You’re back in class, trying to keep up with lectures and assignments. There are no more mask regulations, and the six-feet-apart stickers have been removed from grocery store floors and subways. But something feels off.
Have we really beaten the pandemic?
You’re constantly exhausted, your brain feels foggy, and the walk between Robarts Library and the Medical Science Building leaves you winded. What if COVID-19 has left a lasting impact?
10 to 30 per cent of non-hospitalized and 50 to 70 per cent of hospitalized COVID-19 cases lead to prolonged symptoms.
Long COVID — or post-acute sequelae of COVID-19 (PASC) — is a chronic condition where symptoms persist for days, weeks, or even months after illness, and thousands are experiencing its effects. This isn’t just the tiredness from staying up until 3:00 am working on a project or the dizziness after skipping breakfast. Long COVID is still an emerging medical condition.
What is Long COVID, and who’s at risk?
According to research, 10 to 30 per cent of non-hospitalized and 50 to 70 per cent of hospitalized COVID-19 cases lead to prolonged symptoms. Over 200 symptoms have been identified, affecting various organ systems, and at least 65 million people are estimated to have Long COVID.
Long COVID’s adverse outcomes include cardiovascular disease, type 2 diabetes, and postural orthostatic tachycardia syndrome (POTS) — a condition that leads to a high elevation of heart rate when you go from sitting or lying down to standing up.
Some of the most common symptoms include fatigue even after rest, brain fog, dizziness, shortness of breath, sore throat, heart issues (eg. chest pain, POTS, or an irregular heartbeat), and muscle and joint pain. This collection of symptoms suggests the condition involves immune dysfunction and microvascular (the small blood vessels in the body) damage.
Scientists are investigating multiple potential causes, including immune system dysfunction, persistent viral fragments, blood clotting abnormalities, and imbalance in the gut microbiome.
Long COVID has no single cure yet, but emerging therapies — such as antiviral medications like Paxlovid, anti-inflammatory drugs, and even experimental gut microbiome treatments with probiotics — show promising results.
The Canadian context
A narrative analysis of Canadian patients found that individuals seeking treatment for Long COVID often experience medical skepticism, lack of effective treatments, and difficulty accessing specialists.
This analysis — alongside another study that analyzed the general public’s sentiments about long COVID — highlighted key challenges patients face, including the struggle to convince doctors, family, and friends that their symptoms were real, often being dismissed or told that their condition was psychological. The emotional toll of a new, less-studied illness was significant, with many turning to online support for validation and advice.
Many patients also had to navigate an exhausting healthcare system, dealing with multiple specialists and a general lack of knowledge about the condition. The growing need for research and better treatments is increasingly apparent, but addressing it remains a novel challenge that requires time and funding.
Dr. Angela Cheung: leading Canada’s fight against Long COVID
One of Canada’s most prominent researchers in Long COVID is Dr. Angela Cheung, a senior scientist at Toronto General Hospital Research Institute and a professor at U of T. As a leading expert in the field, Dr. Cheung has been at the forefront of Long COVID research, dedicating her career to uncovering the causes, risk factors, and potential treatments for this complex and persistent condition.
In 2023, the Canadian Institutes of Health Research awarded Dr. Cheung a $20 million grant to lead a nationwide study on Long COVID. This grant will fund critical research on diagnostics, rehabilitation, and innovative treatment options. Her work focuses on understanding how Long COVID affects different individuals, with particular attention to those at higher risk, such as immunocompromised patients and marginalized communities.
Dr. Cheung has also been a vocal advocate for improving patient care. In a recent episode of the podcast Behind the Breakthrough by University Health Network, she noted that Long COVID affects women more than men, although men tend to experience more acute symptoms. This may be due to a variety of reasons, from differences in hormone levels, socioeconomic factors, or even that women may be more attentive to their bodies and related distress.
Dr. Cheung’s work is not just shaping Canada’s response to Long COVID; it contributes to the global scientific effort to understand and treat this condition more effectively. In the podcast, she said, “I enjoy doing what I do. I like to be able to ask questions and try to find answers. I like looking after patients. I like to try to fill a gap in knowledge as well as, you know, science. I like to move things forward if I can.”
Long COVID may not make the news as often anymore, but its effects are life-changing for many. As research progresses, the goal is clear: to improve diagnosis, develop effective treatments, and ultimately, give those affected the opportunity to fully recover.
