May 11, 2022

Lasting effects for 1 in 10 COVID-19 patients who go long-haul

The long COVID seems to affect about one in 10 people who have recovered from a COVID-19 infection.

Even as the unpredictable rise and fall of COVID-19[female[feminine infections continue at home and around the world, a new and ugly pandemic problem is emerging.

We know it generically as “long COVID“although it is not generic, and we still know very little, including what it is, who, when and how hard it will hit, how long it will take to recover or if a full recovery is possible for all.

Long COVID, or post-COVID, condition has symptoms which may include difficulty breathing, chest pain, brain “fog”, fatigue, loss of smell or taste, nausea, anxiety and depression, among others.

It seems affect around one in 10 people who have recovered from COVID-19 infection. In Canadaa conservative estimate is that long COVID has so far affected 100,000 to 150,000 people, although studies assessing prevalence have serious methodological flaws.

Post-viral syndromes

The medical and research community first became aware of the long COVID as a sometimes debilitating post-viral syndrome that first appeared to affect patients who had had severe COVID-19especially those who had been treated in intensive care.

What’s difficult about identifying long COVID is that the symptoms are broad and can be associated with other conditions, and some, like anxiety, depression, and fatigue, may not be confirmed by laboratory tests.

Similar symptoms that follow viral infections other than COVID have been seen before. Post-viral syndrome after flu continues to haunt some long after the infection is over, for example. Even common and generally less harmful viral infections like mononucleosis can sometimes have very serious and lasting sequelae.

COVID Long Calendar

What is difficult in identifying long COVID is that the symptoms are broad and can be associated with other conditions.

But the long COVID appears to be different: it’s often more severe and harder to track. Although we and others are heavily engaged in long-term COVID research, it will likely be a year before we have a better picture of the disease. Once we do, it should be easier to develop therapies.

Among the questions that demand urgent answers is whether long COVID is a typical post-viral syndrome that follows a predictable pattern, or has a unique immune fingerprint. Are there clinical, radiological or other markers of long COVID? Is there evidence of persistent low-grade infection or relentless inflammation?

Part of the challenge is that researchers like us are trying to study the aftermath of COVID-19 while the world is still grappling with the acute phase of the pandemic, including the new Omicron variant.

cause and effect

We work systematically to determine what the cause and effect might be. We need reliable evidence, but it is elusive.

Even finding the “control population,” or comparison population, for research — those who weren’t affected — is difficult, as some people who have been infected with COVID-19 have never been diagnosed, while others have been infected. others were diagnosed without testing.

As long as there remains a segment of the population who may or may not have had COVID-19, it is devilishly difficult to put together a control group that would allow us to draw definitive conclusions about how long COVID lasted – and what it was. is not .

Another hurdle is that we lack detailed pre-infection health information for COVID-19 patients, making it difficult to measure how post-COVID-19 status has changed them.

If a patient is depressed now, for example, could there be another cause, or could the condition have developed before the infection? Could the persistent cough be rooted in something that happened before or after a COVID-19 infection?

Viruses and Hosts

The relationship between hosts and viruses can be complex and very varied. He is shaped by a patient’s condition before being infected and by the individual’s immune system. The interaction between these factors creates a wide range of potential outcomes, making it more difficult to study and treat this new condition.

One theory that we and our colleagues are exploring through research is that COVID-19 triggers such a powerful immune response that it may not be the virus that is directly responsible for long COVID, but the response of our body to this one.

Virus cell disintegration destroys COVID concept

When a patient’s body is unable to clear a virus quickly, it intensifies its immune response and may end up making antibodies against itself.

Some of the long effects of COVID appear to be caused by inflammationwhich is part of the body’s typical reaction to any virus. This reaction is exaggerated in COVID-19especially with regard to the inability of the immune system to regain normal functioning.

When a patient’s body is unable to rapidly eliminate a virus, it intensifies its immune response and may end up make antibodies against itself. Part of what we see with the long COVID may be due to the collateral damage of this response, especially when the inflammation resulting from the acute infection was severe.

Despite logistical, methodological, scientific and other hurdles – including general pandemic overload – research is essential to answering these and other questions.

The health system must plan for the resources needed to support this large group of patients, perhaps for years after the pandemic is over. Learning more about this serious and growing problem is the only way to solve it.

Written by:

  • Manali Mukherjee – Assistant Professor of Medicine, McMaster University
  • Zain Chagla – Associate Professor, Division of Infectious Diseases, Department of Medicine, McMaster University

This article was first published in The conversation.The conversation


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