How long will it take to understand the long COVID?

How long will it take to understand the long COVID?

Rachel Robles contracted COVID in March 2020. The 27-year-old data analyst hasn’t gone a single day without symptoms since. Most doctors didn’t believe her when she described how she had gone from running the Brooklyn Half Marathon the previous year to being so cripplingly fatigued that her couch felt like quicksand. How she suddenly found it difficult to put numbers together, despite her technical background. How no matter how many breaths she took, she still felt hungry for air.

Three months later, a doctor told her, “COVID doesn’t last 90 days. Either you get over it or you die.

This dichotomy – in which the only possible outcomes of COVID are either full recovery or death – has proven to be anything but true. Between 8 million and 23 million Americans are still sick months or years after being infected. The confusing array of symptoms known as long COVID has left around 1 million of these people so disabled they are unable to work, and those numbers are likely to rise as the virus continues to evolve and spread. spread. Some who escaped long COVID the first time get it after their second or third infection. “This is a huge public health crisis following acute COVID infection,” says Linda Geng, physician and co-director of Stanford Health Care’s long-running COVID clinic.

Although there is no longer any debate that the long COVID is a real phenomenon – both the Centers for Disaster Control and Prevention and the World Health Organization have acknowledged its existence – the science is so new that many questions remain about how to define the condition, what causes it and how to treat it effectively. It has become clear, for example, that the long COVID can take different forms. “Not everyone has the same disease,” which means there are different causes, says Akiko Iwasaki, an immunologist at the Yale School of Medicine.

Scientists have proposed several different, but interconnected, origin stories to explain these far-reaching symptoms: The coronavirus could damage organs, cause tiny blood clots, trigger autoimmunity, hide in tissues, or cause new and persistent symptoms in other more subtle. To complicate matters further, these stories are not mutually exclusive: several may occur at the same time in a particular patient, or one may trigger another in an unfortunate sequence of events that keeps the patient in perpetual poor health. By sorting out the theories one by one, researchers are gaining a better understanding of this enigmatic disease and getting closer to therapies that not only mask the symptoms, but eliminate the root cause.

Produced by Hunni Media for Knowable Magazine

Listening to the sick

Many of the earliest insights into the long COVID were gleaned from experiences shared by patients. A survey by the Patient-Led Research Collaborative, a team of long-term COVID patients researching their condition, compiled a list over 200 different symptoms in 10 organ systems. These range from the most common complaints like fatigue, cognitive impairment, shortness of breath, irregular menstruation, headaches, heart palpitations, sleep problems, anxiety and depression, to others conditions like double vision, peeling skin, hair loss, tinnitus, tremors. , food allergies and sexual dysfunction. The constellation of reported symptoms may vary from person to person and may even change over the course of the disease.

Because there is no agreed-upon definition of long COVID, no simple diagnostic test, and no way to clearly distinguish one subtype from another, the various manifestations of this mysterious disease are often lumped together under one umbrella. large umbrella, which confuses researchers. Still, emerging research provides early evidence for several promising hypotheses.

One theory attributes the disease to persistent organ or tissue damage caused by the initial infection with SARS-CoV-2, the virus that causes COVID-19. Although the coronavirus enters the body through the respiratory tract, it can cross the bloodstream to infect the kidneysheart, the nervous systemand intestine. In the process, it can trigger waves of inflammation which reverberate throughout the body, causing collateral damage to several organs.

In a study, researchers from the University of Oxford compared brain scans of people before and after contracting COVID and found that even mild cases can cause the virus. brain to shrink 0.2 to 2% more than in people who had not been infected. Since adults generally lose about 0.2% of their brain volume in memory-related regions each year, resulting in a mental decline equivalent to 1 to 10 years of aging. It is too early to know if this effect is temporary or could lead to age-related disorders later in life.

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