Among the many confusing aspects of Coronavirus The spectrum of possible symptoms, as well as their severity and duration. Some people get mild illness and recover quickly, without any lasting effects. But studies estimate that 10% to 30% of people report persistent or new Medical problems Months after their initial coronavirus infection – a constellation of symptoms known as long COVID. People with mild to moderate illness, as well as people with no underlying medical conditions, may experience some mild chronic symptoms, including fatigue, shortness of breath, and irregular heartbeat. HeadacheDizziness, Depression And problems with memory and concentration.
Such chronic medical problems are so diverse that a study by a patient-led research team evaluated 203 symptoms that can cause people to look fluctuating or blue after recovery.
Head of Research and Development of the VA St. Louis Healthcare System and Clinical Public Health Researcher at the University of Washington, St. Louis. Ziad al-Ali said, “If you have seen a patient with colic for a long time, you have seen a long-term coward. Covid.“
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How doctors currently diagnose chronic COVID
There is little consensus on the exact definition of long COVID, also known by the medical term PASC, or post-acute sequelae of COVID-19. While the World Health Organization It is said that the initial bout or positive test results of chronic covid disease start after three months, the disease control and prevention centers set the timeline only after one month.
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Some researchers and Health care Providers use other time frames, trying to make the situation more difficult to study and quantify, said Al-Ali, who has conducted several studies on long-term post-COVID issues.
Patients experiencing persistent symptoms go to their doctors for tests such as electrocardiogram, chest X-ray, CT scan And blood work doesn’t always identify physical problems, al-Ali said. Researchers are working to find specific biological factors, called biomarkers, that are associated with persistent COVID symptoms. These symptoms may include Swelling Or some molecules produced by the immune system that can be measured by blood tests, for example.
For now, doctors must rely on the details of their patients’ symptoms and reject alternative explanations or reasons. Some post-COVID clinics have multi-disciplinary teams of specialists who evaluate patients to find the best treatment options.
What causes long COVID?
It’s not clear what exactly drives the long COVID, but research has begun to provide some clues. Some experts hold the theory that a Immunity Overdrive response when first sick can cause swelling and damage throughout the body, eventually leading to prolonged COVID symptoms, says Dr. John Smith, an infectious disease physician at the University of California, San Francisco. Michael Peluso said.
“We know that during acute COVID-19, some people actually have a regenerative-up immune response and some people have a reduced immune response, and that response can determine the projection of how well someone does,” he said.
Another explanation, experts say, may be yours Immune system It does not stop completely after the initial infection.
Who is at risk?
Research provides some indications about which patients may be at greater risk of long-term symptoms. In a study of 209 patients published in January, researchers found four factors that could quickly identify a person’s coronavirus infection that appears to be associated with an increased risk of symptoms lasting two to three months.
One factor was initially the level of coronavirus RNA in the blood Infection, An indicator of viral load. Another was the presence of autoantibodies – antibodies that accidentally invade body tissues as they do in cases like lupus and rheumatoid arthritis. The third factor was the reactivation of the Epstein-Barr virus, which can cause mononucleosis and infect most people, mostly when they are young, and then usually become inactive.
The fourth factor was type 2 DiabetesHowever, experts say that in studies involving a large number of patients, diabetes may be just one of many medical conditions that increase the risk of long-term colic.
Studies at post-COVID clinics have also found other pre-existing medical conditions that can put people at risk for chronic COVID. Of the first 100 patients treated for neurological and cognitive symptoms at the post-COVID clinic at Northwestern Memorial Hospital in Chicago, 42% were previously reported. Depression Or worry, although such patients may find it easier to seek neurological treatment, doctors said. Other pre-existing conditions include autoimmune diseases and headaches.
Studies also suggest the risk of developing long COVID peaks in middle age, Peluso said. The average age of patients in the Northwest Study was 43. An analysis of 78,252 private health insurance claims in the United States found that people between the ages of 36 and 64 accounted for two-thirds of chronic covidar patients. (But that study did not include many Medicare recipients, so it did include relatively few elderly patients.)
While women may be unevenly affected, some studies have found that approximately 60% of patients are women. A similar pattern has been seen in other chronic conditions such as ME / CFS (myalgic encephalomyelitis / chronic fatigue syndrome), which has many of the same symptoms as the symptoms of chronic colic.
Because the epidemic has had a significant impact on the black and Latino communities in the United States, and those groups have limited access to medical care, they may also have long-term COVID cases, Peluso said.
Can vaccines protect against COVID in the long run?
The picture is still in focus, but several studies suggest that covid vaccine may reduce the risk of long-term symptoms – but not eliminate it.
The United Kingdom’s Health Safety Agency analyzed eight studies that looked at vaccines and long-term COVID before mid-January. Six vaccinated individuals who then became infected with the coronavirus were found to be less likely to develop long-term covid symptoms than non-vaccinated patients. The other two studies have found that Vaccine The prospects for the development of long COVIDs have not been significantly reduced.
In that analysis, a study, which was not peer-reviewed, found that approximately 240,000 U.S. patients who received a single dose of the covid vaccine before their infection were 7 to 10 times less likely to report symptoms than unvaccinated patients. Long COVID after 12 to 20 weeks. But another large study of electronic patient records from the U.S. Veterans Health Administration, still not reviewed, found that those vaccinated had only a 13% lower risk than patients who did not receive the vaccine six months later. Vaccinated patients are more likely to benefit from lung problems and less chance of developing them Blood clots Difficulties, said Al-Ali, one of the study’s authors.
“Reliance on vaccines as the only mitigation strategy is completely inadequate,” al-Ali said. “It’s like going to fight a shield that only works partially.”
Seeking medical care
If you are worried about any dull symptoms after a confirmed or suspected coronavirus infection, don’t be afraid to ask for help. The first step is to check with your primary care provider. Many doctors have long been aware of this Symptoms of covid And may recommend tests that at least rule out other causes of your symptoms.
“Although we say that prolonged COVID occurs when symptoms persist for one month or three months after infection, you do not have to wait long to get help,” Al-Ali said. “People should really respect their symptoms.”
Some chronic COVID problems can be managed with existing medications or treatment of symptoms such as headaches or gastrointestinal problems. Physical therapy and “cognitive rehabilitation,” often with approaches used for patients experiencing strokes or brain injuries, may be helpful over time. Some people are physically fit and Mental health Rehabilitation services and breathing exercises, which can help them build strength and endurance for slow physical activities.
People with chronic COVID also want to consider joining a research trial, Peluso said. You can find ongoing clinical studies at your nearest universities and educational centers or sign up to be part of a recovery initiative.
“Participating in research can be very powerful,” Peluso said.
This article originally appeared in The New York Times.
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