Understanding Long COVID
The COVID-19 pandemic has brought significant challenges to individuals worldwide, not only in terms of immediate health impacts but also long-term consequences. Many people who have been infected with SARS-CoV-2, the virus that causes COVID-19, continue to experience symptoms beyond the acute phase of the illness. This condition, often referred to as long COVID, shares similarities with myalgic encephalomyelitis/chronic fatigue syndrome (ME-CFS) and requires attention and understanding from healthcare professionals.
Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC) or long-haul COVID, occurs when individuals do not fully recover from COVID-19 within approximately three months. Although most individuals with SARS-CoV-2 experience mild or moderate symptoms, a subset of about 15% develops severe COVID-19. Among those with symptomatic infections, about 6% have not fully recovered and 42% experience partial recovery even after 18 months of follow-up.
The prevalence of long COVID varies depending on the severity of the initial infection, but even a conservative estimate suggests a significant number of affected individuals. Risk factors for developing long COVID include certain autoantibodies, diabetes type 2, obesity, high blood pressure, chronic lung disease and even previous infection with the Epstein-Barr virus, which causes mononucleosis.
Symptoms range from fatigue and brain fog to post-exertional malaise, but there are hundreds of possible symptoms reported by patients. It is important to note that some individuals with long COVID may not exhibit visible pathology in blood tests or imaging scans, leading to misconceptions that their symptoms are psychogenic. However, it is crucial to approach long COVID with compassion and understanding, recognizing it as a biologically based medical illness.
The similarities between long COVID and ME-CFS are striking. ME-CFS refers to myalgic encephalomyelitis/chronic fatigue syndrome and shares many overlapping symptoms with long COVID. Both conditions are characterized by post-exertional malaise, cognitive impairment and unrefreshing sleep. The majority of symptoms exhibit significant overlap, suggesting common underlying mechanisms.
Research on long COVID is ongoing, and there is evidence to suggest that a substantial portion of individuals with long COVID may meet the diagnostic criteria for ME-CFS. Reactivation of latent viruses, such as the Epstein-Barr virus, is observed in long COVID, similar to the role of viral infections like mononucleosis in triggering ME-CFS. These parallels highlight the need for comprehensive studies to understand the shared mechanisms and develop effective treatments.
To promote awareness and understanding of long COVID and ME-CFS, healthcare professionals must respect each person's journey and legitimize their experiences. Building a partnership between practitioners and patients is essential, acknowledging the patients' knowledge and empowering them in their healthcare decisions. It is crucial to recognize the significant research efforts underway, with numerous scientists and research hubs dedicated to uncovering the complexities of these conditions. The evolving understanding of long COVID and ME-CFS will undoubtedly shape the future of medical practice and lead to improved outcomes for individuals with unexplained illnesses.
Despite the decreasing numbers of cases and deaths, COVID-19 still poses challenges to healthcare systems worldwide. The emergence of new variants further emphasizes the need for continuous monitoring and adaptation to changing circumstances.
This article is based on an interview with Dr. Leonard Jason of De Paul University in Chicago on an upcoming episode on MindBody Matters, available on Spotify or wherever you get your podcasts.
