With ONS statistics revealing that almost 400,000 people in the UK have struggled with long Covid for at least a year after their initial infection, with sufferers reporting fatigue, muscle pain, brain fog, headaches, a fast heart rate and various other symptoms, many of them are asking ‘when will I recover?’ 

We talk to Dr. Ali Khavandi, a prominent cardiologist and holistic wellbeing expert and consultant at St Joseph’s Cardiology Centre at St Joseph’s Hospital in Newport.  Dr. Khavandi is currently working with Long Covid patients and believes that there is hope for sufferers – particularly when the physician can offer an individual pathway and holistic recovery plan for each patient.

Dr. Khavandi says:

“I had COVID-19 and can really empathise with sufferers, having taken 3 months to recover myself – although many patients have been sick for a year or more already.

These are the steps I believe will be most helpful in delivering improvements for patients:

Obtaining a clear diagnosis and assessment

“A new report from the BBC is interesting, because it was able to identify that there are two groups of Long Covid sufferers – those who were very seriously ill and those who had mild initial illness. While these sufferers share many symptoms, the prognosis and timescales for recovery are likely to differ, and this is what I have observed in practice.

“However, in both groups treatment needs to begin with really good imaging and diagnostics to establish whether there is any physical damage to the organs.

“Covid is a particularly nasty virus, and we sometimes see scarring on the lungs and heart as well as to other organs like the liver and kidneys.

“I am fortunate to work with patients at both St. Joseph’s Cardiology Centre and United Hospitals Bath – both have exceptional diagnostic equipment. At St. Joseph’s, we also have access to a Lung Health Check and a CaRi-Heart Health Check, which utilise the latest AI technology.

Access to the best diagnostic equipment available gives us a head start, because a thorough assessment is critical if we are to offer these patients a positive outcome.

Tackling Diagnostic Challenges

“The sheer numbers of patients presenting with Long Covid symptoms is likely to raise issues for the NHS – budgets and diagnostic resources are already stretched post-pandemic and there are also nurses off work with Long Covid. The burden of adding almost 400,000 new patients in need of specialist assessment is a challenge – but one which needs to be met.

“Patients who were very sick initially are more likely to have measurable physical damage – and if a patient has been ventilated or very seriously ill with any other illness, we would not expect them to be back at work quickly. Year-long recovery timescales are not uncommon and Covid 19 patients are no different.

“Organ damage is something we already know how to treat, such as a weakened heart or damaged lungs. The established treatment pathways for helping patients recover from these will be equally effective for damage caused by COVID-19.

“Provided the damage has not been catastrophic, we usually achieve good results through treatment, and even with catastrophic damage, we can normally help patients improve.

What if imaging reveals nothing?

“Where diagnostics reveal no clinical findings but the patient is struggling with Long Covid symptoms, this is broadly similar to the pattern we see in other post-viral patients who are recovering from what has been essentially a ‘shock to the system’. We can expect many of the patients who were not initially seriously ill to fall into this group – their symptoms are very real and have a physical cause.

“Certain illnesses can overwhelm the body’s autonomous nervous system, causing it to react inappropriately to stimuli, leaving the patient exhausted and suffering an entire repertoire of unusual symptoms – which would certainly explain the multitude of long covid symptoms.

“There is no ‘quick fix’ for this, but a holistic, tailored approach that includes diet and regulated exercise will help to reset the autonomous nervous system and help the body recover normal function – something we already do with ME patients, many of whom improve or recover.

Creating a Recovery Plan for Long Covid Sufferers from both groups

“In addition to any treatment for specific damage, I believe that treatment for both Long Covid groups will deliver the best outcomes from a tailored treatment plan with the following characteristics:

1) As well as treating any physical injury, a plan must be individually tailored to the patient and include rest, appropriate levels of exercise and diet as well as ‘medical’ options. For recovery from any long-term illness, in my view this approach achieves more than a prescription alone.

2) A plan must consider both physical AND mental health – with a huge list of ‘strange’ symptoms from the patient’s perspective and a relatively new illness, supporting a long covid patient’s mental health will be vital to recovery, helping them recognise and celebrate small milestones and set realistic goals.

3) The plan must include progress monitoring and recording. If a patient does 10 steps one week and 11 the week after, that may seem slow progress but it is actually a 10% improvement. This is vital.

Delivering a Realistic Prognosis

“Of course, Long Covid patients want to know when they can expect to feel better – and with such a broad range of symptoms, that presents a challenge.

“The good news is that while the overall clinical pattern of Long Covid may be new, established treatments we use in other long-term illnesses are relevant and can help, and we already have an idea on recovery timescales for these.

“By working with patients on an individual treatment plan, setting realistic, long-term goals and supporting them to reach milestones, I am confident we can help the majority of Long Covid patients see significant improvement, if not full recovery over time. Time, rest and a tailored, 1:1 approach are key.”

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