Unraveling the Mysteries of Long Covid: Causes, Symptoms, and Treatment Options
In August 2021, Heather Marti, a university program administrator from West Virginia, contracted Covid-19 and soon began experiencing a range of debilitating symptoms. Marti describes her experience as agonizing muscle pain, gastrointestinal problems, weeks-long migraine-like headaches, brain fog, and extreme mental fatigue. She compares it to having all the wires in her body crossed, impacting every system. Marti’s story is not unique; many individuals are searching for answers about long Covid, a condition characterized by the continuation or development of symptoms three months after initial infection with Sars-Cov-2.
According to the World Health Organization (WHO), approximately 6% of those who contract Covid-19 end up with long Covid. This translates to at least 17 million people in Europe alone in the first two years of the pandemic. Melissa Heightman, who opened one of the first specialist long Covid clinics at University College London Hospitals, acknowledges that finding a simple cure or silver bullet for long Covid is unlikely due to the complex nature of the condition.
One surprising aspect of long Covid is that many sufferers were never severely ill with the virus. Walter Koroshetz, co-chair of a research program at the US National Institutes of Health (NIH), explains that hospitals initially set up clinics to support those who had been in intensive care. However, they soon realized that even individuals with mild or moderate infections could experience prolonged after-effects. This revelation highlights the need to understand the biologic mechanisms behind long Covid.
Researchers believe that some long Covid sufferers, particularly those who had severe infections, may not have fully cleared the virus from their bodies. This could lead to persistent activation of the immune system and chronic symptoms. Autopsies conducted by the NIH found evidence of active traces of the Covid virus in individuals who had died up to 280 days after infection. To address this, some patients in the NIH’s Recover trial are receiving a longer course of antiviral drugs to eliminate any remaining pockets of the virus.
Another theory suggests that long Covid is primarily an autoimmune disorder. The immune system of sufferers may become overactive, leading to an attack on healthy cells. The NIH’s Recover investigators are testing an autoimmune treatment called intravenous gamma globulin (IVIG), which resets the immune system and acts as an immune suppressant.
In addition to antiviral and autoimmune approaches, metabolic drugs like Metformin and dietary supplements are being tested to alleviate long Covid symptoms. A recent study led by Professor Onur Boyman of Zurich University found changes in blood protein in people with long Covid, offering another avenue for research.
Clinics like the one at University College London Hospitals focus on helping patients cope with specific symptoms such as disordered breathing, fatigue management, and addressing the psychological impact of the condition. Experts have found that extreme tiredness is a significant indicator of how quickly a patient will recover from long Covid.
While classic long Covid is associated with a specific set of symptoms, some researchers are investigating a potential link between infection and an increased risk of conditions like heart disease, stroke, and diabetes. Data from various countries, including Germany and the UK, suggest that Sars-Cov-2 infection may lead to a higher risk of chronic diseases.
However, researchers are now examining whether individuals infected with the Omicron variant are less likely to face long-term health risks compared to those infected with earlier variants. Factors such as mutations, widespread vaccination, or unknown factors could potentially contribute to this difference. The results of these studies are expected to be published later this year.
While vaccination appears to reduce the chances of developing long Covid in breakthrough infections, it may also reduce the severity of the condition. This offers hope for a potential easing of the long Covid burden. However, Ziyad al-Aly, R&D chief at Veterans Affairs St Louis Health Care System, warns that Covid’s enduring impact on health may have permanently increased the incidence of certain diseases like strokes. He expresses concern that governments have not fully grasped the costly implications for healthcare systems.
In conclusion, the quest to unravel the mysteries of long Covid continues. Researchers are exploring various causes, including persistent viral presence and autoimmune responses. Treatment options range from antiviral drugs to immune system reset approaches. Clinics are focused on managing symptoms and addressing the psychological impact of the condition. While vaccination offers some hope, the long-term health implications of Covid-19 remain a concern. Governments must recognize the lasting impact on healthcare systems and allocate resources accordingly.
