Tasmanian researcher looking for long COVID answerers

In 2020, following an outbreak of COVID-19 in the North-West of the state, NWRH registered nurse Janine Akehurst was diagnosed with COVID-19.

Ms Akehurst recovered from the initial symptoms of the virus, but subsequent symptoms, including fatigue and cognitive impairments, have forced the nurse to step away from her job at the hospital.

The prolonged illness is known as long COVID and can last for weeks and months after the coronavirus has run its course.

The moderately active 56-year-old, who worked at the NWRH for 21 years with no significant health issues prior to contracting the virus, said she hardly recognises herself after experiencing the long-term impacts of COVID-19.

"I very rarely took paracetamol or other medications," she said.

"I lived a very full life and I've been lucky enough to travel the world, but COVID changed my life so much that some days I don't recognise myself."

She said the fatigue she was experiencing had made it impossible to maintain the same workload she had undertaken prior to contracting COVID, with no amount of rest or recuperation able to abate the feeling.

"I was once a very active person that thrived on pressure at work, but now I struggle with the day to day tasks and sometimes the smallest tasks take a lot of effort," she said.

"When you are tired you have a good sleep and you feel better. I could sleep and never feel better."

In addition to the fatigue, Ms Akehurst said she suffers from constant headaches, chest tightness and heart issues.

She said the issue with her heart reached a critical point, and in September 2020 she had a stent placed in her coronary to regulate her heart rate and blood pressure.

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She said chronic pain was also an issue, with the nurse experiencing swelling and joint pain on a daily basis, and nerve pain that caused a burning sensation on her skin.

Ms Akehurst said while these issues had significantly impacted her quality of life, she had continued to work at the hospital.

However, after a while, the fatigue and cognitive symptoms of long COVID led the nurse to step away from her 11-year career as a scrub-scout nurse - for the foreseeable future.

She said the cognitive impairment has proven to be the most significant and pronounced issue stemming from her diagnosis.

"I have significantly lost the ability to hold information in my mind and manipulate it," she said.

"My visual-spatial working memory falls into the low average range, so it suggests I will have problems following everyday conversations and keeping up with my peers.

"My pattern of performance has been associated with damage to brain function."

Ms Akehurst said she initially returned to work on a three-day-a-week roster, but her fatigue and cognitive impairment resulted in that being reduced to one day a week, until she took time off indefinitely.

"I went back to work for six months on a return-to-work program, which I couldn't cope with because I just needed to sleep all the time, and so I wasn't functioning in my role," she said.

"I had just been going in there and doing some paperwork, which I even struggled with."

While little is known about long COVID, research is currently underway to better understand the illness and the long-term health impacts.

Launceston-based Australasian Society for Infectious Diseases president-elect Professor Katie Flanagan is part of a team working with researchers at RMIT in Melbourne to understand long COVID.

Professor Flanagan said at present, very little was known about the illness, but hoped new research underway would illuminate the issue.

"We're trying to understand what kind of immunological impact and long-term impact COVID-19 has on the immune system, and why that might lead to all of these symptoms - which are a really vast array of symptoms," she said.

Although Tasmania only recorded a limited number of COVID cases, Professor Flanagan said long COVID was common in adults who had contracted the virus, with about one in three people developing symptoms.

She said for some people the symptoms were minor and had minimal impact, while others found symptoms debilitating.

"For some, It's not too bad," she said. "They can function and carry on with their normal life and their normal working life, they just feel very fatigued and just not very well, and it will resolve. But for other people, I've heard descriptions of people being absolutely debilitated and just not able to work."

Professor Flanagan said she and her team had received funding from the Clifford Craig Foundation to collect blood samples from healthcare workers in the North-West region who had been infected with COVID-19.

She said the research would take a broad approach to understand what happens to the immune system over a long period of time, and investigate changes in people who had contracted COVID.

"Some of those people have experienced long COVID, some of them are still unwell actually, well over a year after they were infected with COVID and SARS COVID-2," she said.

"We're going to really interrogate the immune system of people that have experienced previous COVID and see what the long-term impact is."

Professor Flanagan said patients diagnosed with long COVID reported symptoms related to their muscular, cardiac and neurological systems and explained her research aimed to understand if the impact of COVID on the immune system could create an autoimmune response in other bodily systems.

She said while the research was expected to be ongoing, a range of COVID samples were being analyzed by colleagues at RMIT in Melbourne with preliminary results expected within the next 12 months.

Until more was known about the cause and effect of long COVID, Professor Flanagan said treatments would need to be based on a case by case basis - as no specific treatment existed.

However, with the symptoms of long COVID sharing similarities with chronic fatigue, Professor Flanagan said some relief could be sought if chronic fatigue treatments were applied to long COVID patients.

Ms Akehurst said she understood some people were hesitant about getting vaccinated, but said after living with the symptoms of COVID-19 for 18 months, she urged those with concerns to consider their health and the health of their families if they were to become ill.