Nearly a third of Covid-19 survivors have symptoms, some up to 9 months later, a new study finds

As people with Covid prolonged coping with persistent symptoms such as fatigue, chest pain, difficulty breathing and brain fog, the ongoing question has been when – and if – these symptoms may end. .

With preliminary research showing that lingering symptoms may last at least several months among those who have never been admitted to hospital, new data from a research letter published in JAMA reveals that symptoms in up to a third of outpatients are predominant, some lasting up to 9 months.

Although the study by researchers at the University of Washington was small, it contributes to the ongoing body of literature that describes the severity of the disease in a growing number of people. For their study, researchers performed a follow-up questionnaire of 177 patients between 3 and 9 months after the onset of Covid-19, with an average age of 48 years (age range, 18–94 years).

Of the 177 outpatients (90% never admitted to hospital), researchers found that it was obesity (24/177 patients) and loss of smell or taste (24/177 patients ) the most common harmful symptoms. Four patients (2.3%) also reported brain fog, among which 23 patients (13%) reported other symptoms.

Among the patients examined, hip tolerance was the most common underlying condition. In total, 49 of 150 outpatients (32%), and 5 of 16 hospitalized patients (31%) reported at least 1 persistent symptom. The study found that, out of 31 patients with hypertension or diabetes, 11 (35%) had persistent symptoms.

“This small study shows that long tail of post-Covid-19 symptoms can occur in some people. ”Said Amesh Adalja, MD, an infectious disease physician and senior scholar at the Johns Hopkins Center for Health Security. “The key is unraveling the cause, the risk factors, and determining whether all of these patients are similar or represent different disease processes. ”

“For example, loss of taste and smell is different in sex than ADL (activities of daily living) – stimulating symptom,” Adalja offered.

Determining whether an immunologic defect is common among all patients who develop Long Covid is one of the biggest challenges that researchers have been trying to solve, such as Adalja suggests.

Covid-19 research suggests the role of post-viral inflammation from SARS-CoV-2, prompting researchers to compare Covid-19 with other harmful diseases such as ME / CFS (myalgic encephalomyelitis) seen in patients with post-viral weakness and weakness after development of Epstein-Barr virus, Ebola, Ross River virus, various enteroviruses, as well as West Nile virus and Borrelia burgdoferi (Lyme disease).

Dr. Anthony Fauci, Director of the National Institute for Allergies and Infectious Diseases (NIAID) said in a Medscape interview with Dr. Anthony Fauci. Eric Topol that Covid long-term patients may develop “post-viral syndrome that is very similar to ME / CFS.” But this is an ongoing challenge.

That said, we know that patients have symptoms that indicate a loss of proper regulation of the autonomic nervous system – a system that controls non-regulatory functions such as heart rate, respiration, blood pressure, sweating and body temperature. One example of such intolerance is presented as POTS syndrome (postostatic orthachatic tachycardia syndrome), in which post-viral inflammation is believed to interfere with the ability of blood vessels and nerves to cope with changes. in volume or blood pressure, leading to abnormally high heart rates, low blood pressure and fainting. POTS can lead to a major weakening in daily work, and this is one of the worst conditions associated with Long Covid.

The drug for heart failure, ivabradine, (Corlanor), may help reduce elevated heart rates and other associated symptoms associated with POTS, according to the results of a new study recently published in the Journal of the American College of Cardiology. The study found that the drug significantly reduced standing heart rates compared with placebo, eliminating the typical increase in standing-related heart rate in patients with POTS. Ivabradine supplementation may come from its ability to selectively reduce heart rate, while not lowering blood pressure.

Although there are many subtypes of POTS syndrome, it is possible that this drug may help treat Long Covid patients with this disorder. Conventional methods include midodrine, a drug that increases blood pressure but often has devastating side effects (skin tingling, abdominal pain, urinary problems, dry mouth, chills, sleep, colds). and “goosebumps”) and fludrocortisone which may lead to increased pressure and retention flow. While beta blockers may also be used, they can lower blood pressure, increasing the risk for depression and fatigue.