KUALA LUMPUR - As a Malaysian state lawmaker, Madam Kamache Doray Rajoo has many responsibilities and a busy work schedule, giving political talks and helping her constituents in Pahang.

But after she contracted Covid-19 in January, the 51-year-old has to slow down as she is suffering from "long Covid" syndrome.

"I get very tired every day. I used to be able to walk long distances before. Nowadays, I am unable to walk fast or long distances because I will have difficulty breathing," Madam Kamache told The Straits Times.

"I used to give speeches at political rallies, but now I can't even say more than two or three sentences as I have been wheezing almost every day."

She cannot sleep at night due to back pain and is also afraid she may have breathing difficulties while she is asleep. "It's a phobia that is already there now. I'm having sleepless nights. It is a nightmare."

For education consultant Sue Azni, 47, she has experienced a long list of health problems after recovering from Covid-19 last month.

These included fatigue, difficulty in breathing, brain fog, headache, tinnitus (ringing in the ears), joint pain, depression, chest pain and rashes. "I am on medical leave. I can't cope with all my work duties, I am not fit enough," she told ST.

"I have trouble understanding and thinking now. I am also slow at typing now. I just did a cognitive test today and the result was not so good. They are referring me to a neurologist," she said.

Fortunately, her employer has been understanding. She has been going for follow-up treatments at a government hospital and also has an insurance policy.

Malaysia has been struggling to control a resurgent third wave of the coronavirus which is still chalking up more than 4,000 new cases a day in the last few weeks.

Health director-general, Tan Sri Dr Noor Hisham Abdullah, earlier this month revealed that a clinical study conducted by the ministry showed that more than half, or 66 per cent, of 1,004 category 4 and 5 Covid-19 patients who required oxygen or intubation, suffered from long Covid.

"This syndrome is a condition in which a former Covid-19 patient still shows signs and symptoms for a period of up to 12 weeks or more and those symptoms cannot be explained by any alternative diagnosis. This condition results from a complication of Covid-19 infection on the function of various organs in an individual's body," said Dr Noor Hisham.

Treatment is given based on symptoms exhibited by the patient.

He said patients will be referred to the relevant areas of expertise and that clinical studies will continue to be conducted to understand and identify the effects of long Covid.

The most common symptoms include fatigue, dyspnea or shortness of breath, joint pain and chest pain, as well as psychological distress, such as post-traumatic stress disorder, anxiety, depression, concentration and sleep abnormalities, said Associate Professor Malina Osman, an epidemiologist and biostatistician at Universiti Putra Malaysia.

Long Covid can affect multiple organs and all age groups, including paediatric patients.

She cautioned that the true figure of long Covid sufferers may be higher than the study suggests.

"There is a possibility that some of them did not go to government hospitals for treatment or they may just simply stay at home or go to private clinics," she told ST.

"As we have more than 700,000 cases, some of those who survived may have these complications. Therefore we have to anticipate these issues to offer better care for those affected patients, particularly if they have underlying chronic disorders as well."

Malaysia on Friday (June 25) reported 5,812 new cases, raising its total cases to 722,659.

State assemblyman Madam Kamache said she is slowly recovering and has resumed some of her duties, including sending out food bags to her constituents during an ongoing nationwide lockdown.

But for others, the effects may linger longer.

Dr Malina said: "The symptoms can last for more than a year and this produces challenges for future chronic management of Covid-19 infection."

What is long-haul Covid-19?

Long-haul Covid-19 refers to the long-term symptoms that some coronavirus patients continue to experience after recovering from the disease.

The symptoms may persist for weeks and months.

Studies show that this can occur in anyone infected with the coronavirus, regardless of their age, severity of illness, or whether they were symptomatic during infection.

What are the symptoms?

The symptoms vary, but many patients have reported suffering from breathing difficulties, pain, fatigue, high blood pressure, high cholesterol, headaches and insomnia long after they recover.

Some have also reported experiencing loss of their senses of taste and smell, as well as brain fog.

What proportion of patients are affected?

A recent United States study found that nearly a fifth of Covid-19 patients without symptoms went on to experience conditions consistent with long-haul Covid-19 a month after their initial diagnosis. The figure grew to 27.5 per cent among symptomatic patients who were not hospitalised, and to half among those who were.

Health experts have also said that these symptoms appear to be afflicting more younger people.