More than a year after battling COVID-19, Rebekah Hogan is still suffering from severe brain fog, pain and fatigue, leaving her unable to do nursing work or handle household activities.
Long COVID has made her question her ability as a wife and mother.
“Is this permanent? Is this the new norm?” Said Latham, 41, a New York, woman, whose three children and husband also have symptoms of the condition. “I want my life back.”
By some estimates more than a third of COVID-19 survivors will develop such permanent problems. Now, with oomicrons spreading widely around the world, scientists are racing to pinpoint the cause of the bedwetting condition and find treatments before a possible explosion in tall COVID cases.
Could it be an autoimmune disorder? This may help explain why long-term COVID-19 disproportionately affects women, who are more likely than men to develop autoimmune diseases. Can microclots cause symptoms ranging from memory lapses to discolored toes? This is understandable, as abnormal blood clotting can occur in COVID-19.
As these theories and others are tested, there is new evidence that vaccination may reduce the chances of developing COVID in the long run.
It is too soon to know that people infected with the highly contagious Omicron type will develop a mysterious constellation of symptoms, usually diagnosed several weeks after the initial illness. But some experts believe that the wave of Kovid-19 may last for a long time and they say that doctors need to be prepared for it.
With $1 billion from Congress, the National Institutes of Health is funding a wide range of research on the condition. And clinics dedicated to its study and treatment are popping up around the world, affiliated with places such as Stanford University in California and University College London.
Why does this happen?
The momentum is being built around a few key principles.
One is that the virus infection or remnant persists after the initial illness, causing inflammation that leads to prolonged COVID.
Another is that viruses latent in the body, such as the Epstein-Barr virus that causes mononucleosis, become active again. A recent study in the journal Cell pointed to Epstein-Barr as one of four possible risk factors in the blood, including pre-existing type 2 diabetes and coronavirus RNA levels and certain antibodies in the blood. Those findings need to be confirmed with more research.
A third theory is that autoimmune reactions develop after acute COVID-19.
In a normal immune response, viral infections activate antibodies that fight off invading virus proteins. But sometimes later, the antibodies reform and mistakenly attack normal cells. This phenomenon is believed to play a role in autoimmune diseases such as lupus and multiple sclerosis.
Justina Furt-Bober and Dr. Susan Cheng were among researchers at Cedars-Sinai Medical Center in Los Angeles who found that people who have COVID-19, including cases without symptoms, have up to six of these symptoms. There are a variety of advanced “autoantibodies”. Months after recovery. Some are similar to those found in people with autoimmune diseases.
Another possibility is that small clots play a role in the prolonged COVID. Many COVID-19 patients develop elevated levels of inflammatory molecules that promote abnormal clotting. This can lead to the formation of blood clots throughout the body that can lead to strokes, heart attacks, and dangerous blockages in the legs and arms.
In her laboratory at Stellenbosch University in South Africa, scientist Racia Pretorius has found microclots in blood samples from patients with COVID-19 and in those who later developed long-term COVID-19. She also found elevated levels of a protein in the blood plasma that inhibits the normal breakdown of these clots.
They believe that these clotting abnormalities persist in many patients after an initial coronavirus infection and that they reduce oxygen delivery to cells and tissues throughout the body, leaving not all symptoms associated with long-term COVID. There are.
it can kill almost anyone
Although there is no definitive list of symptoms that define the condition, the most common include fatigue, problems with memory and thinking, loss of taste and smell, shortness of breath, insomnia, anxiety and depression.
Some of these symptoms may first appear during an initial infection, but persist or reappear for a month or more. Or new ones may develop, which can last for weeks, months, or more than a year.
Because so many symptoms accompany other diseases, some scientists question whether the coronavirus is always triggered. The researchers hope that their work will provide definitive answers.
Long COVID affects adults as well as children of all ages. Research shows it is more prevalent in people who were hospitalized, but it also strikes a significant portion of those who were not.
Retired flight attendant Jackie Graham’s battle with COVID-19 at the start of the pandemic was not enough to keep him in the hospital. But months later, she experienced shortness of breath and heart palpitations. She could not taste or smell it. His blood pressure rose.
In the fall of 2020, she was so tired that her morning yoga would send her back to bed.
“I’m an early riser, so I’d get up and push myself, but then I was done for the day,” said Graham, 64, of Studio City, Calif. “Six months ago, I would have told you that COVID ruined my life.”
New York nurse Hogan was also not hospitalized with COVID-19, but has been debilitated since her diagnosis. Her husband, a disabled veteran, and children aged 9, 13 and 15 soon fell ill with fever, abdominal pain, and weakness for almost a month. Then everything seemed to get a little better until new symptoms appeared.
Hogan’s doctors think that autoimmune abnormalities and a pre-existing connective tissue disorder that causes joint pain may have made her prone to developing the condition.
There are no treatments specifically approved for chronic COVID, although some patients find relief with pain relievers, drugs used for other conditions, and physical therapy. But there may be more help on the horizon.
Immunobiologist Akiko Iwasaki is studying the possibility that COVID-19 vaccination may reduce prolonged COVID symptoms. His team at Yale University is collaborating with a patient group called the Survivor Corps on a study that involves vaccinating previously undiagnosed chronic COVID patients as a potential treatment.
Iwasaki, who is also an investigator with the Howard Hughes Medical Institute, which supports the Associated Press’ Department of Health and Science, said she is conducting this study because patient groups have found some people’s COVID-19 long after getting their shots. Improvement in symptoms is reported.
Study participant Nancy Rose, 67, of Port Jefferson, New York, said many of her symptoms subsided after the vaccination, although she still experienced fatigue and memory loss.
Two recently released studies, one from the US and one from Israel, provide preliminary evidence that getting vaccinated before getting COVID-19 can help prevent the disease or at least reduce its severity. . Both were done before the emergence of Omicron.
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 participants received one or two Pfizer shots; Others had not been vaccinated. Those who received the two shots were at least half as likely to report fatigue, headache, muscle weakness or pain and other common chronic COVID symptoms as the unvaccinated group.
With few clear answers, the future for patients is doubtful.
Many, like Graham, see improvement over time. She sought help through a lengthy COVID program at Cedars-Sinai, enrolled in a study there in April 2021, and was vaccinated and promoted.
Today, she said, her blood pressure is normal, and her sense of smell and energy levels are approaching pre-Covid levels. Nevertheless, she retired early because of her ordeal.
Hogan still struggles with symptoms that include nerve pain and “spaghetti legs,” or limbs that suddenly become limp and unable to bear weight, a condition that also affects her 13-year-old son.
Some scientists worry that long-term COVID in some patients may become a form of chronic fatigue syndrome, a poorly understood, long-lasting condition with no cure or approved treatment.
One thing is certain, some experts say: Prolonged COVID-19 will have a huge impact on individuals, health care systems and economies around the world, costing many billions of dollars.
Even with insurance, patients can run out of thousands of dollars at a time when they are too sick to work. For example, Graham said she paid about $6,000 for things like scans, labs, doctor visits, and chiropractic care.
South African scientist Pretorius said there was genuine concern that things could get worse.
“So many people are losing their livelihood, their homes. They can’t work anymore,” she said. “Prolonged COVID will probably have a more severe impact on our economy than acute COVID.”
The Associated Press Department of Health and Science receives support from the Howard Hughes Medical Institute’s Department of Science Education. Associated Press is solely responsible for all content.