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“Long COVID” is one of many scary phrases that have entered our vocabulary since the pandemic upended global life.© Provided by Boston Herald London Beyond the Pandemic-Long COVID
Those who have it are afflicted with a COVID that seems never to go away, a lingering torment that demoralizes as much as it incapacitates. With the current panic over the Delta variant, there’s a danger that we will not accord this slow-burn condition the attention it deserves.
With symptoms ranging from severe fatigue and lightheadedness to anxiety and, in some extreme cases, psychosis, these long-haul patients are begging for help. They aren’t a niche segment of the population. Studies indicate that as many as three out of 10 people infected with COVID-19 may experience long COVID. One study of hospitalized COVID-19 patients found nearly 80% experienced lingering aftereffects six months after discharge. And yet, doctors struggle to find an explanation for their conditions.
Another part of the problem is that almost all studies of long COVID focus on its effects in the unvaccinated. Very little research has been done on those with a “breakthrough infection” — the contracting of COVID-19 after vaccination. Preliminary research in Israel suggests that symptoms of COVID can endure for up to six weeks in breakthrough cases.
What makes long COVID so puzzling is the variety of possible symptoms, of which there are potentially hundreds. Patients report shortness of breath, fever, difficulty concentrating and skin conditions, to name a few. Some patients experience hearing loss and now need to wear hearing aids. Still others report fatigue so severe that they struggle to get out of bed or move from the couch. There’s no diagnostic test for long COVID, and brain MRI scans and other tests fail to yield results.
But this list of symptoms also gives researchers multiple vantage points from which to study the condition.
Some scientists theorize that fighting COVID 19 leaves behind viral particles that trigger a generalized cycle of inflammation long after the body has defeated the pathogen itself. Others think the virus may burrow in human tissues, allowing it to surface sometime later when immunity weakens. Viruses like HIV and herpes simplex are known to act in this way.
In select cases, doctors have diagnosed patients complaining of long COVID symptoms with a rare condition known as postural orthostatic tachycardia syndrome, POTS for short. POTS arises from dysfunction in the autonomic nervous system, the part of our bodies that regulates functions such as breathing, heart rate, blood pressure and digestion. The condition often appears suddenly, following a viral infection.
The more doctors research and learn, the more easily they can attend to long-haulers’ symptoms. And in guidelines released mid-June, the Centers for Disease Control and Prevention recommended doctors focus their approach on patients’ specific symptoms.
Thus, in the fight against long COVID, doctors should target the symptoms patients are experiencing with treatments already proven to address those indications.
For patients experiencing high blood pressure, for instance, doctors can prescribe beta blockers to slow their heart rate. Those patients who feel extreme fatigue can benefit from medicines used to treat chronic fatigue syndrome. Some patients with a POTS diagnosis see positive results from a drug called ivabradine. Other long-haulers have tried intravenous immune globulin transfusions to reduce inflammation.
A number of drugs, FDA-approved for other ailments, are finding welcome additional use in the treatment of COVID. Empagliflozin, commonly used for Type-2 diabetes, promises to protect against COVID-related organ failure. Baracitinib, an anti-inflammatory drug developed for rheumatoid arthritis, has shown notable effectiveness in reducing COVID-related mortality.
Patients experiencing respiratory problems may benefit from a new drug known as Tavalisse, which has FDA approval for use in patients suffering from a rare condition known as thrombocytopenia. Meanwhile, a recent study found that Low Dose Naltrexone — a therapy greenlit for patients who suffer from chronic fatigue or chronic pain — shows potential to safely and effectively disrupt COVID-19’s ability to attack the body.
The finding of a treatment to alleviate lasting symptoms is a prayer answered for long-haulers. Many have been forced to quit their jobs because their symptoms are too severe to let them work a full day. Those fortunate enough to attend long-haul rehabilitation still average 100 days of care before recovery.
Curing long COVID requires dedicated research and investment. With tens of thousands of Americans getting infected with COVID-19 every day, the scientific community must double down on finding cures.
Dr. Jeffrey Gold is a family physician and the owner of Gold Direct Care in Marblehead.
Source : https://www.msn.com/en-us/health/medical/gold-doctors-battle-against-debilitating-long-haul-covid/ar-AAOcZms914