COVID-19 patients are being recruited for a study of the long-term impact of the virus, with an emphasis on cardiovascular disease. Preliminary results on lasting symptoms are expect in three months.
By then, the exact persistent symptoms of the virus and a rough estimate of the number of people suffering from these will be known, according to the doctors behind the research. The idea is to get a picture of what is going on in the local population as regards the condition termed long COVID.
In addition to morbidity and mortality, long COVID describes prolonged illness in patients who have either recovered but still experience symptoms such as fatigue, difficulty breathing, insomnia, joint and chest pains, or who have suffered these for longer than expected.
It is important to distinguish between virological and clinical cure, said the chairman of the Department of Medicine at Mater Dei Hospital, Prof. Stephen Fava. He explained that virology, noted daily in official statistics, means a negative test result and no more risk of contagion, but not necessarily that all symptoms have subsided.
The research is likely to continue for three years as needed, said consultant cardiologist Caroline Magri, who is supervising the PhD study by Rachel Xuereb, conducted in collaboration with the departments of Medicine and Pathology.
Some 30 patients who tested positive in September have so far been recruited, but between 200 and 400, including those who were negative at the same time to compare results, are needed for the study.
They are being urged by the researchers to take up the letter of invitation that will be sent to them.
Elevated cardiac markers
International studies have shown elevated cardiac markers, used to evaluate heart function and useful in the early diagnosis of disease, in patients with COVID-19, Magri pointed out.
Assessments of the lining of the vessels and heart in COVID-19 patients have found the presence of the virus, causing inflammation that could result in long-term problems.
Local patients with elevated markers will undergo specialised tests to assess whether the heart muscles could be affected, she said.
The study stems from the fact that SARS, a viral respiratory disease that did not affect Malta but is related to COVID-19, has been shown to cause long-term derangement in metabolism, glucose and lipid profiles that could lead to atherosclerosis, Magri explained.
Meanwhile, COVID-19 clinics are also being set up by Magri and Fava to assess any long-term problems in every positive case in Malta.
It is currently being determined whether it is logistically possible to follow up most, if not all, COVID-19 patients, barring the elderly and children.
Junior doctors will from next week be contacting people who contracted the virus to assess symptoms following recovery, connected with long COVID.
They will be carrying out questionnaires on quality of life, and on the basis of feedback, will assess who needs to be followed up with simple blood tests and further investigations at hospital, the consultant cardiologist said.
“This is for their own good to identify any long-term problems that no one knows of yet,” she said, urging patients to be responsive to the calls.
“The start of the clinic is dependent on whether we are inundated with COVID-19 cases,” Magri continued.
The areas most affected by COVID-19 are the heart and lungs, and respiratory physicians, who currently have their hands full with positive cases, are likely to come on board in future, she said.