More than four years after the coronavirus disease 2019 (COVID-19) pandemic was declared a pandemic, millions of Americans are still experiencing a prolonged illness.
According to the latest federal Household pulse surveyfrom January 9th to February 5th, 6.8% of U.S. adults currently have long-term COVID-19 disease, and 17.6% have long-term COVID-19 disease. .
use 2020 US Census Bureau According to estimates, this means that 17.5 million adults currently have a long-term illness with COVID-19 and 45.4 million have previously had a long-term illness with COVID-19. means.
Since the early days of the pandemic, scientists have learned a lot about what puts people at risk for long-term COVID-19 infection, but they still have a lot to learn about what causes the condition and how to treat it. “We’re just scratching the surface,” the researchers say. that.
“We know a lot more today than we did four years ago, that’s a fact,” Dr. Alba Azola, assistant professor of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine, told ABC News. Ta. “However, the exact pathophysiology and mechanisms that cause these symptoms are not clear.”
“We’ve only just scratched the surface and are just beginning to understand what’s different about people who develop long-term COVID-19 infections and those who get COVID-19 and then fully recover,” she said. added.
What is long coronavirus?
Prolonged COVID-19 infection occurs when a patient remains symptomatic at least four weeks after the infection has cleared. In some cases, symptoms can last for months or years.
Symptoms vary and include fatigue, difficulty breathing, headaches, brain fog, joint pain, muscle pain, and persistent loss of taste and smell. Centers for Disease Control and Prevention (CDC).
Azola said not all patients will have all the symptoms, but they can experience a variety of symptoms.
Long-term coronavirus infections occur most often in people who have been seriously ill, but anyone can develop this condition. According to the CDC, people who have not been vaccinated against COVID-19 are at increased risk of developing long-term COVID-19 infection.
Mystery regarding the cause of the prolonged novel coronavirus infection
Scientists are unsure of the cause of the prolonged coronavirus infection, but Identified risk factors These include having an underlying medical condition or experiencing multisystem inflammatory syndrome caused by COVID-19.
Research also shows that patients who have been infected with the coronavirus for a longer period of time are more likely to: Decrease in cortisol levels and decreased testosterone levels.
Another theory is that the virus particles could become reactivated and people could suffer long-term symptoms.
“Of course, all we want is to be able to diagnose and treat,” Dr. Fernando Carnavalli, director of the Mount Sinai Post-COVID Care Center in New York, told ABC News. “Some of us are really suffering from brain fog and other symptoms that are seriously impacting our quality of life. And that’s why some of us feel that way.” [the research] Not enough. But I think we’re on our way. ”
Studies are also unclear as to why some patients recover and others do not.
David Spiel, 41, of New York City, was infected with the novel coronavirus disease (COVID-19) in March 2020 and was admitted to Lenox Hill Hospital in critical condition. After his discharge from the hospital, he said he experienced a consistently high heart rate.
It was several months later that he was diagnosed with a long-term coronavirus infection. It was a long road to recovery, but Spiel has largely regained his health since his initial infection.
However, his wife is suffering. Spiel said she has been infected with the coronavirus twice, and the second time she suffered severe brain fog and was no longer able to work, but it is unclear whether she became disabled.
“I’m not 100%. Sometimes, when I’m doing a lot and it’s very tiring, I can say, ‘Okay, this is still a part of me, but not as much as I can understand.'” I can’t,” he told ABC News. “My biggest question is, how did I recover? What happened?” We have no idea what the turning point was when everything went normally. ”
Treatment still requires clinical trials
There is no single treatment or cure for this condition, as people who have had COVID-19 for a long time can experience a variety of symptoms.
Patients and healthcare providers often need to work together to create a personal care plan to manage symptoms.
“We need to remind ourselves that this disease is complex if we don’t know much about its pathophysiology and its biomarkers,” Carnavalli said. “There are several things that people are trying, and these treatments may have some effect.”
National Institutes of Health (NIH) recovery initiative It has started several clinical trials on potential treatments for the long-lasting coronavirus.
The only drugs and treatments available at this time are aimed at reducing the symptoms of long-term COVID-19, but are not specific to long-term COVID-19. Spiel said he was prescribed propranolol, a drug that slows the heart rate and makes it easier for the heart to pump blood.
Spiel said he took very low doses of the drug for about two years before he no longer needed to take it.
Azola said he hopes clinical trials will eventually lead to the development of effective treatments, but urged patients and the public to be patient.
“The reality is that science is advancing, but it will take a long time for that to translate into clinical improvements and treatments,” she says. “So there’s a huge chasm between the science and the clinical treatments available to us.”
“You have to get used to not knowing.”
Doctors say one of the hardest things about treating long-term coronavirus patients is that they don’t have answers about why they’re feeling the way they are or how best to treat them. It has said.
“I think this is probably one of the most difficult things to do as a physician working with this patient population,” Azola said. “Because as doctors, we want to help people, we want to make people better, we want to know the answers. But when the coronavirus is prolonged, it’s very frustrating. We want to find those answers. Do not have.”
“You have to kind of get used to not knowing…but you have to be curious and work with your patients to find creative ways to benefit them and find creative ways to improve their quality of life.” You have to find a way,” she said. Added.
Azola is now helping patients better manage their symptoms and pain so they can at least participate in daily activities, even if their coronavirus symptoms linger for too long and prevent them from being free. Told.
Spiel said it’s often difficult to explain what you’re going through to others who haven’t experienced the coronavirus, even your own family and friends.
“People say, ‘No, it’s okay,’ or ‘Try this, do that,’ but the only way to really understand a prolonged COVID-19 outbreak is to see it happen to you. It doesn’t seem like it. I wouldn’t wish that on anyone,” he said. “The reality is that it’s very difficult to explain to people because every case is completely different.”
Azola also warned families and caregivers of long-term coronavirus patients not to ignore patients and their feelings.
“Sometimes by pushing yourself too hard or trying to push yourself beyond your energy range, you can actually harm yourself and end up incapacitating yourself,” she says. “So for people who have family members and caregivers, it’s certainly important to continue to help them, because that’s the only way they’ll get better.”
