What is Long COVID?
For many COVID patients, they recover within the first few weeks of the infection. With vaccinations and masking protocols, many more have prevented infection or at least prevented admissions to the hospitals. Then there are the unfortunate COVID patients that are trapped by their ongoing symptoms, for several weeks, even months. These patients are called “long-haulers” or “long COVID” patients. They can present with a wide range of symptoms such as: shortness of breath, inability to concentrate/focus, a.k.a. “brain fog”, chronic fatigue, gastrointestinal problems, anxiety/depression among others. As per CDC , the rate of occurrence of these symptoms in current literature can vary (5% to 80%). Defining what is long COVID (or post-COVID condition) is difficult to streamline. This is due to the variable nature of the data collected: what time frames are used, outpatient vs. inpatient settings, assessment of symptoms.
Research
The etiology of why some become have a prolonged course with either recurring or new symptoms after the initial infection phase is the subject of ongoing research, such as the NIH RECOVER Initiative . With the studies in this initiative, researchers hope to gain more insight into prevalence, risk factors and possible treatment strategies. Another study at the Yale School of Medicine, by immunologists Akiko Iwasaki, PhD and Aaron Ring, MD, PhD, have found high levels of autoantibodies in COVID patients. Instead of attacking the virus, these autoantibodies attack different organ systems. This could shed some light on why some people develop this prolonged COVID course and perhaps produce more targeted treatment options.
Dr. Bruce Patterson, former Medical Director of Diagnostic Virology at Stanford University, co-founder of IncellDx diagnostic laboratory, came up with Longhauler Index. It uses cytokine markers (proteins that help regulate immune responses), to identify the chronic COVID patients. The treatment plan includes three medications, Maraviroc, statins and the notorious Ivermectin for 4-6 weeks. He’s been treating patients since September 2020 and claims that most patients improve with this regimen. However, more data is needed: treatment studies and validation by other laboratories.
Is There Any Treatment?
Dr. Patterson may be on to something. And some may opt to try it his way. At the moment, there isn’t an official guideline to treatment. Since COVID affects multiple organ systems, the treatment approach will also be multidisciplinary, and symptom based. All of this can be quite stressful for a person to go through. It would be beneficial to have a holistic approach to these patients, in the form of offering resources for support groups or referrals to social workers and community health workers.
Final Thoughts
Dealing with COVID has been a challenge for the medical community and the general population at large. From the start of the pandemic, the healthcare system has been on the brink. Then came the vaccinations that gave us a fighting chance but then the variants started coming. It’s one thing after another. Yet, we are still here. It may seem like a hopeless situation to some. Though they may not see it or be aware of it, there are people working diligently to help us learn more about this tricky virus and its consequences. So here we go, on this long COVID road, we keep on keeping on.
Valerie Kabul is a Physician Assistant at Mount Sinai Morningside (NYC) in the always busy hospital medicine department. Prior to 2016, she worked in a gastroenterology/hepatology practice for 10 years. In her free time, she likes reading and learning about health and wellness, integrative medicine. She also likes to channel the adventurous spirit of Moana, through her travel blog How Far I’ll Go, where she shares the explorations of local getaways and faraway places.
