Held hostage by COVID-19 for years

Held hostage by COVID-19 for years

UM leads research into Long Covid

29-06-2022 · Background

Long Covid is not just one, but several illnesses. This is what Maastricht researchers presume, who are co-ordinating a national research project into this "insanely heterogeneous syndrome".

Just look at all the different names that are being used, says Maastricht clinical epidemiologist Sander van Kuijk. “Post covid-19 syndrome, post-covid condition, post-acute sequelae of SARS-CoV-2, long covid. Whereby the last one is the most confusing of all in the Dutch-speaking world because of the suggestion of a lung disorder.” 

And yes, some patients are short of breath, even months later, but others don’t have that problem. They are mostly tired, have headaches, find it hard to concentrate, or have their hair falling out. Van Kuijk: "These are the five most frequently reported physical complaints, as was recently discovered in a meta study. The study included almost fifty thousand Dutch patients with persisting complaints. But the list of symptoms is much longer." 

In The Lancet, researchers counted 203 symptoms in ten 'organ systems'. That explains why each medical specialism has something to say about the illness. Cardiologists can still see damage to the heart muscle in a quarter of their patients six months later. Lung specialists report that the intake of oxygen is not reaching the blood properly. Neurologists are seeing a lot of cognitive complaints, such as a failing memory and ‘foggy’ heads. 

"If the manifestations are so diverse," says Van Kuijk, " it makes it difficult to speak of a single disease. Yes, it all starts with an infection of the SARS-CoV-2 virus. That is the trigger, but the results are insanely heterogeneous. Some patients don’t even have physical symptoms, just mental issues, depression, listlessness."

The World Health Organisation speaks of post-covid condition if people still have symptoms three months after the infection (and which have lasted for two months) and cannot be explained by other diagnoses.


Van Kuijk and Maastricht cardiologist Chahinda Ghossein are leading a national project, called Corona Follow-Up (CORFU), which brings together seven medical specialisms. The aim is to map out the persistent symptoms, the quality of life, and the underlying biological mechanisms. CORFU should also result in reliable predictions about which patients develop long covid and which don’t? In all, it affects one in five.

Van Kuijk: “The power of the project is that the various specialisms are working together. They are from the UMCs in Utrecht, Leiden and Nijmegen, but Zuyderland is also participating, as well as EuroQol, an internationally renowned agency that develops questionnaires. We are hoping to link symptoms that at first sight don’t have anything in common with each other. We are wondering, for example, whether there is a link between existing heart problems, such as arteriosclerosis, and persisting lung problems? Or whether patients in whom multiple organs have been damaged, have a greater chance of long-term symptoms?”

Not a lot is known about long covid. “We do know that patients who have spent time in the ICU have more risks than those who were on a normal ward. But, again, the picture is diverse. People who reported having a mild infection, are sometimes extremely tired six months later. And others who were in the ICU briefly now have no symptoms at all.”


To make things even more complicated: the long-term symptoms also differ per virus variant. What we do know, says Van Kuijk, is that delta variant caused more deaths than the omicron one. In the case of the latter variant, half of the Netherlands was sick, but the effects were less serious. We expect that those variants will have a different effect on the long-term symptoms. Something that also applies to the vaccination status. The fact whether people have been vaccinated or not, will unmistakably make a difference.” 

To be able to study this well, research financier ZonMW is funding CORFU with some six hundred thousand euro. Van Kuijk and Ghossein hope that the project, which will run until January 2023, will be eligible for additional funding.

“ZonMW demanded that the results should be available quickly, which of course is understandable. But now that we have been working on this for a while, we see that we have work for years. Our dream is that the present collaboration will result in a knowledge centre.”

Illustration: Simone Golob

Categories: news_top, Science
Tags: Long covid,covid-19,reserach,health,FHML,CORFU,project,study.instagram

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