Some recent studies point to Type 2 diabetes and a past history of infection with the Epstein-Barr virus as increasing the risk for long COVID.” — Frank Coletta, M.D.
The early research on long COVID
only included patients who were hospitalized with acute COVID-19. In these patients, up to 80% had at least one remaining COVID-19 symptom several months after leaving the hospital. However, a more recent survey
found that close to 20% of people who test positive for COVID-19, but did not have any symptoms, may also develop long COVID. “One of the mysteries of long
COVID is that people with very mild symptoms or no symptoms can still get it,” says Coletta. Women are at higher risk than
men for long COVID. Older age is another risk factor. The risk of long COVID goes up for every decade of age, although long COVID has also been reported in about 10% of children.
Additional risk factors are
smoking, high blood pressure, and being overweight. “Some recent studies point to
Type 2 diabetes and a past history of infection with the Epstein-Barr virus as increasing the risk for long COVID,” adds Coletta. Epstein-Barr virus (EBV), also
known as herpesvirus 4, is one of the most common viruses in the world. EBV has been linked to other post- viral disorders like chronic fatigue syndrome and multiple sclerosis. According to Columbia University
School of Public Health, serious cases of long COVID almost always occur in people who are unvaccinated.
HOW IS LONG COVID DIAGNOSED AND TREATED? With many diseases, there are blood tests or imaging studies that can lead to a diagnosis. For long COVID there are only symptoms. When a diagnosis relies only on
symptoms and history, it is called a clinical diagnosis. Blood test findings that lead to a diagnosis are called biomarkers. So far, the biomarkers for long
COVID are the ones that would be found in many other inflammatory diseases. “Researchers are looking for
antibodies that the immune system may make in response to COVID, called autoantibodies. They could be specific biomarkers for long COVID, but so far there are no blood tests for diagnosis,” explains Coletta. Treatment for long COVID is
symptomatic, which means there is no treatment for the condition itself, just for the symptoms it causes. “We can give nonsteroidal anti- inflammatory drugs for aches and fever and cough medicine for coughs, but we don’t have anything that can change the course of long COVID. “Exercise to improve physical
condition lost during COVID may help,” explains Coletta. Other treatments may include psychotherapy for anxiety or depression, and medications for insomnia, palpitations, or shortness of breath.
WHAT CAUSES LONG COVID? “We only have theories right now. There may be persistent viral particles
in the blood or in tissue that do not show up on COVID tests but continue to cause inflammation. “Long COVID could also be
an autoimmune disease, which is why researchers are looking for autoantibodies,” says Coletta. In an autoimmune disease, the immune system makes antibodies that attack the body, resulting in inflammation. One theory is that long COVID is
not a new condition that is only caused by COVID-19. It may be a known condition called post-viral fatigue, or post-viral syndrome. These conditions occur after
many viral infections, including other coronaviruses like SARS and MERS. Another possibility is that long
COVID is chronic fatigue syndrome.
WHAT IS THE PROGNOSIS FOR PEOPLE WITH LONG COVID? That is another unanswered question. Although it seems like we have been living with COVID for a long time, it only became widespread in the U.S. in early 2020. The most recent studies suggest that
about 23% of people with long COVID are completely back to normal after one year. Future studies will follow people with long COVID over time and we will find out if long COVID is a long-term disease for some people. If so, that disease will be called
chronic COVID. “That is one more question we don’t have an answer for, but in my experience dealing with patients, about 90% recover from long COVID over time,” says Coletta.
APRIL 2022 | NEWSMAX MAXLIFE 83
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