The hunt for a long Covid cure – from vaccines to antihistamines and singing

There was little in those early days of the pandemic that Dr Nathalie MacDermott hadn’t previously experienced. Having worked on the frontline of the Ebola epidemic in Liberia, West Africa, in 2014, the 39-year-old specialist in paediatric infectious diseases was well aware of what happens when a virus runs out of control. 

Working in a London hospital during the first wave, she knew from her experience with Ebola that there was a high chance she and colleagues would contract Covid. But what she could never have imagined is that one year on she would be left badly incapacitated by what started as a relatively mild infection. 

Today Dr MacDermott struggles to walk more than 200m without crutches and has problems with her bladder and bowel. She has lost sensation in her hands and feet, consistent with a spinal cord injury, although her scans continue to be normal. “Very slowly getting worse” is how she describes the ongoing deterioration of her health. 

“Living in London alone, it has been a challenge,” she says. “Obviously I have days where I want to throw something at a wall and moments where I think, what does this look like in the long term? But I tend to focus on the positive side. As long as I can practically address my limitations and continue doing most of what I did before, I can just get on with things.”

According to figures released by the Office for National Statistics this month, 1.1 million people in Britain were experiencing so-called long Covid symptoms over a four-week period after contracting the virus at least three months before. The sheer scale of those suffering from the condition and the breadth of symptoms associated with it means researchers are struggling to ascertain even the prevalence of long Covid – let alone what treatments might help bring it under control. But one year on, some broad trends are emerging. 

First, as various studies are now beginning to show, women of working age are more susceptible. Last month preliminary research presented to the government’s Scientific Advisory Group for Emergencies (Sage) claimed women under 50 who were hospitalised were five times as likely to develop long Covid as men in the same age group. Women were five times as likely as men to report a new disability, six times as likely to experience greater breathlessness and twice as likely to feel more fatigued up to 11 months after leaving hospital. Earlier findings by King’s College London showed women were twice as likely to suffer long Covid symptoms than men (although that risk levels out after the age of 60).

The other trend identified by the ONS is that younger people are particularly vulnerable. Long Covid rates were highest (18.2 per cent) among 25 to 34-year-olds, although statisticians say this is not yet clear whether it is down to an increased risk of catching the virus, or a particular susceptibility to lasting infection.

Last month, the PHOSP-Covid group – the first UK-wide study established to examine the recovery of patients hospitalised with Covid – offered an indication of the economic impact of long Covid. Of the 67.5 per cent of participants who were working before contracting the disease, 17.8 per cent had since ceased their employment.

The root cause of long Covid remains unknown, though it is likely to be down to the inflammatory response to Covid. Studies have shown long Covid sufferers have elevated levels of a chemical called C-reactive protein, which is a marker of inflammation in the body, associated with poor recovery from illness in general. Some experts have speculated that long Covid is more prevalent in women because of differences in their immune response to the virus: men may tend to “have a more severe condition at the time of the infection”, while women have “a continued inflammatory reaction that then leads to a higher likelihood of having long Covid”, Chris Brightling, professor of respiratory medicine at the University of Leicester and a PHOSP-Covid study researcher, said last month. It is known that autoimmune diseases – where the body attacks its own healthy cells and organs – are more common in women. 

Another possibility could simply be “survivor bias”, as more men have died from Covid-19. 

Last month the National Institute for Health Research published a review claiming the sheer breadth of conditions associated with long Covid means one in 10 patients suffer some associated symptoms – more than twice the number previously thought. Dr Elaine Maxwell, the author, suggests it may in fact be four different syndromes: post-intensive care syndrome, long-term organ damage, post-viral syndrome and potentially a separate novel syndrome, each with their own underlying causes.

Any treatments against such a wide range of syndromes remain in their infancy. The English National Opera and Imperial College have recently extended a pilot trial using singing and breathing lessons after some early positive results.

To date there have been more than 60 long Covid clinics established across England and Wales, but Dr Maxwell says she has not seen evidence of any successful treatment. “To better understand how to treat it we need to understand sub-divisions of long Covid better,” she says.

Meanwhile, emerging evidence suggests that coronavirus vaccines may improve symptoms. Dr David Arnold, a respiratory researcher at North Bristol NHS Trust, has been examining their effect on long Covid. In a study of 44 patients, which has not yet been peer-reviewed, he found that those who had been vaccinated reported an improvement in their symptoms, including breathing and joint pain, compared with those who had not. One month on from their jab, 23.2 per cent said that their long Covid symptoms had improved.

While there is certainly enough evidence to suggest that a mild initial infection does not prevent long Covid symptoms developing, Dr Arnold insists the risk remains highest among those who initially were hospitalised with the virus. Because vaccines also reduce the initial severity of the illness, he hopes the rollout will soon start bringing down long Covid cases. “I don’t think there is any doubt that vaccination will reduce long Covid in general,” he says. 

Gez Medinger, 41, is a London-based film-maker who has conducted his own long Covid research after suffering with severe symptoms for more than a year. Before contracting the disease last March he was running 90km a week and aiming for a time of two hours and 50 minutes in the upcoming London Marathon. Now just a walk to the nearest Tube station, or even a conversation over the phone, can leave him exhausted.

“This is an illness we don’t understand,” he says. “The control of your own life has been wrestled away from you.”

Medinger recently conducted a survey among patient support groups and found that of nearly 600 long Covid sufferers who had had a vaccine, a third reported feeling better, though just under a half felt unchanged.

Medinger himself experienced mixed results after the first vaccine.

He has had more luck with other experimental treatments. For six months he has been taking antihistamines, which were initially prescribed by Dr Tina Peers, who established a private menopause consultancy in 2019 and is investigating an as yet unproven link between long Covid and histamine intolerance. Medinger says they have “moderated my symptoms but are by no means restorative”.

Last October, a paper in The Lancet by researchers at Birmingham’s Queen Elizabeth Hospital suggested that niacin and folic acid should be trialled in research of treatment for long Covid (among other pre-approved drugs) because of their potential beneficial effect on muscles and the cardiovascular system. 

So varied are the symptoms that any broad brush treatments remain a long way off. While the vaccine has alleviated long Covid for some, when Dr MacDermott had her first dose of the Oxford/AstraZeneca vaccine she suffered a resurgence of symptoms that took her four weeks to recover from.

She is being treated by a neurologist and receiving physiotherapy, but says her prognosis remains “guarded”. 

She doesn’t know if she will ever be able to walk properly again, or end up in a wheelchair. But she continues to hope. “I’ve seen some pretty horrific things,” she says, recalling her time in West Africa. “But I just try to look on the bright side.”

Have you suffered from long Covid? Tell us about your experience in the comments section below.