A nurse assists a patient walking in the Covid-19 alternative care site located in a parking garage at Renown Regional Medical Center in Reno, Nevada on December 16, 2020. When her school closed in March 2020 due to the pandemic, Chimére Sweeney, an English teacher in Baltimore, expected to return to her students once the situation with the new SARS-CoV-2 virus improved. However, life took a different turn when she contracted Covid shortly after and never fully recovered.
Initially experiencing muscle aches, Sweeney’s symptoms worsened in the following weeks to include panic attacks, blurry vision, constipation, partial hearing loss, facial paralysis, memory issues, and a stutter. Despite being told she would improve after two weeks, Sweeney, now 42, continued to struggle with severe whole body pain, sleep disturbances, depression, rashes, urinary issues, memory loss, and irregular periods.
Nearly five years later, long Covid continues to affect Sweeney, along with millions of others, with over 200 varied symptoms impacting multiple organ systems. The lack of an approved test or standard treatment for long Covid poses challenges for those affected. While the Centers for Disease Control and Prevention estimate that 1 in 20 adults in the U.S. live with long Covid, the true number may be higher due to underreporting.
Efforts to understand and address long Covid, including the NIH’s RECOVER initiative, have faced obstacles such as funding cuts and lack of a cohesive approach. The termination of key advisory committees by the previous administration raised concerns about the progress of long Covid research and treatment development.
As the world navigates the ongoing challenges of long Covid, medical experts and researchers continue to seek answers and solutions to support those living with this debilitating condition.
Let’s work together with patients to find solutions and continue building on the progress we’ve made so far. “We have not yet provided answers that match the severity of the public health crisis we are facing,” he remarked.
Long Covid can be caused by various factors. While SARS-CoV-2, the virus responsible for Covid, is a common culprit, other viruses like Epstein-Barr, influenza, and varicella-zoster can also trigger lingering symptoms. Covid appears to have a higher likelihood of leading to chronic illness compared to other pathogens, though the exact reasons for this are still unknown. Some theories suggest that viral remnants persist in the body, potentially stimulating the immune system and causing lasting symptoms. Reactivation of dormant viruses like EBV and HIV is also a possible cause, as is the production of antibodies that mistakenly attack healthy tissues.
Research indicates that Covid can affect blood vessels, leading to clot formation and contributing to symptoms like irregular heartbeats and heart failure in long Covid patients. While the exact cause of long Covid remains unclear and may involve a combination of factors, increased inflammation in the body seems to play a key role in its development.
Diagnosing long Covid can be challenging, as there is no specific test for the condition. Patients often undergo numerous tests and scans to rule out other illnesses, which can be costly and time-consuming. Identifying biomarkers associated with long Covid could help streamline the diagnostic process.
One study found that routine lab tests may not be effective in diagnosing long Covid, prompting researchers to search for new biomarkers. Recent research suggests that decreased blood flow in the retinal blood vessels may be linked to long Covid, potentially affecting brain circulation and mitochondrial function.
This theory suggests that many individuals with long Covid may experience cognitive issues, fatigue, and exercise intolerance due to disruptions in energy levels, as explained by Koralnik. The research, published in February in the Journal of Imaging, indicates that the retina could potentially serve as a biomarker for long Covid. While other studies hint at potential biomarkers in the gut and immune system, Brode cautions that these early findings are preliminary and based on small sample sizes.
Although a diagnostic test for lingering symptoms would be beneficial, some experts stress that the absence of one should not impede ongoing research into long Covid treatments. Julia Moore Vogel, a senior program director at Scripps Research and a contributor to the Patient-Led Research Collaborative for long Covid, points out that conditions like migraine lack definitive biomarkers or diagnostic tests yet have approved treatment options. Despite the challenges, Vogel remains optimistic about advancements in long Covid research.
However, progress in developing treatments for long Covid has been disappointing, with no specific medications approved by the Food and Drug Administration. Clinical trials are exploring the efficacy of existing drugs used for other conditions in managing long Covid symptoms. Pacing activities and receiving physical and cognitive behavioral therapy are essential components of managing long Covid symptoms in the absence of targeted treatments.
Recovery from long Covid remains a challenge, with only a small percentage of individuals recovering after two years, according to Cohen. Vaccination against Covid appears to improve long-term recovery outcomes, particularly among those vaccinated. Moving forward, a multifaceted approach involving various treatments may be necessary to effectively manage the diverse manifestations of long Covid.
Booster shots are recommended for those experiencing improvements, but it is important to be prepared for challenges along the way. Living with long Covid can be draining, so it is crucial for those not affected to provide support. Clinical trials need to be adaptable to accommodate patients who may be restricted to their homes. The long Covid community continues to seek answers and relief, with hope for better quality of life through well-designed trials.
