Scientists race to understand how long COVID lasts as patients wait to recover – NBC Chicago

More than a year after her COVID-19 seizure, Rebekah Hogan still suffers from severe brain fog, pain, and fatigue that makes it impossible for her to do nursing work or handle household activities.

Long COVID made her question the value of a wife and mother.

“Is this forever? Is this the new standard? ”I want my life back.”

More than a third of people with a mild case of COVID-19 are found to have developed problems three to six months after they were diagnosed with COVID, a 2021 study by University of Oxford researchers establish. Another study by the University of Arizona It is estimated that more than two-thirds of people with mild or moderate infections develop symptoms at least 30 days after testing positive.

Now, with omicrons sweeping the world, Scientists are trying to determine causes of bedridden illness and seek treatment before potentially explosive outbreaks of persistent COVID cases.

A study from the University of Arizona found that many mild cases of COVID-19 may experience long-term symptoms.

Could it be an autoimmune disorder? That may help explain why COVID-19 has prolonged disproportionately affecting women, who are more likely to develop autoimmune diseases than men. Could microclot be the cause of symptoms ranging from memory loss to discolored toes? That could make sense, as abnormal blood clotting can occur during COVID-19.

As these and other theories are tested, there is new evidence that vaccination can reduce the risk of developing COVID in the long term.

It is too early to know whether people infected with the highly contagious omicron variant develop mysterious symptoms, often diagnosed weeks after the initial onset of illness. However, some experts say there is a possibility of a protracted COVID wave and say doctors need to prepare for it.

With $1 billion from Congress, the National Institutes of Health is funding a wide range of studies on the condition. And clinics devoted to researching and treating it are springing up around the world, affiliated with places like Stanford University in California and University College London.

What causes ‘long COVID’?

Momentum is building around several key theories.

One is an infection or remnant of the virus that persists during the initial illness, causing the inflammation that leads to persistent COVID.

Another cause is that latent viruses in the body, such as the Epstein-Barr virus that causes mononucleosis, are reactivated. ONE Recent research in the journal Cell points to Epstein-Barr in the blood as one of four possible risk factors, which also include pre-existing Type 2 diabetes and levels of coronavirus RNA and certain antibodies in the blood. Those findings must be confirmed with more studies.

The third hypothesis is that autoimmune reactions develop after acute COVID-19.

During a normal immune response, a viral infection activates antibodies against the invading viral proteins. But sometimes after that, the antibodies come back and mistakenly attack normal cells. That phenomenon is thought to play a role in autoimmune diseases like lupus and multiple sclerosis.

Justyna Fert-Bober and Dr. Susan Cheng are among the researchers at Cedars-Sinai Medical Center in Los Angeles who found that a number of people had contracted COVID-19, including those who did not. symptomatic, there are many types of “autoantibodies” that increase to six. several months after recovery. Some cases are similar in people with autoimmune diseases.

Another possibility is that small blood clots play a role in long-term COVID. Many COVID-19 patients develop high levels of inflammatory molecules that promote abnormal blood clotting. That can lead to blood clots throughout the body causing strokes, heart attacks and dangerous blockages in the legs and arms.

In her laboratory at Stellenbosch University in South Africa, scientist Resia Pretorius found microslots in blood samples of patients with COVID-19 and in those who later developed long-term COVID. She also found that high levels of the protein in the blood plasma prevent the normal breakdown of these clots.

She believes that these clotting abnormalities persist in many patients after the initial coronavirus infection, and they reduce oxygen delivery to cells and tissues throughout the body, resulting in most if not all. persistent COVID-related symptoms.

What are the symptoms of long-term COVID?

Although there is no definitive list of symptoms that define the condition, the most common symptoms include fatigue, problems with memory and thinking, loss of taste and smell, trouble breathing, insomnia, anxiety and depression.

Some of these symptoms may appear first with the initial infection but persist or recur a month or more later. Or new ones can develop, lasting weeks, months, or more than a year.

Because so many symptoms occur with other diseases, some scientists question whether coronavirus is always the cause. The researchers hope their work will provide definite answers.

Prolonged COVID affects adults of all ages as well as children. Research shows it is more common in people who are hospitalized, but also occurs in a significant portion of people who are not hospitalized.

Retired flight attendant Jacki Graham contracted COVID-19 at the beginning of the pandemic which wasn’t bad enough to get her into the hospital. But months later, she felt short of breath and her heart was racing. She could not taste or smell. Her blood pressure spiked.

In the fall of 2020, she becomes so tired that morning yoga will put her back in bed.

“I’m an early riser, so I have to get up and try, but then I get done for the day,” says Graham, 64, of Studio City, California. Studio City, California said. “Six months ago I told you COVID ruined my life.”

Hogan, the New York nurse, was also not hospitalized with COVID-19 but has been depressed since being diagnosed. Her husband, a disabled veteran, and their 9, 13, and 15-year-old children became ill soon after and developed fever, stomach pain, and weakness for about a month. After that, it all seemed to get a little better until new symptoms appeared.

Hogan’s doctors think that autoimmune abnormalities and pre-existing connective tissue disorders that cause joint pain may make her more susceptible to developing the condition.

Is there a lasting treatment for COVID?

There is no specifically approved treatment for persistent COVID, although some patients get relief from pain relievers, medications used for other conditions, and physical therapy. But there can be much more help.

Immunologist Akiko Iwasaki is investigating the tantalizing possibility that a COVID-19 vaccination might reduce persistent COVID symptoms. Her team at Yale University is collaborating with a group of patients called the Survivor Corps on a study that involves vaccinating previously unvaccinated COVID patients as a treatment. Feasibility.

Iwasaki, also an investigator with the Howard Hughes Medical Institute, which supports the Associated Press’s Department of Health and Science, said she is undertaking the study because patient groups have reported improvements in COVID symptoms. prolongation of some people after they are vaccinated.

Study participant Nancy Rose, 67, of Port Jefferson, New York, said many of her symptoms went into remission after she got the vaccine, although she still had fatigue and memory loss. .

Two recently published studies, one from the US and one from Israel, offer preliminary evidence that getting vaccinated before getting a shot of COVID-19 can help prevent the disease from prolonging or at least reduce the severity of the disease. its serious. Both were performed before the omicron appeared.

Neither has been published in a peer-reviewed journal, but outside experts say the results are encouraging.

In the Israeli study, about two-thirds of the participants received one or two injections of Pfizer; others have not been vaccinated. Those who received two shots were at least half as likely to report fatigue, headache, muscle weakness or pain, and other common persistent COVID symptoms compared with the group that did not receive the shot.

Uncertain future

With some obvious answers out there, the future is murky for the patient.

Many people, like Graham, see improvement over time. She sought help through an extended COVID program at Cedars-Sinai, enrolled in a study there in April 2021, and has been vaccinated and strengthened.

She said her blood pressure is normal today, and her sense of smell and energy levels are approaching pre-COVID levels. However, she is forced to retire early because of her ordeal.

Hogan still struggles with symptoms including severe nerve pain and “noodle feet,” or suddenly becoming limp and unable to bear weight, a condition that also affects children. her 13 year old son.

Some scientists worry that prolonged COVID in some patients could turn into a form of chronic fatigue syndrome, a long-term condition that is poorly understood and for which there is no known cure or treatment. .

One thing’s for sure, some experts say: prolonged COVID will have huge effects on individuals, healthcare systems and economies around the world, costing billions of dollars.

Even with insurance, patients can lose thousands of dollars at a time when they are too sick to work. Graham, for example, said she paid about $6,000 out-of-pocket for things like scans, tests, doctor visits, and chiropractic care.

Pretorius, a scientist in South Africa, said he was really worried that things could get worse.

“A lot of people are losing their livelihoods, losing their homes. They can’t work anymore,” she said. “Prolonged COVID is likely to have a more severe impact on our economy than acute COVID.”

The Associated Press Health and Science Division receives support from the Howard Hughes Health Institute’s Science Education Department. AP is solely responsible for all content. Scientists race to understand how long COVID lasts as patients wait to recover – NBC Chicago


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