A year after the start of the coronavirus pandemic, and amid the emergence of new variants of Covid-19 across the world, there is another related problem that people are now experiencing. This is called long Covid.
Long Covid is different from the ordinary Covid-19 infection that can last for weeks up to three months. The latter is called long-duration Covid and the patients recover if they do not succumb to the illness. According to Dr. Anthony Komaroff, editor-in-chief of the Harvard Health Letter, Long Covid is also different from the condition of patients who suffered damage to major organs such as the lungs, heart, kidneys, or brain because of Covid-19 infection.
What Is Long Covid?
Dr. Komaroff defines patients with long Covid as those diagnosed with Covid-19 but no longer have the virus detectable in their body, yet they still experience persistent symptoms of the infection. They should have no evidence of permanent damage to major organs that can be causing such symptoms.
Among the symptoms reported by long Covid sufferers are lack of energy, feeling exhausted and sick after slight mental or physical exertion, extreme fatigue, shortness of breath, body aches and pains, difficulty concentrating, mental haze, and forgetfulness. Others also report fever, headaches, rapid heart rate, gastrointestinal issues, lack of appetite, sleep disorders, dizziness upon standing up, anxiety, and depression.
Dr. Komaroff says early studies state that 10 percent of those infected by Covid-19 can develop long COVID. He adds that long Covid lasts at least a year and how long it stays is yet undetermined.
Findings from various literature show that long Covid can affect not only those who went through severe Covid-19 but also those who had mild and moderate cases.
There are many terms used for long Covid, such as post-Covid syndrome, post-acute Covid-19 syndrome, and long haulers. The National Institutes of Health (NIH) refers to it as post-acute sequelae of SARS-CoV-2 infection (PASC).
A study published on MedRxiv surveyed 3,762 respondents from 56 countries. All had Covid-19 that lasted for more than 28 days before June 2020, although only 8.4 percent were in the hospital. Many of them continue to experience symptoms that bring significant disability after seven months. The most common symptoms were fatigue, general weakness after exertion, and cognitive dysfunction or brain fog. Most had relapses triggered by physical or mental activity and stress. Because of their condition, 45.2 percent had to reduce their work schedule while 22.3 percent were not able to work.
In a study of 177 people by Washington University published in February this year, a third were still reporting symptoms nine months after they had Covid-19.
Long Covid Clinics
Some clinics cater to patients with long Covid. Most of them, however, require a prior diagnosis of Covid-19. This disqualifies long Covid sufferers who had mild Covid and did not undergo testing. Fortunately, there are some, like a clinic affiliated with the University of Minnesota Medical School, that accept all patients with long Covid symptoms.
If long Covid sufferers are house-bound and unable to perform daily tasks, they will need help from home health aides. These aides can visit their homes at certain hours to do the chores they cannot do for themselves, including personal tasks such as bathing and dressing if needed.
One Possible Diagnosis
The U.S. Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) Clinician Coalition encourages medical providers to consider a diagnosis of ME/CFS for Covid long-haulers. ME/CFS is a post-viral syndrome that frequently follows an infectious illness. Its main marker is malaise or feeling extremely exhausted and sick after physical exertion. Patients also experience flu-like symptoms, widespread pain, a considerable loss of function, difficulty standing for long periods, and deep exhaustion that does not improve with rest. They do not feel refreshed upon waking. Their thinking capacity and memory are failing. They report sensitivities in their sense of smell, taste, hearing, touch, and sight.
In February this year, the National Institute of Neurological Disorders and Stroke (NINDS) acknowledged the overlaps between PACS and ME/CFS.
The NIH announced on February 23 that it is investing $1.15 billion over four years to fund long Covid or PACS research. Its main goal is to eventually find treatments, and to do so it needs to gain a better understanding of the biological basis of PASC and why some people are more vulnerable to it than others.
The NINDS is leading these studies and will also be studying PACS in relation to ME/CFS.
A recent happy turn of events is the experience of a few long Covid sufferers who felt better after their first vaccine shot. Several small surveys show that about a third of respondents saw some improvement in their condition. While these surveys still need confirmation from more formal studies, the outlook is optimistic.
Long Covid or PACS causes severe and life-changing long-term symptoms. While patients must find ways to live with it now, there is hope as further studies are underway to tackle this condition.
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