The debilitating reality of Long Covid takes a frightening shape

COVID-19 long haulers: Why are they still sick?

Covid 'survivors' face potential years of fatigue, pain, cognitive decline and heart problems

Dr. Bob Wachter has two words for his post-SARS tracking of SARS-CoV-2, better known by the long Covid: "It's bad." The doctor, a professor of medicine at the University of California, San Francisco, and a widely recognized Covid-19 expert, sees Covid unfolding for too long for his wife.

“Now 5 weeks after the injury, Katie is experiencing extreme tiredness, some brain fog and frequent headaches,” Wachter tweeted yesterday. "She's an amazingly high energy person, and now she's been wiped out most afternoons."

Somewhere between 7.7 million and 23 million Americans and 100 million people globally have learned that even if their initial attacks with Covid-19 weren't that bad, symptoms may not go away for weeks, months, or even years. Or it could go wrong. Even fatal. More than two years after the outbreak of the epidemic, a clear picture of the devastating long-term effects of the disease is emerging, so common and well-documented that it can now be considered a disability under the federal Americans with Disabilities Act.

Treatment options for long-distance drivers, as they are sometimes called, are limited to current treatments for individual symptoms - pain relievers or physical therapy, for example - rather than any treatment or even helpful first aid for the underlying cause of the injury. Wide range of effects. In fact, the Centers for Disease Control and Prevention's long Covid web page does not have a treatment section; Instead, it has a section titled Living with Long Covid, which notes that symptoms can last for years.

“Tens of millions of people with Covid will have persistent symptoms that interfere with quality of life,” Wachter wrote. "They will be disabled in some."

The amazing numbers are now visible

The World Health Organization says COVID-19 began when symptoms persisted three months after the initial infection, although the CDC considers them persisting four weeks later. According to a review of statistical studies earlier this year, 49% of people diagnosed with Covid-19 have persistent symptoms after four months. Last April, scientists reported in the Journal of Infectious Diseases that women are more likely to use long-distance transportation than men.

While different studies using different methods have drawn different conclusions, the broad brush strokes are the same.

Another review of studies, published in March in the journal Brain, Behavior and Immunology, found that a third of people who confirmed their Covid-19 diagnosis experienced persistent fatigue after 12 weeks or more, and about 20% had persistent cognitive damage. Half of people hospitalized with Covid-19 early in the pandemic developed persistent symptoms two years later, according to a study in The Lancet Respiratory Medicine.

A separate study, detailed in Frontiers in Aging Neuroscience, analyzed a subgroup of people who were dealing with symptoms of COVID-19. It was found that 70% of them had problems with concentration and memory several months after the injury.

“Covid has long received very little attention, either politically or medically,” said Lucy Cheeky, a researcher in psychology at the University of Cambridge and senior author on the paper. “It needs to be taken more urgently, and cognitive issues are an important part of this. When politicians talk about 'living with Covid' - that is, undiluted infection, it is something they ignore."

(Note: A new study, released the day after this article was originally published, followed 56 people who, after initial mild or moderate episodes of Covid-19, developed persistent neurological symptoms, including headaches, fatigue, and problems with memory and concentration. After By six months, two-thirds still had symptoms - most notably poor memory and problems concentrating - but most were less severe.The researchers, writing in Annals of Clinical and Translational Neuroscience, aim to have annual check-ups with participants for follow-up to 10 years. ).

Persistent brain fog or other cognitive effects also increase depression and anxiety.

“Those who have a more severe or complicated case of Covid-19 for prolonged periods may experience a profound sense of helplessness,” says Jordan Anderson, MD, professor of psychiatry and neuroscience at Oregon Health & Science University School of Medicine. “Depression and anxiety are how the brain responds to the limitations of a new health condition. The longer a person is exposed to health challenges, the more deteriorating their mental health.”

Other prolonged symptoms of Covid include loss of taste or smell, diarrhea, loss of appetite, shortness of breath, hair loss, and rash. A new study, though unproven, suggests that a prolonged period of COVID-19 infection may be fueling a mysterious global rise in hepatitis cases among children.

crux of the problem

Other than the primary respiratory infection caused by the coronavirus, Covid-19 has been shown to infect all organs of the body. So, the effects of Long-Covid are sometimes obvious to the affected person, but sometimes they lie in relative silence.

Another study earlier this year showed that people who have contracted Covid-19 are 55% more likely to have a heart attack or stroke, for up to a year after infection. The findings, published in the journal Nature Medicine, included data on 153,760 people who developed the disease, compared to the 11 million who did not.

Higher odds of cardiovascular events, including death, were found even for people who had Covid-19 but were not hospitalized during the acute initial phase.

He said: “People who have had Covid-19 and have not had symptoms, or have had Covid-19 that was so mild that they were able to breastfeed at home, without going to the doctor, are still at increased risk of developing heart disease over a course of time. Course General Study author Ziad Al-Aly, MD, assistant professor of medicine at the University of Washington.

It is not yet clear exactly how the virus causes the damage that leads to heart problems a year later.

“A lot of different things can happen,” Al-Ali said. "It is possible that the virus itself and the immune response to it cause severe infections in the heart later on and produce some of the manifestations we saw here." Or he said the disease could kill cells that line the vessels of the heart, eventually causing blood clots.

Uncertain years to come

The best treatment for prolonged Covid-19 is, by far, not to catch Covid-19. This means all proven precautions, each with holes but combined they offer the best odds of avoiding infection. They include avoiding crowded indoor spaces, concealing and improving ventilation and air purification.

And of course vaccinations. However, while vaccines remain a major means of preventing Covid, especially in preventing severe cases, they are not ideal either. Last month, researchers reported in Nature Medicine that the risk of death among vaccinated people who contracted Covid anyway, is 34% lower than that of the unvaccinated. Vaccinations reduce the risk of long-term COVID-19 disease by about 15%.

Meanwhile, there has been little research on treatment options for the long-term COVID-19 virus. It is not yet clear how this could affect people in the coming years, but the results so far point to a long and difficult road ahead for millions of people, along with bleak but unknown outcomes.

“The heart does not regenerate or recover easily after a heart injury,” Al-Ali said. "These are diseases that will affect people for life."