‘New Public Health Dilemma’: Long COVID Symptoms, Risks & Unknowns

Over two years into the coronavirus pandemic, millions of patients around the globe are suffering from the lingering symptoms of long COVID, while doctors still search to find answers for treatment.

Long COVID, known as post-acute sequelae of COVID-19, is a wide range of complications after a patient has recovered from an initial infection of the SARS-CoV-2 virus.

The average duration of a COVID-19 infection can be anywhere from two to fourteen days, and it is normal to feel some continuing after-effects weeks later from any virus.

While there is no standardized test for diagnosing long-haul COVID, experts say the condition can occur months after recovering from the onset of symptoms.

“So much of the focus up until now has been on the actual infection and preventing the infection, but now we have a new public health dilemma on our hands. I would argue an even bigger public health dilemma — all the people who recover but are not the same,” Dr. Purvi Parikh of the Allergy & Asthma Network told NBC New York.

Parikh is an allergist and immunologist located in Midtown Manhattan. She has seen more than 12,000 cases of long COVID.

Long COVID Symptoms

Patients suffering from long-haul conditions can experience a range of issues, such as cardiovascular, neurological, and psychological problems. Below are just a few long-haul systems reported:

• Breathlessness
• Chest tightness
• Palpitations
• Fatigue
• Fever
• Brain fog
• Sleeplessness
• Weight loss or gain
• Loss of taste and/or smell
• Depression
• Anxiety

Dr. Jonathan Shammash of Hackensack University Medical School said patients have come forward with some symptoms similar to Chronic Fatigue Syndrome or CFS.

“Patients presenting with long COVID can have a variety of presentations. There are patients that present with symptoms that are similar to what we used to term Chronic Fatigue Syndrome (CFS) which is also now called myalgic encephalomyelitis (ME),” Dr. Shammash said to NBC New York.

These post-COVID patients similar to those with CFS often experience profound fatigue worsened by activity. One common complication shared by long haulers is brain fog, which is defined as a mix of confusion, forgetfulness, and inability to focus on tasks.

Along with fellow researchers, Parikh analyzed the surrounding mechanics of over 100 COVID long haulers. The study found persistent fragments of the SARS-CoV-2 virus fifteen months post-infection.

These findings could help scientists better understand what is driving post-COVID conditions. Parikh shared with NBC New York how she believes long COVID could be a condition of inflammation.

“Our theory or thought maybe is that there is a prolonged inflammation in these individuals. In these 144 people, we found that they still have pieces of the original virus in their white blood cells, so is that it? We can’t say for sure, but this could be a clue,” said Dr. Parikh.

Who Gets Long COVID?

More than half of the over 200 million people diagnosed with COVID-19 worldwide will undergo post-COVID symptoms, according to Penn State College of Medical Research.

This team urges the government and health care organizations to prepare for the uptick in psychological and physical care.

One study released earlier this year discusses four aspects that could link to an increased risk of developing long COVID.

These factors published by the journal Cell are the level of coronavirus RNA in the blood, presence of autoantibodies, reactivation of Epstein-Barr virus, and having Type 2 diabetes.

“Approximately, 10 to 30 percent of patients with an acute COVID infection may develop long COVID,” said Dr. Shammash, who notes that number has fluctuated but is a good range.

In his experience, middle-aged women tend to develop long COVID as it may relate to inflammatory reactions or a higher chance of developing an autoimmune disease.

“To be honest, I haven’t seen a real trend because I have seen almost every age develop long COVID. Really young, healthy people — navy seals, police officers, other physicians — who now have trouble functioning,” added Dr. Parikh.

Children should also be cautious when considering long-haul impacts. According to data collected by over 20 studies from Europe, Asia, Australia, and South America, one in four children with COVID-19 symptoms develop long COVID.

Among over 80,000 children studied, 25% endured symptoms for at most 12 weeks or combat new complications that appear over three months, according to this medRxiv report.

This story is part of a series following long COVID experts and patients during the two-year pandemic anniversary.