Crabb said GPs must be familiar with the long COVID support, advice and symptomatic treatments that exist and how patients can access them.
 
‘We also want GPs to encourage their patients to protect themselves from getting infected and re-infected because each re-infection carries a risk of long COVID,’ he said.
 
‘One of the lesser-known aspects of COVID-19, is the likelihood that the higher the infective dose you receive, the more severe the disease you get.
 
‘How much virus is circulating in a room and how long people are exposed to it all play a part in determining the severity of the infection.
 
‘If you can reduce the amount of virus you are exposed to, chances are you can reduce your risk of infection and the severity of that infection.’
 
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