Long COVID is not inevitable. It just feels like it

People with “long-distance” disease appear to have suffered from aberrations early in the COVID pandemic — an unfortunate few, for whatever reason, seem unable to initiate the disease.

Nearly three years later, we know better. Long COVID is not rareand the rank of those affected by it is swelling.

Up to one in five American adults people who have had COVID-19 are living with persistent COVID, a condition loosely defined as symptoms that persist or appear long after the initial COVID infection has disappeared, according to the Centers for Control and Prevention. American Disease.

Many people have accepted COVID infection as inevitable — and now even repeat COVID infections. Prolonged COVID acceptance is also inevitable, especially with studies that have found that catching the virus repeatedly can increase the risk of contracting it.

But such fatalistic thinking is irrational, says Dr. Alexandra Brugler Yonts, an infectious disease specialist who runs a permanent COVID clinic at Children’s National Hospital in Washington, DC. Luck.

“That’s like saying people are going to get the flu,” she said. “Absolutely dangerous.”

Panagis Galiatsatos, an assistant professor in the Johns Hopkins Division of Pulmonary Medicine & Critical Care, who treats patients with persistent COVID, says that COVID does not have a “binary outcome”.

“There’s a bunch of ways people get it,” he said Luck, adds that “how you catch COVID” can determine if you develop long-term COVID. For example, people who get vaccinated and/or treat their infection with the antiviral drug Paxlovid may have a lower risk of developing a new disability, some studies suggest.

Statistics such as the CDC’s assertion that one in five U.S. adults who have had COVID have long since had COVID are often based on surveys, with individuals self-identifying and not necessarily being diagnosed.

Such surveys are essentially asking, “Have you had any new health problems since you had COVID?” Brugler Yonts said. “It’s a challenge, because life goes on, and people still develop health conditions.”

It is often impossible to say whether post-COVID health occurs without infection, or whether infection has accelerated the course of the disease already occurring, she adds.

There is no formal consensus on how to define the condition, which can be more than 200 potential symptoms and can have a different onset from soon after the infection clears up to several months later.

“We are still struggling as a health organization to define long-term COVID appropriately,” said Galiatsatos. “No biomarkers, no testing.”

These factors lead Galiatsatos and Brugler Yonts to believe that long-term COVID is actually less common than we thought — a reassuring thought.

All viruses have the potential to cause complications after the infection clears up,” and we need to remind [cases] Galiatsatos said.

“It’s like shaving your legs. The initial impact of the scratch is gone, but the scar will take time to heal. Patients who are still coughing after two months — that’s part of the healing process. “

COVID, like other viruses, can cause organ damage that “may take some time to improve,” he said.

But it’s not long COVID, in his estimation. He defines true long-term COVID as new symptoms that persist six months or more after infection for which no other cause has been found. Such patients often have symptoms of shortness of breath, chest discomfort and fatigue, he says, but no obvious organ damage – and often neurological symptoms, such as headaches and loss of taste. and smell, during their acute infection.

“Long COVID is a diagnosis of exclusion,” says Galiatsatos. “There are more potential symptoms that occur randomly than anything else.”

Vaccinations and antivirals like Paxlovid “can keep the viral load low enough that it doesn’t develop into neurological complications,” says Galiatsatos. “It’s hard for me to believe that something this common will create lasting COVID for everyone.”

Is the long COVID inevitable or impossible for an individual? It’s impossible to know, and such uncertainty can be demoralizing.

But don’t swing your arms in the air and be careful with the wind, advises Brugler Yonts.

“Just because I’ll probably catch the flu at another time in my life doesn’t mean I lick the subway tracks.”

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