Long Covid mainly affects the brain as hearts and lungs have been found to repair themselves, Professor Jack Lambert has told the Oireachtas Health Committee.
This has led to as many as one in five Long Covid patients suffering from anxiety, depression, and post-traumatic stress disorder, while they bounce between different hospitals and GPs with no coherent national approach in place, the committee heard.
Thousands of euro are being spent by the State and sometimes by patients themselves to have tests done when pooling information would be more effective, he said.
Prof Jack Lambert, who treats Covid-19 patients and Long Covid patients at the Mater Misericordiae Hospital in Dublin, has found patients suffering with persistent 'brain fog' cognitive issues, exhaustion, sleep disturbances and psychological issues that they did not have before.
They also have blood pressure, pulse, and thermoregulation problems, which were “all due to a 'dysautonomia', abnormal signalling from the vagus nerve as it courses out of the brain,” he said.
“We became aware that the heart and the lungs repaired themselves,” he said. “And that Covid also affected the brain, and this is where residual damage persisted, and that some people, even a year after infection, had residual symptoms that were all referable to this brain inflammation.”
He said the system needs to listen more to patients. PET scans have shown areas of damage backing up descriptions of brain fog but access to these specialised scanners is limited, he said.
The Mater clinic, in partnership with UCD through funding from the Health Research Board, has seen over 1000 patients, has over 80 follow-up patients monthly, and 25 or more new patients monthly.
He told Social Democrat TD Roisin Shortall Omicron BA.5 is now surging in Ireland.
“The virus is not going to go away, it is going to infect everyone. It will not kill them as it did before,” he said. “But it will affect them and there are certain disabilities associated with that.”
Offering some hope to Long Covid patients, he told Fianna Fáil TD Cathal Crowe the majority recover within one year.
“The message is that our data shows in our clinics 30% of them still had significant symptoms after one year, but with time they improved,” he said.
“The percentage of them who had severe symptoms, can’t get out of bed, can’t focus, unable to go to work, that is a small number and it drops with time. But still, I have some patients who were infected in March and April 2020.”
Asked about treatment, he said a pilot study showed Low Dose Naltrexone seemed to help, within two months, for a group of patients who had been unwell for an average of 333 days.
Prof Lambert was critical of the Irish health system’s response to Long Covid, pointing out that a Model of Care published i September last year is still not enacted in a practical way at all chosen sites.
He called in particular for guidelines and structured support for GPs, telling Fine Gael TD Colm Burke that they do not have clear pathways for referring patients onwards.
He said having offered to assist with new guidelines many times, he only received a phone-call on Tuesday evening from the department of health.
He said every country is still learning about Long Covid, but when pressed said France appears to be “ahead of the curve” now, and although the UK is still more focused on physical symptoms, that is changing.