One-third of long Covid sufferers have serious brain issues after one year

Infectious disease expert tells Oireachtas committee up to one-in-20 with condition unable to function or get out of bed

One-third of people with long Covid are still suffering from significant neurocognitive defects after one year, while up to one-in-20 are still completely unable to function or get out of bed, according to one of the State’s top infectious disease experts.

Prof Jack Lambert, who established a clinic to examine the effects of long Covid at the Mater hospital during the early stages of the pandemic, appeared before the Oireachtas health committee on Wednesday. To date, the clinic has examined more than 1,000 patients.

While it is not yet possible to ascertain what proportion of those infected with the virus go on to suffer from long Covid, Prof Lambert said he is still dealing with patients who were infected in March 2020 who remain “incapacitated”.

“About one-third of our long Covid patients still have significant neurocognitive defects at one year,” Prof Lambert said. “It is less at 15 months, less at 18 months, but there is still a population of patients that just don’t get better.”

He said about 10 per cent of long Covid patients are healthcare workers, and the neurocognitive defects he described include “persistent brain fog, cognitive issues, exhaustion, sleep disturbances, and psychological issues they did not have before”.

“About 1-5 per cent are still disabled with long Covid at one year to the point they are unable to function, unable to work, unable to get out of bed,” he said.

“From our GP-supported publications, 15-20 per cent of people with long Covid have unexplained anxiety, depression, PTSD, and some are experiencing problem alcohol use to cope with the challenge of long Covid.”

Prof Lambert said that while damage to the lungs and the heart from Covid-19 appears to fully heal, the brain is the “primary target” of long Covid, and that it is not recovering in the same way.

“Covid-19 is a scary virus,” he said. “It damages the brain and it damages the immune system. I continue to wear my mask. I encourage people to take this virus seriously. We are still learning about it and it is not going to go away.

“So many long Covid patients are told there is nothing wrong with them and to just exercise more. There is the belief these patients are making up their illness, or if they just try harder and be mindful, they will get better. That doesn’t work for this condition.

“The reality is most of the patients I took care of were healthcare workers who have never missed a day of work in their lives. There is damage to the brain and that is where the focus should be.”

Prof Lambert said the current model of care for long Covid is “not sufficient” and it is letting patients down.

“What we propose at the Mater is a centre for neurorehabilitation with a national network to support GPs, as there are so many patients throughout the country with long Covid and many of them cannot travel as they are too ill,” he said.

“Of the 1,000 patients that I’ve seen, probably 20 of them needed pulmonary support short-term, but all of them needed neurological support. Neuro-rehab should be moved up to the number one issue. The other issues are minor.

“Access to neuro-rehabilitation is quite poor. We were under-resourced before Covid came along. Patients are quite limited in their options. They are spending a lot of money. It is even more of a challenge for those who cannot afford to access private care.”

Prof Lambert added that while vaccines prevent the infected from progressing to serious, acute illness, they have not decreased the number of patients at risk from long Covid. “That’s not the way these vaccines work,” he said. “If there is a benefit, it is a minimal one.”

Colin Gleeson

Colin Gleeson

Colin Gleeson is an Irish Times reporter