- The Washington Times - Monday, April 26, 2021

Some COVID-19 patients, often referred to as COVID-19 long-haulers, experience symptoms or develop new ones that persist for weeks or months after initial infection.

“Long-haul symptoms post-COVID are something that is not fully understood at this point. It appears, like with many other infectious diseases, some proportion of those infected have a long tail of symptoms such as fatigue and cognitive issues,” said Dr. Amesh Adalja, a senior scholar at Johns Hopkins Center for Health Security.

The condition could include symptoms that stick around when a person first falls ill or it can be new symptoms such as worsening chest discomfort and brain fog that pop up a month post-infection and after patients feel like they’ve improved, Dr. Jason Maley of the Harvard Medical School told The Harvard Gazette.

Anyone who has had COVID-19, even if they experienced no symptoms or had a mild illness, can develop long COVID, according to the Centers for Disease Control and Prevention. People with long COVID have reported a wide range of symptoms, including fatigue, headache, loss of taste or smell, and dizziness.

The Mayo Clinic warns that while COVID-19 primarily affects the lungs, it can damage other organs such as the heart and brain.

Months after COVID-19 recovery, imaging tests of some patients have shown lasting damage to the heart muscle, even among those with mild coronavirus symptoms.

COVID-19 also can cause strokes, seizures and Guillain-Barre syndrome, a condition that causes temporary paralysis, and increases the risk of developing Parkinson’s and Alzheimer’s disease. Organ damage from COVID-19 could increase the risk of long-term health issues.

It is unknown why some people experience long COVID, but scientists are looking into its possible causes.

“The task is being able to separate out and define this syndrome with attention to persistent symptoms that impact one’s ability to perform activities of daily living,” Dr. Adalja said. “Once a definition and clinical criteria can be delineated, detailed study of idiosyncrasies in genetics and immune system function can be pursued.”

He added that COVID-19 long-haulers don’t appear to have any evidence of ongoing infection for the most part, making it difficult to understand the pathophysiology. Some risk factors of long COVID include being female, being an older person and having comorbid conditions, he noted.

Risk factors such as high blood pressure, smoking, diabetes, obesity and other conditions could make someone more likely to have a “serious bout” of COVID-19, Johns Hopkins Medicine experts say. But there isn’t a clear link between these factors and long-term problems.

Experts theorize that health problems endure in some people due to organ damage, persistent inflammatory or autoimmune response or for other reasons.

Some patients could take three to six months to recover, get back to their normal energy levels and have their breathing improve, Dr. Maley told The Harvard Gazette. Others could experience problems nine to 12 months post infection and still not have noticed any improvement, he said.

A new CDC study found that 69% of 3,171 nonhospitalized adult COVID-19 patients had one or more outpatient visits 28 to 180 days after diagnosis. Two-thirds had a visit for a new primary diagnosis and about one-third had a new specialist visit, says the study, which was published Friday on the CDC website.

Patients with new visits commonly reported symptoms potentially linked to COVID-19. Although visits for these symptoms declined after 60 days, some patients still continued outpatient visits 120 to 180 days later.

Up to 40% of COVID-19 long haulers who received a coronavirus vaccine have reported improvements to their symptoms, says Akiko Iwasaki, professor of immunobiology at Yale School of Medicine.

“I’ve heard from people who say they no longer have ‘brain fog,’ their gastrointestinal problems have gone away, or they stopped suffering from the shortness of breath they’ve been living with since being diagnosed with COVID-19,” said Ms. Iwasaki, according to Yale Medicine.

The vaccine could be helping the immune system resist lingering residual virus or the vaccine could be halting a harmful immune response or it could be resetting the immune system, the immunobiologist said.

• Shen Wu Tan can be reached at stan@washingtontimes.com.

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