- The Washington Times - Thursday, March 23, 2023

Older, heavier women who smoke and are unvaccinated are at significantly higher risk of developing so-called long COVID than people with healthier lifestyles, a study has found.

Nine public health researchers published the meta-analysis of 41 studies covering 860,783 patients Thursday in JAMA Internal Medicine. It is the first study to summarize all comorbidities identified in long COVID research published in leading medical journals as of Dec. 5.

Researchers found that while being female and over 40 were the top risk factors for contracting long COVID, also known as “Post-COVID-19 condition,” others involved preventable conditions for all patients — such as being unvaccinated, overweight and a smoker.

They noted that patients who received two doses of a SARS-CoV-2 vaccination were 43% less likely to develop the condition, which the World Health Organization defines as acute symptoms lasting at least three to five months after infection.

Symptoms include loss of taste and smell, shortness of breath, muscle weakness, lightheadedness and various psychological and behavioral issues.

“While there are things we cannot change, such as our age or sex, we can take some actions that can be beneficial for the prevention of long COVID,” lead researcher Vassilios Vassiliou, a professor of cardiac medicine at the University of East Anglia in Great Britain, told The Washington Times. “These would include having or maintaining normal body weight, avoiding or stopping smoking and being vaccinated for COVID-19.”

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Another key risk factor for long COVID: being hospitalized for other illnesses at the time of infection.

Asthma, anxiety, depression, heart disease, immunosuppression diseases, chronic kidney disease and pulmonary obstructions were the most common afflictions mentioned in the research.

Healthy lifestyle changes are the best way to prevent and shorten long COVID because existing medications and new treatments like plasma apheresis and “mindfulness” have all proven inconclusive in treatment studies, said Mr. Vassiliou.

“As more studies emerge, we are getting closer to grasping the full picture and hopefully we will identify appropriate treatments,” he said. “Until then, prevention is better than cure, therefore optimizing all risk factors, including being vaccinated, is the only thing that we can do at the moment.”

The study provides a more comprehensive picture of a “poorly understood condition” that has evaded effective treatment, some medical experts said Thursday.

“We lack basic definitions, full understanding of causes, biomarkers or the ability to know if it is more than one condition,” said Dr. Amesh Adalja, an infectious disease specialist and senior scholar at the Johns Hopkins Center for Health Security. “Until that basic knowledge is acquired it is nearly impossible to develop evidence-based treatment options.”

“Right now, we are still trying to understand long COVID, from the biological standpoint to the common symptoms to the risk factors,” said Dr. Panagis Galiatsatos, a physician at the Johns Hopkins School of Medicine. “Knowing that the vaccine is protective will be one factor to assist in the prevention of long COVID, along with other modifiable risk factors like cigarette consumption.”

In an Aug. 3 column for the Journal of the American Medical Association, Rachel Levine, assistant secretary of health and human services, cited an April 5 Biden administration memo calling for “a whole-of-government response” to address the growing number of Americans whose symptoms outlast the coronavirus.

According to a 2022 Centers for Disease Control and Prevention study of 63.4 million health records, 1 in 5 adult COVID-19 survivors aged 18 to 64 years and 1 in 4 survivors 65 and older have lingering health problems “related to their previous COVID-19 illness,” Dr. Levine said.

Those problems often target the organs with new-onset heart disease, diabetes, kidney disease, hematologic disorders, neurologic conditions and mental illnesses like anxiety and depression.

Dr. Levine also cited a parallel modeling study showing that 4.3 million to 9.7 million adults, especially women, “have new long-term symptoms that limit their daily activities after SARS-CoV-2 infection.”

In extreme cases, some long COVID sufferers have been unable to return to work up to six months after infection, and others still cannot taste or smell most food a year and a half after infection.

At the Vanderbilt University Medical Center, a new Adult Post-acute COVID Clinic has experimented with some treatments for long COVID symptoms.

But vaccination is the best preventive measure and people without taste or smell just have to wait for it to come back, said Dr. William Schaffner, a professor of preventive medicine at the school.

“Treatments are empathetic supportive care along with some more specific therapies determined by prominent symptoms. For example, intellectual exercises for brain fog, physical therapy and graduated exercise for fatigue,” Dr. Schaffner said. “As I understand it, most folks with loss of taste and smell gradually recover at least some sensation over five to six months.”

For more information, visit The Washington Times COVID-19 resource page.

• Sean Salai can be reached at ssalai@washingtontimes.com.

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