Dear doctors: When will treatments for the long COVID be available? I had COVID-19 early on, when there was no testing for it yet, and I never really recovered. Does the long COVID still happen to people who get sick now?
Dear reader: As many of you know by now, the term “long COVID” refers to the persistent and often debilitating physical symptoms that persist for weeks or months after a person has recovered from an initial infection with SARS- CoV-2. Almost two years after the start of the pandemic, nearly 250 million people have been diagnosed with COVID-19 worldwide. Data shows that at least a third and up to half of them have symptoms that persist for at least six months. These include a prolonged loss of the sense of taste and smell, persistent cough, chest congestion, muscle pain, weakness, heartbeat or beating heart, difficulty concentrating, and profound fatigue. A growing number of people with long-standing COVID find themselves forced to cut back on their daily activities or even quit their jobs because the collection of symptoms interferes with their ability to function. At the start of the pandemic, the long COVID appeared to be an outlier. However, it is now a known part of the disease process.
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It is still unclear what is causing the long COVID. It affects people of all ages, including children, and even occurs in those with mild initial illness. One theory that was posed early on is that fragments of the virus can linger in the body, triggering an immune response to fight a threat that is no longer there. Another plausible idea is that infection with SARS-CoV-2 leaves the immune system itself in a bad state, much like what happens in an autoimmune disease.
More recently, scientists at Yale University and the University of California at San Francisco have discovered what they see as promising clues as to what is going on. By studying the blood of patients with long COVID, researchers identified unusually high levels of compounds called cytokines. These are small proteins secreted by certain immune cells whose main role is to regulate inflammation. Depending on the specific type – there are pro-inflammatory and anti-inflammatory cytokines – they play a role in increasing or decreasing inflammation. The results in patients with long COVID suggest that the immune system keeps their bodies in a state of chronic inflammation. The researchers’ blood work also revealed unusual activity in key “attack” cells of the immune system, such as T lymphocytes. This supports the scenario of persistent viral particles in the bodies of patients with long COVID.
While there is no known cure for the long COVID at present, intensive research is ongoing. Scientists study antiviral drugs to remove persistent viruses or viral particles from the body. The use of immunosuppressive drugs to manage inflammation is also being explored. For now, however, treatment is a multidisciplinary approach to alleviating and managing each patient’s unique symptoms. This includes specialists in neurology, cardiology and pulmonology, as well as emotional and mental support that can help patients endure the COVID long marathon.
Send your questions to [email protected], or write to: Ask the Doctors, c / o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095.