If you are planning to join a crowd at a sporting event, mall, beach, or go to a movie, you should be reminded that Covid is still here. In fact, infections are rising, with over 100,00 new cases and over 500 deaths daily in the U. S.
The majority of those who contract the virus will fully recover in a few short weeks—many, but not everyone. The risk of the mysterious condition that has become known as long Covid is soberingly real. The CDC defines long Covid as associated health problems that last for more than a month after one has a Covid infection.
Staggering numbers of Americans are suffering from “long Covid.” It makes it very challenging to answer the simple greeting, “How are you?” Most respond with the standard “fine,” but the truth is much more complex.
Instead of recovering in a few weeks, these patients are told it may take several months. For some, it can even take years. It can be discouraging, isolating and lonely. The world seems to move on without them.
The two most common symptoms of long Covid are shortness of breath and fatigue. Profound fatigue. The simple act of taking out the garbage or walking a dog can cause such extreme fatigue as to make them take a nap for hours or even all day to recover.
Chest discomfort, headache, dizziness, palpitations, an inability to regulate body temperature, and difficulty concentrating (brain fog) are other common symptoms of long Covid.
Diagnosis
Experts are searching for ways to diagnose long Covid adequately. They agree that long Covid is an actual condition. Still, traditional diagnostics like standard blood tests, CT scans, MRIs, brain scans, x-rays, or physical examinations cannot diagnose long Covid.
This inability to make a clear and consistent diagnosis can be disconcerting to someone with many of the long Covid symptoms. Hopefully, the medical community will soon develop a set of diagnostic criteria and rules that will benefit all those suffering from long Covid.
Currently, the National Institutes of Health has instituted a comprehensive study called “Recover.” The goal is to discover why some people who contract COVID-19 develop long Covid. This program is an important initiative because it is a healthcare emergency.
The CDC reports that more than 50% of all Americans have been infected with Covid. Estimates say that approximately 20% of Covid patients will develop long Covid. That translates to tens of millions of people in the United States who will suffer from long Covid.
Interestingly, long Covid shares similarities with other infections, such as Lyme disease and Epstein-Barr, which can also be challenging to diagnose.
Some notable observations:
- Those with severe or prolonged Covid are at higher risk for developing long Covid.
- Vaccination lowers the risk for death, severe illness, and the development of long Covid.
- Long Covid occurs more frequently in women than men.
- Long Covid can occur in children.
But, the picture is still not clear. For example, many people with very mild cases of Covid, infections that do not require hospitalizations or even doctor’s visits, can still get long Covid. The Mayo Clinic reports that almost 75% of patients with long Covid had very mild Covid infections.
Possible causes
The cause of long Covid remains elusive, but some hypotheses include:
- The inflammation associated with Covid can cause long-lasting damage to the heart, lungs, and blood vessels.
- The immune system can get confused and attack normal tissue long after the Covid infection has resolved.
- Covid infection can disrupt a person’s normal microbiome: the trillions of bacteria living within us that protect and help us, their human hosts.
Treatment
Long Covid is challenging to treat. The good news is that most with long Covid get better over time. Rehabilitation services, including occupational and physical therapy, are also beneficial.
The key is to gently direct the patients into a much better place to understand the course and to better control and manage their symptoms until they resolve. The key is to get support early. The earlier, the better. Talk to your physician if you have symptoms 3-4 weeks after a Covid infection.
Most sufferers with long Covid want others to know that hope is essential. Things will get better, but only with time. Everyone wants the pandemic to be over, but we must still understand that for many it is far from over.
For more information, visit survivorcorps.com (a long COVID patient support organization), or the CDC’s long COVID website at www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html.
Charles E. Crutchfield III, MD is a board-certified dermatologist and clinical professor of dermatology at the University of Minnesota Medical School and a Benedict Distinguished Visiting Professor of biology at Carleton College. He also has a private practice, Crutchfield Dermatology in Eagan, MN.
He received his MD and Master’s Degree in molecular biology and
genomics from the Mayo Clinic. He has been selected as one of the top 10 dermatologists in the United States by Black Enterprise magazine. Minnesota Medicine recognized Dr. Crutchfield as one of the 100 Most Influential Healthcare Leaders in Minnesota. Dr. Crutchfield specializes in
skin-of-color and has been selected by physicians and nurses as one of the leading dermatologists in Minnesota for the past 18 years.
He is the team dermatologist for the Minnesota Twins, Vikings, Timberwolves, Wild and Lynx. Dr. Crutchfield is an active member of both the American and National Medical Associations and president of the Minnesota Association of Black Physicians. He can be reached at CrutchfieldDermatology.com or by calling 651-209-3600.