COVID-19 Update

WaPo:

Opinion: After the pandemic, long covid may unleash a tidal wave of health troubles

Slowly, researchers are uncovering the face of long covid-19, and it is not a happy one. In two years of the pandemic, millions of people survived the infection but have experienced debilitating symptoms lingering for months. While SARS-CoV-2 is a respiratory pathogen, the research is showing it can trigger disorders in other organs and systems of the body. Long covid is neither a picnic nor a fantasy.

No one knows the true scope. An examination of 57 studies around the world comprising 250,351 people, published in the Journal of the American Medical Association in October, showed that covid survivors suffered both short- and long-term difficulties. At six months after diagnosis or hospital discharge, more than half — 54 percent — were still struggling with at least one symptom. The American Academy of Physical Medicine and Rehabilitation runs a model based on the assumption that 30 percent of the 77 million people in the United States who survived covid have had some kind of Post-Acute Sequelae of SARS-CoV-2 infection, or PASC. Even if the total is just 10 percent, that’s still 7.7 million people.

What are the maladies? In one large online survey last year, covering 3,762 people in 56 countries and published in eClinical Medicine, the most common symptoms reported were fatigue, malaise after exertion and cognitive problems, or “brain fog.” Many also said they suffered insomnia and other sleep problems, heart palpitations and rapid heartbeat, muscle aches and joint pain, shortness of breath, and dizziness and vertigo. In other research, covid survivors have been found to suffer heart disease and other serious ailments, such as stroke, months after they were first infected.

In an article published by Science recently, authors Serena Spudich and Avindra Nath noted that the early thinking was the virus may have entered the central nervous system of those suffering covid-related neurological troubles. But they said analysis of cerebrospinal fluid, which flows in and around the hollow spaces of the brain and spinal cord, taken from living patients suffering neuropsychiatric symptoms, has failed to find traces of the virus RNA. Rather, they said, it appears the primary driver of neurological disease in these patients is impairment of the immune system, which leads to cascading other effects. Another study announced recently suggested that long covid could be due to damage to the vagus nerve, which extends from the brain down into the torso and into the heart, lungs and intestines as well as several muscles, including those involved in swallowing.

Just as important in weighing the prolonged impact of the pandemic are the mental health costs of long covid. Long-haulers struggle to overcome loss of employment, anxiety and depression. These ailments must not be stigmatized or ignored.

The pandemic will almost certainly leave in its wake millions of people with lasting symptoms and illness. Judging by the preliminary estimates, this poses an enormous future challenge for health care everywhere. There’s no time to waste researching the causes and damage of long covid, and preparing to treat it in all its manifestations.