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Millions of COVID-19 survivors around the world – even those who had mild illness – report long-term symptoms months later, including brain fog, persistent exhaustion, and damage to the lungs, heart or kidneys.
Why is this important: For too long, these long hauls, as they call themselves, have not been taken seriously enough by providers and researchers, some doctors tell Axios, adding that there is an urgent need for dedicated research. to treat patients with persistent symptoms.
Doctors began to realize COVID was a problem last spring, yet “there isn’t much to show,” says cardiologist Eric Topol, founder and director of the Scripps Research Translational Institute
“I am very disheartened at how low attention has been on this subject. We have at least 10% of people infected with COVID suffering, for a few months or more. [now] six months later. … This is the largest category of people who are negatively affected, many of whom cannot work and cannot function as they normally do. “
– Eric Topol
What is happening: Many providers and healthcare systems initially dismissed the symptoms as something else, but growing evidence points to SARS-CoV-2 as the culprit in many cases.
- A study published in The Lancet examined people with severe COVID-19 illness in China and found that six months later, 75% were still experiencing at least one symptom.
- A pre-printed study in medRxiv, not yet peer-reviewed, investigated 3,762 self-proclaimed long-haul haulers from 56 countries, showing symptoms after the onset of what was likely COVID-19. Six months after the first illness, almost half were unable to work full time and 22% were not working at all. 88% had cognitive dysfunction or memory loss and most had multiple symptoms.
- Fragments of SARS-CoV-2 have been found in several organs and the Mayo Clinic reports that they have often seen complaints of long-term persistent headaches, loss of smell (anosmia) and taste (ageusia) and sleep disturbances.
- Mayo found that some patients had damage to organs, including injured heart muscle, causing myocarditis, palpitations, and rapid heartbeat; scarred lung tissue, causing breathing problems; and neurological damage, causing brain fog, strokes, seizures and Guillain-Barré syndrome.
Between the lines: There are other viruses that cause long lasting symptoms, such as Epstein-Barr, or stay in the system where they can reactivate and trigger later complications, such as chickenpox.
- It is not known if SARS-CoV-2 can hide in the system, but a recent and early study of animals in the journal Viruss indicates that this could be a possibility.
- The cause of the long-running COVID must be discovered before targeted therapies can be developed, says Neha Dangayach, director of neuroemergency and referral management for the Mount Sinai Health System.
- “Is it reactivation of the virus? Is it an immunological response or a persistent immunological response to the initial viral exposure? Or is it recirculation of virus particles that triggers some of these symptoms?” Dangayach asks.
There are also many questions why some people develop a long COVID-19 and others do not.
- “Why you and not me? Why do [some] 80-year-olds who contract COVID die, and some survive? Why do some 20-year-olds who contract COVID need a double lung transplant, while 90% of all others have no symptoms? We don’t know, ”says Igor Koralnik, head of neuro-infectious diseases and global neurology at Northwestern Memorial Hospital, which opened a lengthy COVID clinic in May.
- Topol says they need to determine whether early treatments like monoclonal antibodies can help reduce the risk of long-term COVID.
And after: The long COVID is becoming a higher priority and several longitudinal studies are expected to come out soon, Dangayach says.
- In the United States, Congress has set aside funds for research and the NIH has begun to study the issue, said NIH director Francis Collins.
- Long-haul travelers are urged to find specialty clinics, join support networks, and consider sharing data as part of this patient-led survey.
- While there isn’t enough overall, there are a growing number of multidisciplinary clinics across the country trying to address the myriad of issues associated with a long COVID.
- Koralnik says his clinic “has specialists in all of these different specialties, including psychiatry and social work,” to care for long-term COVID patients.
The bottom line: “It’s really incumbent on us to collaborate across the world and understand this better, to develop targeted treatments and to follow these patients longitudinally to also identify when these symptoms go away and what it takes for those symptoms to go away,” Dangayach says.
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