Some experts have estimated that roughly 30% of Americans infected with Covid may experience what’s known as long COVID. This constellation of symptoms sometimes appears weeks after the initial infection has passed and can last for months or even years. These symptoms can be debilitating and cause major disruptions in health, work and quality of life, many patients and clinicians report, reports US News.
Cause of the syndrome
Researchers and public health specialists are hard at work trying to understand the root causes of this syndrome (more formally identified as post-acute sequelae of COVID-19, or PASC), and health systems around the country are creating programs and facilities to treat patients with long COVID.
The syndrome itself is still poorly understood, but it is “sweeping in its volume” of effects, said Dr. Kristin Englund, founder and director of Cleveland Clinic’s post-COVID reCOVer Clinic, speaking at a recent virtual forum hosted by U.S. News & World Report. Englund refers to long COVID as the “pandemic after the pandemic.”
She said that the syndrome encompasses a wide variety of either new, returning or ongoing symptoms that can last more than 28 days after the patient’s initial diagnosis of COVID.
Patients with long COVID can have symptoms that “can involve nearly every organ system,” Englund said, and include profound fatigue, shortness of breath with exertion, joint pain, chest pain, loss of smell or taste, diarrhea, headache and other issues, such as “brain fog,” memory impairment, insomnia, anxiety and dizziness.
Most worrisome is that “75% of our patients with long COVID were never even hospitalized, and less than 10% were sick enough to be in our intensive care unit,” she said. “We’ve got a lot to learn about this disease.”
Cure for long covid
Another study, from Johns Hopkins, is trying to tease out the syndrome’s causes and symptoms, and what comorbid conditions come into play. “We need to understand if those are exacerbating what we’re seeing in long COVID, or if those are actually driving what we’re seeing,” said Dr. Priya Duggal, professor and vice chair of epidemiology at the Johns Hopkins Bloomberg School of Public Health and co-lead of Johns Hopkins’ long COVID study.
Health care providers are finding themselves in the position of treating patients for a syndrome that still isn’t fully understood. But “this is not unique to long COVID,” Englund noted. “In many aspects of medicine we treat patients for their symptoms before we truly understand what is the underlying cause of them.” So, “for our long COVID patients,” she said, “I need to know the symptoms that they’re having.”
Moving from understanding long COVID to treating it
Once symptoms are fully assessed – 87% of patients say that fatigue is their leading complaint – then they can begin treatments. “Patients are evaluated in a central area, we kind of call it the hub-and-spoke wheel,” Englund said, as it utilizes different specialists who have stepped up to help. Patients realize then “that they’re not alone, that they can connect with others.
They can have their disease process validated,” she added. “These patients are tired of being told, ‘Oh, just get over it and get back to work.’ They want to be validated for what they have” and to “try to get back to a more normal life.”
A current challenge to treating such a large number of potential long COVID patients is the stressed health care workforce. Maldonado noted that about 30% of providers are considering early retirement when there is already a deficit of about 124,000 health care workers nationwide.
On top of that, the number of academic physicians who conduct important research had dropped from about 4% of physicians in the U.S. to about 1.5%, even before the pandemic. Maldonado warned that the cost of education and debt loads were most at fault for this and suggested it should be a priority to address all of these issues to continue the pace of discoveries.
Assessing risks and building a “ground game” to spread awareness
Chan said early data suggest women may be more affected than men. The reasons are unclear, but he noted that women may be more likely to be affected by autoimmune responses. Older individuals with comorbidities are more at risk to develop severe COVID, which also seems to be linked to long COVID.
Similarly, certain racial and ethnic minority groups may be more at risk for COVID and “significantly disproportionately impacted by long COVID in terms of number of cases, hospitalizations, severe disease, etc.,” Chan said. “We also need to look at different diverse sexual and gender groups and how long COVID may affect those groups as well.”
Several studies are underway to learn how long COVID affects the body down to the cellular level. The different variants are also being studied to see if they lead to different forms of long COVID. These are “giving us at least some hope that there’s going to be a framework of initial studies that we can look at so that we can direct our treatments,” Englund said.
Being vaccinated is still the best bet for avoiding COVID and the later complication of long COVID, panelists noted, so fighting vaccine misinformation is crucial.
Patients who suspect they may have long COVID should find a provider “and just let them know that you are having symptoms,” Maldonado recommended. “If they can’t help you, ask them to refer you to another provider who might be able to help. Nobody has the answers right now, but there are some measures that can help at least mitigate some of the symptoms that individuals are having.”
But Maldonado also warned that some individuals are pitching questionable COVID therapy kits and combinations of drugs not authorized for the uses they’re recommending.
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Source: US News