among the many confusing aspects of coronavirus There is a spectrum of possible symptoms, as well as their severity and duration. Some people develop mild illness and recover quickly with no lasting effects. But studies estimate that 10% to 30% of people report persistent or new medical issues Months after their initial coronavirus infection – a cluster of symptoms known as prolonged COVID. People who experience mild or moderate illness, as well as those without any underlying medical conditions, may still experience some debilitating long-term symptoms, including fatigue, shortness of breath, an irregular heart rate, headachedizzy, depression and problems with memory and concentration.
Such long-lasting medical issues are so diverse that a study by a patient-led research group evaluated 203 symptoms that can fluctuate or become blue even after people have recovered. may appear in colour.
As the head of research and development at the VA St. Louis Healthcare System and a clinical public health researcher at Washington University in St. Louis, Dr. Ziad al-Ali said, “If you have seen a patient with COVID for a long time, you have seen a patient for a long time covid.,
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How doctors currently diagnose long COVID
There is little agreement on the precise definition of long-term COVID, also known as the medical term PASC or post-acute sequelae of COVID-19. when World Health Organization The Centers for Disease Control and Prevention sets the timeline after one month, says the longer-term COVID illness or begins three months after a positive test result.
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some researchers and Health care Providers use other time frames, making efforts to study and condition more difficult, said Al-Ali, who has conducted several studies on long-term post-COVID issues.
When patients experiencing persistent symptoms visit their doctors, tests such as electrocardiogram, chest X-ray, etc. CT scan And blood work doesn’t always identify physical problems, Al-Aly said. Researchers are working to pinpoint certain biological factors, called biomarkers, that are related to persistent COVID symptoms. These may include signs of inflammation or certain molecules produced by the immune system that can be measured by a blood test, for example.
For now, doctors must rely on their patients’ description of their symptoms and rule out alternative explanations or causes. Some post-COVID clinics have multidisciplinary teams of experts who evaluate patients to find out the best treatment options.
What is the cause of long COVID?
It’s not clear what exactly drives long-term COVID, but research has begun to offer some clues. Some experts believe that a immunity When you are first sick the reaction is accelerated, which can cause inflammation and damage throughout the body, which can result in prolonged COVID symptoms, says an infectious disease physician at the University of California, San Francisco. Doctor. Michael Peluso said.
“We know that during acute COVID-19, some people’s immune response is actually revved up and some people have a reduced immune response, and that response can determine how well someone does.” ,” They said.
Experts say another explanation could be that your immune system It never stops completely after the initial infection.
Who’s at risk?
The research provides some indications about which patients may be at greater risk of 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 were related to an increased risk of ongoing symptoms two to three months later.
One factor was the level of coronavirus RNA in the blood at early onset infection, an indicator of viral load. Another was the presence of autoantibodies – antibodies that mistakenly attack tissues in the body like they do in conditions such as lupus and rheumatoid arthritis. A third factor was the reactivation of the Epstein–Barr virus, which can cause mononucleosis and infects most people, often when they are young, and then usually becomes dormant.
Fourth factor type 2. was diabetesAlthough experts say that in studies involving large numbers of patients, diabetes may be one of several medical conditions that increase the risk of COVID in the long run.
Post-COVID clinic studies have also found other pre-existing medical conditions that can put people at risk for long-term COVID. In a report on the first 100 patients treated for neurological and cognitive symptoms at a post-Covid clinic at Northwestern Memorial Hospital in Chicago, 42% reported having previously depression or anxiety, although such patients may be more comfortable seeking neurological treatment, the doctors said. Other preexisting conditions included autoimmune diseases and headaches.
Studies also show that the risk of developing longer COVID peaks in middle age, Peluso said. The average age of patients in the Northwestern study was 43. An analysis of 78,252 private health insurance claims across the United States found that people aged 36 to 64 made up nearly two-thirds of long-term COVID patients. (But that study did not include most Medicare recipients, so it included relatively few older patients.)
Women may be disproportionately affected, with some studies finding that about 60% of patients are female. A similar pattern has emerged in other chronic conditions such as ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), which have many of the symptoms similar to those of prolonged COVID.
Peluso said that because the pandemic has had a significant impact on black and Latino communities in the United States, and those groups have limited access to medical care, they may also have longer COVID cases.
Can Vaccines Long Protect Against COVID?
The picture is still coming to mind, but several studies show that getting a COVID vaccine can reduce – but not eliminate – the risk of long-term symptoms.
The United Kingdom’s Health Protection Agency analyzed eight studies before mid-January that focused on vaccines and prolonged COVID-19. Six found that vaccinated people who then became infected with the coronavirus were less likely than unvaccinated patients to develop symptoms of COVID for a long time. The remaining two studies found that vaccination Does not appear to conclusively reduce the likelihood of developing long-term COVID.
In that analysis, a study of nearly 240,000 US patients, which has not been peer-reviewed, found that those who had received even a single dose of a COVID vaccine prior to their infection tended to report symptoms. Patients were 7 to 10 times less likely than non-vaccinated patients. Long COVID 12 to 20 weeks later. But another large study of electronic patient records at the US Veterans Health Administration, which has not yet been peer-reviewed, found that those who were vaccinated had symptoms six months later than non-vaccinated patients. had only a 13% lower risk. Most vaccinated patients benefited from being less likely to develop lung problems and blood clotting difficulties, said Al-Aly, one of the study’s authors.
“The reliance on vaccination as the only mitigation strategy is completely insufficient,” Al-Aly said. “It’s like doing battle with a shield that only partially works.”
seek medical care
If you’re concerned about any symptoms following a confirmed or suspected coronavirus infection, don’t be afraid to ask for help. Contacting your primary care provider is a good first step. More doctors are becoming aware than long symptoms of covid and may recommend tests that can at least rule out other causes of your symptoms.
“Even though we say that long-term COVID is when symptoms last a month or three months after infection, you don’t have to wait that long to get help,” Al-Aly said. “People should really respect their traits.”
Some chronic COVID issues can be managed with existing medications or treatments for symptoms such as headaches or gastrointestinal problems. Physical therapy and “cognitive rehab,” including approaches often used for patients who experience strokes or brain injuries, can also be helpful over time. Some people have tailored physical and . benefit from mental health Rehabilitation services and breathing exercises, which can help them gradually build back strength and stamina for physical activity.
Peluso said people with a longer COVID-19 might also consider joining a research trial. You may be able to find continuing clinical study at universities and educational centers near you, or sign up to be part of the Recover Initiative.
“Participating in research can be very empowering,” Peluso said.
This article originally appeared in The New York Times.
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