[The Long COVID Assault] Sick for Months... No Treatment Available

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# Lee (43), an office worker living in Jangan-gu, Suwon-si, Gyeonggi Province, tested positive for COVID-19 and has not regained his sense of taste even after two months. He thought he had a relatively mild case with slight body aches and loss of appetite during the isolation period, but since then, all flavors such as sweet, bitter, and sour have disappeared from all foods. Naturally, his appetite decreased, and as he became weak and tired, his concentration at work declined, and he felt lethargic and bothered by everything, disrupting his daily life. Lee said, "I try to eat spicy food on purpose, but I can only eat a few bites before putting down my chopsticks," adding, "When I cough repeatedly on an empty stomach, the pain feels like it pierces my ribs, which is not only agonizing but also embarrassing for those around me."

Cases complaining of 'Long COVID' (long-term aftereffects of COVID-19) have been rapidly increasing after COVID-19 infection. With the cumulative number of confirmed COVID-19 cases in Korea exceeding 17 million, the battle against aftereffects has begun.

Although confirmed patients are officially no longer COVID-19 patients after a one-week isolation period, some experience Long COVID symptoms such as cough, phlegm, taste and smell disorders, and depression. To date, Long COVID reported in academic circles includes as many as 200 symptoms such as fatigue, cough, shortness of breath, chest pain, muscle pain, loss of smell and taste, memory loss, sleep disorders, and depression.

The World Health Organization (WHO) defines Long COVID as symptoms lasting at least two months after confirmation, while the U.S. Centers for Disease Control and Prevention (CDC) defines it as symptoms appearing four weeks after infection.

According to an analysis released earlier this year by the Health Insurance Review and Assessment Service, 19.1% (4,139) of 21,615 confirmed COVID-19 patients visited hospitals with one or more aftereffects after recovery. This refers to newly occurring symptoms not recorded in medical records during the three-month and six-month follow-up periods after testing positive. A preliminary survey conducted by the National Institute of Health in cooperation with domestic medical institutions also found that 20-79% of confirmed patients complained of fatigue, shortness of breath, forgetfulness, sleep disorders, and mood disorders.

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According to statistics compiled by the COVID-19 Aftereffects Clinic at Myongji Hospital in Ilsan from the 21st of last month to the 11th of this month, patients most frequently complained of cough (31%) as an aftereffect symptom, followed by general weakness (13%), bronchitis (acute and chronic, 9%), breathing difficulties (9%), esophagitis (8%), gastritis (7%), and abnormal phlegm (7%). On average, it took 24.3 days for these patients to visit the clinic after being released from isolation. Among 545 patients whose isolation release dates were known, 14% (76 patients) visited the clinic after more than a month, and some patients suffered from aftereffects for over 749 days after isolation release.

Domestic experts predict that 10-20% of confirmed patients may experience COVID-19 aftereffects, estimating that by June, the number of Long COVID patients could reach 3 million. The WHO reports that 20-30% of confirmed patients suffer from such aftereffects, which means that based on this criterion, 3.4 to 5.1 million of the 17 million cumulative confirmed cases in Korea could experience aftereffects.

Experts emphasize the need to focus on early treatment for patients complaining of Long COVID symptoms despite the decrease in new COVID-19 cases and the government's easing of quarantine measures.

While Europe, the United States, and other regions that experienced large-scale outbreaks early in the pandemic have already reported various cases and conducted research on aftereffects, Korea, which saw a rapid increase in confirmed cases after the Omicron surge, has only recently begun to focus on COVID-19 aftereffects and complications. The Korea Disease Control and Prevention Agency's National Institute of Infectious Diseases has started a survey on aftereffects involving 1,000 recovered and confirmed patients, but the results are expected to be released around the second half of this year.

Accordingly, it is pointed out that patients should be guided to actively seek medical care if abnormal symptoms persist for more than three weeks after isolation release. In addition, systematic management guidelines and research on aftereffects are urgently needed. Ha Eun-hye, head of the COVID-19 Aftereffects Clinic Center at Myongji Hospital, said, "Most patients visiting the aftereffects clinic complain of two or three or more complex symptoms," adding, "It is important to comprehensively address aftereffects through collaborative treatment and, in severe cases, to continue appropriate treatment through follow-up observation in specialized departments."

Professor Kim Woo-joo of the Department of Infectious Diseases at Korea University Guro Hospital said, "A significant number of confirmed patients complain of not-so-mild aftereffects, and if they do not receive timely treatment, they may suffer lifelong physical and mental disabilities," emphasizing, "The government should establish treatment guidelines and prepare clinics for Long COVID syndrome to respond actively."

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