Long Covid Update

In a bulleted format: From Twiv (this week in virology), recorded 5/31/2024

Researcher Judith Bruchfeld, a researcher in Sweden is interviewed.

Summary points about Long Covid:

The term is used a lot and means different things to different people—doctors included. The WHO recently defined it and the standard is low—virtually ANY symptom in any organ system lasting long enough (months) after a Covid infection is included.

The most common symptoms are  dyspnea, fatigue, palpitations, pain, brain fog.

This makes studying it very difficult with an eye on cause/treatment. The mechanisms for the cause of symptoms may vary by organ system.

Most evaluations for progress --good and bad --with long Covid depend on subjective ie self reporting of symptoms using numeric scales (not unlike pain scales with 0 no pain and 10 the worst pain ever).

There are some objective measures—one is a measure of endothelial function (lining of arteries) after infection.

Sex differentiates how long covid affects people!

Men with it tend to be older, needed hospitalization, and had other medical problems like uncontrolled high blood pressure, obesity, diabetes, etc.

Women tend to be younger and with no obvious health problems…..

Symptoms can come immediately after the infection or months later.

Mild Covid can just as easily cause this syndrome as severe Covid.

The risk remains no matter how many times you get Covid ie your third Covid infection may be the one that gives you long Covid.

Vaccinations reduce the risk of Long Covid--and there is a theory that the more one is vaccinated, the more protection against Long Covid---this is not proven.

A first vaccination AFTER Long Covid present changes nothing re Long Covid.

Paxlovid use reduces the risk of Long Covid.

Full recovery is possible but a significant percentage continue with symptoms: 10%?

ALL sub-variants are associated with Long Covid

The study of this condition has made the various “chronic fatigue syndrome’s” (like ME CFS) gain more attention and focus and reflections on similar but as yet “cause unknown” processes. Patients with these should now get credibility as having more than psychiatric problems.

That said—people with chronic conditions with symptoms as noted above suffer from depression compared to their non affected peers—-attention to depression be it through medication, counseling, or both is always a good idea.

Lastly, if physical capacities are limited—those eligible for study in Sweden have to be missing work at least half the time—they can benefit from structured Physical and Occupational Therapy.