The lengthy haul: When COVID-19 signs don’t go away

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*This text is an replace to the unique article, revealed on July 6, 2021. It was up to date in July 2022 to replicate new info.

Whereas most individuals who get COVID-19 bounce again after a couple of weeks, some battle with signs and well being issues like mind fog, fatigue, complications, dizziness, and hassle respiration, even months after the preliminary an infection is over.

Medical doctors and scientists are working to grasp these mysterious signs, generally known as “lengthy COVID.” Who will get them? Why? How lengthy do they normally final? To assist reply these questions and extra NIH is funding analysis on the long-term well being results of COVID-19, together with lengthy COVID and different post-COVID situations.

What’s lengthy COVID?

The time period “lengthy COVID” is usually used to explain a set of signs and well being issues that some individuals who had COVID-19 expertise after the preliminary an infection is over.

There are a couple of completely different phrases to explain long-term well being results of COVID-19. Lengthy COVID is one, however you may additionally hear phrases like “post-COVID syndrome,” “post-COVID situations,” “continual COVID,” or “post-acute sequelae of SARS-CoV-2 (PASC).” Folks with lengthy COVID are generally known as “long-haulers.”

What are the signs?

Lengthy COVID impacts completely different folks in several methods. Whereas some folks with lengthy COVID discover unusual signs after they first begin recovering from COVID-19, others don’t discover something is incorrect till properly after the an infection has cleared.

Folks have reported a variety of signs that impression their capacity to maneuver and suppose, in addition to their temper. The signs usually worsen after doing psychological or bodily work, generally known as post-exertional malaise. A few of these signs can embrace: 

  • Normal signs reminiscent of:
    • Fever
    • Fatigue
    • Joint or muscle ache
  • Respiratory and heart-related signs reminiscent of: 
    • Bother respiration
    • Cough
    • Chest ache
    • Pounding coronary heart
  • Neurological signs (associated to the mind and nervous system) reminiscent of: 
    • Problem considering or concentrating (generally known as mind fog)
    • Complications 
    • Sleep issues
    • Nervousness and despair 
    • Dizziness or lightheadedness upon standing up
  • Digestive signs reminiscent of:

Signs can final for weeks and even months after COVID an infection. They will vary from comparatively gentle to extreme, and so they can change, disappear, and reappear over time.

What causes lengthy COVID?

It’s not clear what particular organic course of causes lengthy COVID, however researchers have uncovered a couple of clues that might make clear this mysterious situation.

One clue is the way in which that completely different folks’s immune programs reply to COVID-19 an infection. Analysis reveals that folks with essentially the most extreme COVID-19 signs and folks with lengthy COVID usually tend to have larger ranges of dangerous antibodies known as “autoantibodies.” Autoantibodies are proteins within the immune system that that assault and injury wholesome tissue, and they’re concerned in lots of autoimmune ailments.

There could also be a number of causes of lengthy COVID, which might assist clarify the wide selection of signs. A few of the present theories are:

  • Autoimmune response. A wholesome immune system helps defend us by combating a virus or an infection. Typically it mistakenly assaults wholesome cells, tissues, and organs. That is known as an “autoimmune response,” and it’s what occurs in autoimmune ailments like lupus, a number of sclerosis, and rheumatoid arthritis. The COVID-19 virus might stress the immune system a lot that it triggers an excessive autoimmune response that continues after the affected person has recovered from the preliminary an infection.
  • Persistent virus. The virus might conceal and proceed to multiply within the physique for months and even years. This implies it doesn’t instantly trigger signs and isn’t essentially infectious, but it surely might trigger signs down the street.
  • Dormant virus. Lengthy COVID could possibly be signs of a very completely different dormant (or inactive) virus just like the Epstein-Barr virus, the virus which causes mononucleosis, or “mono.” This idea proposes that COVID-19 an infection might reactivate―or get up―the dormant virus.
  • Organ injury. COVID-19 might trigger long-term injury to the physique’s organs or blood vessels, which can trigger lengthy COVID signs.

Who can get it?

Present estimates on how frequent lengthy COVID is amongst individuals who have had COVID-19 fluctuate extensively. Researchers are working to higher perceive who’s probably to expertise long-term issues from COVID-19, however analysis on who will get lengthy COVID can be combined and sophisticated. Individuals who had extreme circumstances of COVID-19 appear extra prone to get lengthy COVID―particularly in the event that they had been hospitalized or admitted to an intensive care unit. However some folks with lengthy COVID didn’t have any signs from COVID-19 or solely had gentle or average signs.

Different teams who could also be at better danger embrace ladies, African Individuals, individuals who had sure well being points earlier than getting COVID-19, and individuals who didn’t get a COVID-19 vaccine.

How is it identified and handled?

There isn’t a particular take a look at for diagnosing lengthy COVID. In case you are experiencing lengthy COVID signs, you need to speak to your physician. If you already know you’ve had COVID-19 up to now, you and your physician can work collectively to rule out different doable causes to your signs.

Till we all know extra concerning the organic processes behind lengthy COVID, remedy for folks with lengthy COVID focuses on managing particular person signs.

How is it being studied?

In December 2020, Congress accepted $1.15 billion in funding over 4 years for NIH analysis into lengthy COVID and different long-term well being results of COVID-19.

In February 2021, NIH launched a brand new program to establish the chance components and causes of lengthy COVID and to assist perceive how it may be prevented or handled.

Wish to get entangled?

There are many methods you may contribute to lengthy COVID analysis. You’ll be able to:

  • Join with the RECOVER Initiative. The NIH RECOVER Initiative brings collectively analysis groups, folks with lengthy COVID, caregivers, clinicians, and group leaders. They’re engaged on a number of research at completely different websites throughout the nation to higher perceive, stop, and deal with lengthy COVID and different post-COVID-19 situations in adults and kids. Discover a RECOVER research website and be part of a research. 
  • Find out about patient-led analysis. The Affected person-led Analysis Collaborative is a gaggle of citizen scientists and researchers, a lot of whom even have lengthy COVID. This group is conducting analysis to outline and higher perceive the long-term results of COVID-19, with a robust concentrate on the affected person expertise.  
  • Be part of a scientific trial. Go to ClinicalTrials.gov to search out out about lengthy COVID research occurring all over the world and signal as much as take part.  
  • Be part of a research on the NIH Medical Heart. Find out about find out how to get entangled in COVID-19 research occurring at NIH.

Different accessible model (pdf)

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