Millions of COVID-19 survivors worldwide, even those with mild illness, report long-term symptoms months later, including brain fog, persistent exhaustion, and lung, heart, or kidney damage.
Why it’s important: For too long, these providers and researchers have not taken these long-haul carriers seriously enough, some doctors tell Axios, who say there is an urgent need for dedicated research to treat patients with persistent symptoms.
The doctors began to notice COVID has long been a problem last spring, and yet “there is little to prove,” says cardiologist Eric Topol, founder and director of the Scripps Research Translation Institute.
“I am very discouraged by how little care there has been. We have at least 10% of people with COVID infections who suffer for a few months or even [now] six months later. … This is the largest category of people who are negatively affected, so many of them cannot work and cannot function as they normally do. “
– Eric Topol
What is happening: Many providers and healthcare systems initially ruled out symptoms related to something else, but growing evidence points to SARS-CoV-2 as the culprit in many cases.
- A study published in The Lancet examined people who had severe COVID-19 disease in China and found that six months later, 75% were still experiencing at least one symptom.
- A prepress study a medRxiv, not yet peer-reviewed, surveyed 3,762 self-described carriers from 56 countries, with symptoms following the onset of what would likely be COVID-19. Six months after the first illness, almost half could not work full time and 22% did not work at all. 88% had cognitive dysfunction or memory loss and most had multiple symptoms.
- Fragments of SARS-CoV-2 have been found in multiple organs and the Mayo Clinic reports that they have seen frequent complaints of long-term persistent headaches, loss of smell (anosmia) and taste (ageusia), and trouble sleeping .
- Mayo found that some patients had organ damage, including injured heart muscles, that caused rapid myocarditis, palpitations, and heartbeats; lung tissue with scars, which causes respiratory problems; and neurological damage, causing brain fog, strokes, seizures, and Guillain-Barre syndrome.
Between lines: There are other viruses that cause long-lasting symptoms, such as Epstein-Barr, or that remain in the system where subsequent complications can be reactivated and triggered, such as chickenpox.
- It is unknown whether SARS-CoV-2 may be hidden in the system, but a recent and recent study on animals in the journal Viruss indicates that this could be a possibility.
- The cause of the long COVID needs to be discovered before targeted therapies can be done, says Neha Dangayach, director of neuro-emergency management and transfers for the Mount Sinai health system.
- “Is it a reactivation of the virus? Is it an immune response or a persistent immune response to initial viral exposure? Or is it a recirculation of viral particles that triggers some of these symptoms?” Dangayach asks.
There are also many questions on why some people develop long COVID-19 and others do not.
- “Why you, not me? Why [some] Do 80-year-olds who receive COVID die and some survive? Why do some 20-year-olds with COVID need a double lung transplant, when 90% of the rest have no symptoms? We don’t know, ”says Igor Koralnik, head of neuroinfectious diseases and global neurology at Northwestern Memorial Hospital, which started a long COVID clinic in May.
- Topol says they need to find out if early treatments like monoclonal antibodies can help decrease the chances of long-term COVID.
What follows: 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 some funding for research and NIH has begun studying the issue, according to NIH Director Francis Collins.
- Long-distance carriers are asked to look for specialized clinics, join support networks, and consider sharing data in this patient-driven survey.
- While that’s not enough, there are a growing number of multidisciplinary clinics appearing across the country to try to address the myriad of problems associated along COVID.
- Koralnik says his clinic “has specialists in all of these specialties, including psychiatry and social work,” to care for long-term COVID patients.
The summary: “It is really up to us to collaborate around the world and understand it better, develop specific treatments and follow these patients longitudinally to also identify when these symptoms resolve and what is needed to resolve these symptoms,” says Dangayach.