Long Covid Symptoms and Treatment: What We Know So Far

Among the many confusing aspects of coronavirus are the spectrum of possible symptoms, as well as their severity and duration. Some people develop mild illness and recover quickly, without lasting effects. But studies estimate that 10 to 30 percent of people report persistent or new medical problems a few months after their initial coronavirus infection – a constellation of symptoms known as long covid. People who experience mild to moderate illness, as well as those who have no underlying medical condition, may still experience some debilitating long-term symptoms, including fatigue, shortness of breath, irregular heartbeat, headaches, dizziness, depression, and memory problems. Concentration.

Such chronic medical problems are so diverse that a study by a patient-led research group evaluated 203 symptoms that can cause people to fluctuate or even appear blue after recovery.

As Dr. Ziad al-Ali, head of research and development at VA St. Louis Healthcare Systems and a clinical epidemiologist at Washington University in St. Louis, puts it, “If you’ve seen a patient with long covid, you’ve seen a patient with long covid.”

There is little consensus on the exact definition of the long Covid, also known by the medical term PASC, or the post-acute sequel to Covid-19. Although the World Health Organization states that the actual bouting or positive test results of chronic covid sickness begin three months later, the Centers for Disease Control and Prevention sets the timeline exactly one month later.

Some researchers and healthcare providers, using other time frames, make the study and efforts to measure the condition more difficult, says Dr. Al-Ali, who has conducted long-term research on post-covid problems.

When patients go to their doctor constantly experiencing symptoms, electrocardiograms, chest X-rays, CT scans and blood work do not always identify the physiological problem, Dr. Al-Ali said. Researchers are working to identify specific biological factors, called biomarkers, that are associated with persistent covid symptoms. These may include symptoms of inflammation or some molecules produced by the immune system that can be measured by blood tests, for example.

For now, physicians must rely on their patients’ description of symptoms and rule out alternative explanations or causes. A multi-disciplinary team of specialists evaluates patients to find out the best treatment options in some post-covid clinics.

It’s not clear exactly what drives the long covid, but research has begun to give some clues. Some experts theorize that when you first become ill, an immune system becomes overdrived which can cause inflammation and damage throughout the body, eventually leading to long covid symptoms, says Dr. Michael Peluso, an infectious disease physician at the University of California. Francisco.

“We know that during acute covid-19, some people have really regenerated immunity and some immunity decreases, and that response can determine how well one does,” he said.

Another explanation, experts say, is that your immune system never shuts down completely after an initial infection.

Research suggests that patients may be at risk for long-term symptoms. In a study of 209 patients published in January, researchers found four factors that could be identified early in a person’s coronavirus infection that seemed to be associated with an increased risk of developing symptoms two to three months later.

One reason was the level of coronavirus RNA in the blood early in the infection, which is an indicator of viral load. Another was the presence of autoantibodies – antibodies that mistakenly invade body tissues as they do in conditions such as lupus and rheumatoid arthritis. The third reason was the reactivation of the Epstein-Barr virus, which can cause mononucleosis and infect most people, often when they are young and then usually dormant.

The fourth factor was type 2 diabetes, although experts say that in a study involving a large number of patients, diabetes may be one of the few medical conditions that increase the risk of chronic covid.

Studies at post-covid clinics have also found other pre-existing medical conditions that can put people at risk for chronic covid. In a report of the first 100 patients treated for neurological and cognitive symptoms at a post-covid clinic at Northwestern Memorial Hospital in Chicago, 42 percent previously reported depression or anxiety, although such patients may feel more comfortable with neurological treatment. Other pre-existing conditions include autoimmune diseases and headaches.

Research has further suggested that there is a risk of developing long covid peaks in middle age, said Dr. Peluso says. The average age of patients in the Northwestern study was 43. An analysis of 78,252 personal health insurance claims across the United States found that people aged 36 to 64 accounted for nearly two-thirds of chronic covid patients. (But that study did not include most Medicare recipients, so it involved relatively younger patients.)

While women may be disproportionately affected, some studies have shown that about 60 percent of patients are women. Other long-term conditions, such as ME / CFS (Myalgic Encephalomyelitis / Chronic Fatigue Syndrome), have a similar pattern, with several symptoms similar to those of chronic covid.

Since the epidemic has had a significant impact on the black and Latino communities in the United States, and these groups have more limited access to medical care, they may also have a long number of covid cases, Dr. Peluso said.

The picture is still in focus, but several studies have suggested that taking a covid vaccine may reduce the risk of long-term symptoms – but not eliminate them.

The United Kingdom’s health protection agency conducted an analysis of eight studies that looked at vaccines and long covid before mid-January. Six were found that vaccinated individuals who were then infected with the coronavirus were less likely to develop symptoms of chronic covid than patients who remained unvaccinated. The other two studies found that the vaccine did not significantly reduce the chances of developing long covid.

In that analysis, a study of approximately 240,000 U.S. patients, which was not peer-reviewed, found that those who received even a single dose of the covid vaccine before their infection were seven to 10 times less likely to report symptoms than unwanted patients. Long covid after 12 to 20 weeks. But another large study of electronic patient records from the U.S. Veterans Health Administration, which has not yet been thoroughly reviewed, found that those who were vaccinated had a 13 percent lower risk of developing symptoms six months later than unwanted patients. Dr Al-Ali, one of the authors of the study, said most patients benefited from the vaccine because they were less likely to have lung problems and blood clotting problems.

“Reliance on vaccination as the only mitigation strategy is completely inadequate,” said Dr. Al-Ali. “It’s like going to war with a shield that only works partially.”

If you are worried about any chronic symptoms after a confirmed or suspected coronavirus infection, don’t be afraid to ask for help. Checking in with your primary care provider is a good first step. Many more doctors are becoming aware of the long covid symptoms and may recommend tests that may at least rule out other causes of your symptoms.

“Although we say that long covid is when the symptoms last for one month or three months after the infection, you do not have to wait long to get help,” said Dr. Al-Ali. “People must respect their symptoms.”

If you don’t get help from a primary care physician, you may want to look for a post-covid clinic, although Dr. Al-Ali admits that “it’s easier said than done.” Access to post-covid clinics can be difficult for those who do not have adequate medical insurance. And, in some states, people may have to travel hundreds of miles to get to the nearest one. You can find post-covid clinics near you in the Survivor Corps database.

Bring your medical records if you go to a new provider and make a list of all your symptoms, especially if you have cognitive problems and are likely to forget some health concerns during your appointment.

Some chronic covid problems can be managed with existing medications or treatments for symptoms such as headaches or gastrointestinal problems. The methods used can also be helpful over time for patients who often experience a stroke or brain injury, including physical therapy and “cognitive rehab.” Some people benefit from appropriate physical and mental health rehabilitation services and breathing exercises, which can help them gradually build strength and endurance for physical activity.

Other potential tools against long covid, including antiviral treatment, have only just begun to be studied. The National Institutes of Health is spending more than $ 1 billion on a large research effort called the Health Recovery Initiative, but progress has been slow so far. Lawmakers are pushing for better funding for long-term research and medical services.

Several groups, such as Body Politics, the Long Coveted Alliance, and the Survivor Corps, provide psychological support, as well as resources for treatment, disability benefits, and patient support.

Dr Peluso said people with long covid could also consider joining a research trial. You may be able to find ongoing clinical studies at universities and academic centers near you, or sign up to be part of a recovery initiative.

“Participating in research can be very empowering,” said Dr. Peluso

Leave a Reply

Your email address will not be published.