As the pandemic subsides, long-range Covid still drains patients and confuses doctors | Crown virus

EMily Caffee, a physical therapist and lifelong athlete, relaxed her primary caregiver for suggesting antidepressants when she complained of fatigue, body aches and brain fog in the months after she fell ill with Covid-19 in March 2020.

“She underwent a very thorough medical examination, and many of the lab values ​​returned to ‘normal,'” said Caffee, a 36-year-old Chicago resident. “We didn’t have much to leave in those early days. I think we now have a lot more information ”about long Covid, which was the doctors’ eventual diagnosis for Caffee.

Although there has been significant research on long-term Covid over the past two years – including a number of studies published last week – some infectious disease experts say we still don’t know enough about the prevalence of the condition, what causes it and how to do it. treat it.

More studies on long-term Covid with control groups are needed, and people must continue to take precautions to avoid hiring Covid despite the removal of restrictions and exhaustion due to the pandemic, experts say.

“How worried are people?” Much more anxious than they are, “said Ezekiel Emanuel, a bioethicist at the University of Pennsylvania who was on Joe Biden’s advisory team on Covid during the transition.” People are behaving as if the pandemic is over. The problem with long Covid is like the problem of hypertension or another disease that is in the future. We basically discount the future, especially if the things we need to prevent future bad effects are as difficult as wearing a mask. “

After having Covid, Caffee, who was a competitive rower, attempted to exercise and return to work in acute care at Northwestern Memorial Hospital. But she experienced “relentless and crushing” fatigue and anxiety. She struggled at work and later had to take medical leave.

Emily Caffee in a rowboat.
Emily Caffee is a competitive rower but has been lowered by long Covid. Photo: Courtesy of Emily Caffee

The work was “quite physical, quite cognitively demanding – doing clever reviews, working at the ICU – and it just collapsed,” she said. “A lot of the cognitive tasks I just couldn’t handle.”

Caffee’s experience mirrors that of the other Covid long haulers who, like her, participated in a study conducted at Northwestern, published Tuesday in Annals of Clinical and Translational Neurology. Researchers found that patients continued to have neurological symptoms and fatigue, among other problems, nearly 15 months after infection.

“We saw that although patients tended to improve slightly over time between the first and second visit, they still had a lower quality of life compared to the normal U.S. population in terms of their impression of cognition and impression of fatigue,” said Dr. Igor . Koralnik, Northwestern leader in neuro-infectious diseases and global neurology, who oversees the Neuro Covid-19 Clinic.

Although Covid vaccines were not available when Caffee became ill, people who are vaccinated and have experienced progressive infections have not had much less risk of long-term Covid compared to people who have not been vaccinated, according to a study published Thursday in Natural Medicine.

“Vaccines do protect some but not much of a long Covid. The risk reduction is about 15%, and that’s a very modest amount,” said Ziyad Al-Aly, a clinical epidemiologist at the University of Washington in St. Louis and head of research at the VA St. Louis. Louis. Healthy Care System.

But it is still unclear how common Covid is among people who contract the virus, according to Emanuel and Jennifer Nuzzo, an epidemiologist at the Johns Hopkins Center for Health Security. Estimates of how many Covid survivors develop a long Covid range of 10% to 30%.

Those numbers are often based on retrospective “studies that only look at a proportion of patients and then try to characterize based on very inaccurate measurements” that “experienced certain symptoms over a period of time, but are not compared to any control group,” Nuzzo said. Getting accurate percentages of patients who experience these symptoms after infection can better help us target our resources to help people. “

Nor is it clear whether long Covid is one unique thing, Nuzzo said.

“What we’re talking about is one condition probably not one condition,” she said. “It’s a spectrum of symptoms that people experience after an infection.”

Putting all of these together “limits our ability to focus on how to protect or alleviate people who have suffered,” Nuzzo added.

There has also been insufficient research on what treatments are effective against long-term Covid, Emanuel said.

The medications of people with long Covid should be compared with those of people who have not developed the condition, he said.

“Are we shooting in the dark – at least initially – until we better understand what the immunological defects are that lead to that? Absolutely. Do we have an alternative? Yes, we can just wait and wait and wait. That doesn’t seem to me. the best idea, ”said Emanuel.

While infectious disease experts call for more research, that doesn’t mean they’re trying to reduce the suffering of long-haul carriers, Nuzzo said. Some people with the condition have expressed anxiety that health care providers are not taking their symptoms seriously.

“I think anyone who has ever experienced a chronic illness has probably ever encountered that frustration, feeling that they know something is wrong, and they need help and they don’t get that kind of help and understanding from the medical community that they And so I think that also plays a role, in addition to a list of questions for which science does not yet have excellent answers, “said Nuzzo.

Emily Caffee, right, with a colleague at Northwestern Memorial Hospital.
Emily Caffee, right, with a colleague at Northwestern Memorial Hospital. Photo: Courtesy of Emily Caffee

While suppliers and long haulers are waiting for those answers, the best thing anyone else can do is get vaccinated against Covid, infectious disease experts said.

Emanuel also recommended taking steps on how to install HEPA filters; wearing N95 masks; and not eat in restaurants indoors.

“If it weren’t for a long Covid or one in 2,000 people had a long Covid who had a sharp infection,” Emanuel said he wouldn’t care about masking. But the virus poses a threat “of very serious complication,” Covid said at length.

Caffee, the physical therapist, tried to heal by making dietary changes, meditating, and doing restorative yoga.

It worked.

At the end of summer 2021, she was able to gradually return to work and exercise. She now works full time again and feels “90 to 95% better,” she said.

She now treats people with long Covid who present with a range of problems, including balance problems and neuropathy in legs and feet.

“I certainly hope to continue to serve this community as it will not go away,” she said. “I feel a good sense of validation to offer what I can to help these patients.”

Leave a Reply

Your email address will not be published.