Cesar Chelala
A physician and writer

Long COVID is a cause for concern

Considerable advances have been made in the fight against the coronavirus disease, but the danger isn’t over. Most people who get coronavirus disease (COVID-19) recover within a few weeks. But even those who had mild versions of the disease may still have symptoms that can last for weeks, months or even years after infection. These lasting health problems are called post-COVID-19 syndrome, long COVID, post COVID conditions, or, more technically, post-acute sequelae of SARS COV-2 infection (PASC).

According to published research papers, between one month and one year after having COVID-19, one in five people aged 18 to 64 has at least one medical condition that might be due to COVID-19, while among those age 65 and older, one in four has at least one symptom or medical condition that might be due to COVID-19. What makes diagnosis challenging, however, is that often it is difficult to tell if the symptoms are due to pre-existing conditions or to COVID-19. Sometimes, the symptoms can go away or return.

The most common, and persistent symptoms of long COVID are neurological, such as memory difficulties, lack of attention, dizziness, sleep and mood disorders, and “brain fog”. Also frequent are mental health problems such as anxiety and depression. Respiratory and heart symptoms such as breathing difficulties, cough, chest pain and increased heart rate are also common. Among the most frequent digestive symptoms are diarrhea and stomach pain. Other symptoms include increased tiredness, fever, skin rash, joint or muscle pain, taste and smell disorders, and changes in menstrual cycles, as well as the appearance of blood clots that can provoke pulmonary embolism.

An analysis of several studies has shown that 43 percent of people infected may develop long COVID. Long COVID is different from chronic COVID infection, since those suffering from long COVID test negative for the virus, although they continue having symptoms. Although post-COVID conditions seem to be less common in children and adolescents, they can also experience long term effects. Long COVID conditions can last weeks, months, or even years after the initial infection.

Leaving with long COVID can be heard on those affected, particularly because it is not known how and why this condition develops. What is known, however, is that people with underlying health conditions are more prone to developing long COVID symptoms, particularly those with Type 2 diabetes. Long COVID is also experienced more frequently by those who had previously had a severe COVID infection, are obese or hypertensive, and those with multi system inflammatory syndrome, a condition affecting several organs and tissues.

It has been shown that only sure way not to get long COVID is making all efforts to prevent having COVID-19 in the first place, using public health measures of known effectiveness such as mask-wearing, physical distancing and hand washing. Research has shown that people who are vaccinated and experience a breakthrough infection are less likely to report long COVID conditions, compared to people who are not vaccinated. Vaccination, however, does not completely prevent long COVID. According to a study published in Nature Medicine protection by vaccines, although real, is not as good as one may hope.

The real dilemma is how to confront a situation that, until now, cannot be controlled. Those who develop long COVID should seek immediate medical care. When possible, care should be multidisciplinary in nature and include not only the primary care physician but also the relevant physical therapists, mental health professionals, and hospital social workers. Support groups can also be helpful. However, many more studies are needed to learn how to effectively treat this condition.

About the Author
César Chelala is a physician and writer born in Argentina and living in the U.S. He wrote for leading newspapers all over the world and for the main medical journals, among them The New York Times, The Washington Post, The Wall Street Journal, The Japan Times, The China Daily, The Moscow Times, The International Herald Tribune, Le Monde Diplomatique, Harvard International Review, The Journal of the American Medical Association, The Lancet, Annals of Internal Medicine, and The British Medical Journal. He is a co-winner of an Overseas Press Club of America award and two national journalism awards from Argentina.
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