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‘Crushing exhaustion’: Long COVID takes toll on young patients
By Lucy Carroll
When Payton Jacobs caught COVID-19 during the peak of summer’s Omicron wave, she was unprepared for the symptoms that would linger months after the worst of her illness passed.
After spending the first two weeks of January laid up with the hallmark signs of the virus, the normally fit and healthy 18-year-old later struggled to return to daily activities such as school and sport due to crushing exhaustion and muscle pain.
Payton Jacobs at NSW’s first long COVID clinic at St Vincent’s Hospital in Darlinghurst.Credit: Louise Kennerley
Multiple GP and specialist appointments later, Ms Jacobs was finally referred to a team of doctors at the St Vincent’s Hospital long COVID outpatient clinic – the first facility of its kind to open in NSW.
Led by St Vincent’s Hospital’s director of rehabilitation Steven Faux and respiratory physician Anthony Byrne, the multidisciplinary post-acute COVID clinic, which opened this week, will support patients with ongoing symptoms such as fatigue, shortness of breath and cognitive dysfunction which in some cases can persist months after infection.
The clinic will initially see about 20 patients each week, with other facilities set to open at major referral hospitals across NSW including at Westmead, Royal Prince Alfred and Liverpool.
As coronavirus cases rise, driven by Omicron’s sub-variant, BA.2, services to “support patients with ongoing symptoms of COVID are being progressively implemented as required”, a NSW Health spokesperson said.
“There is still a significant amount we don’t know about what causes long COVID, and why some people develop these chronic symptoms,” Dr Faux said, noting that prevalence data in Australia is limited.
“We are seeing asthma-like symptoms, fatigue and brain fog, but we are not sure exactly why it occurs in some people and not others, or why some people recover six or 12 months after infection.”
Long COVID is generally defined by clinicians as people who have signs and symptoms of the virus that continue for more than three months after being infected and are not explained by an alternative diagnosis.
Dr David Darley, respiratory physician at St Vincent’s, who is also a lead researcher on the landmark ADAPT study, said the most recent data showed about 20 per cent of patients suffered persistent symptoms at eight months after infection.
Payton Jacobs, 18, with doctors Steven Faux and Morgan Hee at St Vincent’s Hospital long COVID clinic. The clinic opened this week. Credit: Louise Kennerley
“But this data was collected in the first 2020 wave and the prevalence of long COVID after the Delta and Omicron waves remains unknown,” he said. “We don’t know what effect vaccination will have on the rates of long COVID. We are doing ongoing studies that are trying to clarify that question.”
For Ms Jacobs, constant fatigue and “muscle aches and pain that are worse at night” has led her to has scale back the days she spends in the classroom, disrupting her first months of year 12.
“I’ve just been exhausted. If I’m at school, I need to rest twice a day,” she said, noting that after trying to return to her regular netball and basketball training in early February she found it impossible “to get through a game ... I had to keep stopping midway through”.
After running a broad spectrum of tests – which all came back clear – her GP referred her to Dr Morgan Hee, one of the rehabilitation medicine physicians who will treat her at the St Vincent’s Hospital clinic.
She will participate in a rehabilitation program, including a graded exercise program to build up endurance and strength and psychological treatments for fatigue.
“There are people we are seeing with just respiratory problems like breathlessness, fatigue cough and wheezing who need pulmonary rehab. And there is another group of patients that might have respiratory symptoms, but also have muscle joint pains and mental health issues after being admitted to hospital and ICU with severe disease,” Dr Faux said.
The clinic would take referrals from general practitioners, Dr Faux said, and extra specialists would be called on when needed.
“Most patients with long COVID are complex. They don’t have just one symptom they have a whole collection of persistent symptoms,” he said.
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