Page 141 - COVID-19 COUNTRY REPORT: Moving Beyond Pandemic EDITION 2022

National Institutes of Health

disease 2019 (COVID-19) have been reported to WHO (26). The WHO estimates that 10-
20% of people infected with SARS-CoV-2 may develop symptoms classified as long Covid.
Globally, the estimated prevalence of long Covid was 37% one month after diagnosis, 25%
at two months, 32% at three months, and 49% at four months (27).
Long Covid has since gained international recognition in the literature, accompanied by
various other descriptors for prolonged or residual COVID-19 symptoms, such as ‘post-acute
sequelae of COVID-19’, ‘ongoing COVID-19’, ‘chronic COVID syndrome’, ‘long-haul COVID’,
and ‘post-COVID-19’ (28). This widespread acknowledgement underscores the importance
of understanding and addressing the long-term consequences of the virus for affected
individuals and public health.

6.4.1.2 Long Covid Stages
Long Covid can be divided into two stages based on the duration of symptoms, as illustrated
in Figure 6.4. Post-acute COVID-19 occurs when symptoms persist for over three weeks but
less than 12 weeks, whereas chronic COVID-19 occurs when symptoms last longer than 12
weeks (29, 30). This distinction is important for understanding the progression and potential
treatment strategies for individuals experiencing the lingering effects of the virus.

Chapter 6

Figure 6.4: Stages of long Covid. (Source: Raveendran A. V., et al. (2021))

According to several systematic reviews, patients worldwide experienced a wide range
of common ongoing symptoms, sometimes more than 60 physical and psychological
symptoms, including fatigue, malaise, altered smell and taste, breathlessness, and cognitive
impairments (31-33). There is also evidence of single or multiple organ impairment in low-
risk individuals (31). In Malaysia, almost 20,000 patients who recovered from the coronavirus
suffer from long Covid. The five most common symptoms of long Covid are lethargy (78.9%),
breathing difficulty while performing certain tasks (52.9%), coughing (18.1%), insomnia
(14.5%), and anxiety (10.4%) (34).
Based on a cross-sectional study conducted by Moy et al. (2022) from July to September
2021, 21% of the 732 survivors who responded to the online survey reported experiencing
long COVID. Approximately 88% had post-COVID-19 symptoms for up to 6 weeks after
diagnosis, 48% for more than six weeks, 21.1% for more than three months (Long Covid), and
10% for more than six months. Fatigue, brain fog, depression, anxiety, insomnia, arthralgia,
or myalgia were the most commonly reported symptoms of Long Covid (more than three
months) (34).

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