“ Long Covid ” still puzzles doctors but treatment is possible



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“People with long-lasting Covid often present with persistent and severe fatigue, headaches and brain fog, which is defined as mild subjective cognitive impairment, around four weeks after acute illness,” Dr Alfonso Hernandez-Romieu , a member of the Centers for Disease Control and the Covid-19 Prevention Response Team (CDC), said at a CDC briefing Thursday.

A study recently published in the journal The Lancet found that out of 1,733 coronavirus patients treated in the Chinese city of Wuhan, 76% still had at least one symptom six months after the onset of their symptoms.

Doctors have reported that the severity of Covid-19 disease may have little impact on whether patients have long-lasting symptoms of Covid, Hernandez-Romieu said.

Dr Allison Navis, assistant professor at Icahn’s Mount Sinai School of Medicine in New York City, said one of the most common symptoms of a long Covid is called ‘brain fog’.

“Brain fog is a symptom. It’s not a diagnosis, and it means a lot of different things to different people,” Navis said. “Often it is a combination of short-term memory problems, concentration or difficulty speaking to find words.”

Navis said brain fog does not appear to have a clear connection with the severity of the Covid-19 infection, age or other risk factors. She said doctors had observed these symptoms in younger patients – including children and adolescents – who had mild coronavirus and were previously in good health.

In the absence of a general diagnosis or a treatment plan for people with long Covid disease, doctors have targeted specific symptoms for treatment, Navis said.

Treat the symptoms

“For brain fog, unfortunately, we don’t have treatments for cognitive changes, so it really does address abnormalities in the blood tests that might be contributing to it, by treating these other factors like sleep and mood,” a- she declared. “If attention is a major problem, medications that can help attract attention may be needed.”

For issues with the sympathetic nervous system, which controls the body’s “flight-or-fight” response, Navis said meditation and breathing techniques can be helpful. For other nervous system issues, she said increased hydration could help.

For fatigue, she advises patients to exercise. “Don’t do anything that makes you feel worse afterwards.”

She also stressed that patients should get enough sleep and take care of their mental health.

“We see a lot of different neurological symptoms in these patients,” Navis said. “I think it’s important to have a big story to try to see if there is a bigger diagnosis that might emerge, instead of having too much tunnel vision on a specific symptom.”

The CDC is working with the National Institutes of Health and the World Health Organization to better define and understand Covid over the long term.

“While we don’t know what causes these symptoms, they are very real to patients, and we are seeing patients getting better,” Navis said.

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