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That means COVID-19 is on the rise.Here’s what you need to know now about the long COVID

That means COVID-19 is on the rise.Here’s what you need to know now about the long COVID

 


coronavirus cases steady decline After a record-length summer spike that recently broke out in the Bay Area, for many who contracted COVID-19 this year during the series of waves caused by Omicron and its variants, COVID-19 The possibility of a prolonged -19 could become a new concern.

Millions of survivors — including those who were vaccinated before being infected — Report ongoing symptoms From fatigue and brain fog to increased heart rate and loss of sense of smell.

But has the proliferation of omicron variants, including the now-dominant BA.5, changed the long-term picture of COVID?

Experts say there is still much to learn, but what we do know about long-term COVID at this stage of the pandemic is how to diagnose it, who is more susceptible, and whether there is a cure. Etc.

How did variants affect the long COVID?

Omicron and its variants have been spreading for months, with each version more contagious than the next. Some subspecies were able to escape vaccines and immunity from previous infections more easily, but on the whole Omicron is less lethal than previous variants, experts say.

In this changing landscape, experts know that “long-term COVID hasn’t gone away,” but according to Dr. Upinder Singh, one of Stanford’s principals, some evidence points Suggesting COVID is less than previous variants. recovery programa nationwide long-running COVID research initiative aimed at enhancing recovery.

a A study published in the medical journal The Lancet Between December 20th and March 9th, thousands of Omicron patients who reported persistent symptoms of COVID for at least one month after infection were followed in June and June 1, 2021. It was compared with reports from patients infected with the delta variant between 11:00 and 27:00. We found that 4.4% of Omicron cases led to prolonged COVID symptoms compared to 10.8% for Delta.

“Vaccination appears to help reduce its incidence,” Singh said.

Phlebotomist Khaliun Gombojav prepares a BinaxNow coronavirus test card at a community test site in San Francisco's Mission District.

Phlebotomist Khaliun Gombojav prepares a BinaxNow coronavirus test card at a community test site in San Francisco’s Mission District.

Stephen Lam/The Chronicle

“But I still tell friends and family that it’s still important to try to avoid getting acute COVID,” she added.

However, the mystery remains.

“We still don’t understand the full physiology of why some people get it and why some people don’t and why some symptoms improve,” Singh said. We also don’t know why COVID can attack all parts of the body “from head to toe.”

Dr. Steven Deeks, who heads the RECOVER program at UCSF, said the risk of hospitalization and death from the current variant is “very low,” especially if you’re vaccinated and have a healthy immune system. If it says “Don’t assume it’s a virus, it’s benign.”

“Many people who have taken Omicron these days have had disabling symptoms that last for weeks,” he wrote in an email. I’m worried.”

How frequent is long COVID?

Simply put, estimates of COVID frequency over time are “all over the place,” Deeks said.

of According to the CDC The proportion of people who contract COVID and continue to develop COVID varies, but we provide some estimates based on research.

• 13.3% more than 1 month after infection.

• 2.5% over 3 months based on self-report.

• More than 30% of hospitalized patients at 6 months.

Deeks suspects that about 10% to 20% of patients have “actually prolonged COVID”, but “it all depends on how the syndrome is defined. there is,” he said.

“The version that causes severe disability is less common, but it does occur and is a great reason to avoid infection in the first place,” he said.

According to Deeks, the big question now is whether omicron and its variants are associated with reduced risk.

“The data are certainly starting to suggest that Omicron is less of a concern than older variants, but we’re seeing more people being vaccinated or having been previously infected again,” he said. “It’s going to be hard to untangle all these tangles.”

To what extent does vaccination reduce long-term COVID risk?

Deeks said it’s widely believed that vaccination helps reduce the likelihood of long-term COVID-19, but there’s still no scientific consensus on how much.

“Almost all research suggests that people who become infected after being vaccinated are much less likely to develop long-term COVID,” Deeks said. His estimate was about 50%.

However, studies vary widely, showing a reduction in the risk of To 80%.

One of the recent studies which included 13 million participants, the largest group of such studies to date, found that vaccination reduced long-term COVID risk by only about 15%.

The degree of additional protection provided by vaccine boosters is also unclear, but Deeks said, “All the science shows that the more immunity you have to COVID, the better off you are in the long run.” says.

A healthcare worker talks to a visitor at a testing station at the Santa Clara County Valley Medical Center in San Jose.

A healthcare worker talks to a visitor at a testing station at the Santa Clara County Valley Medical Center in San Jose.

Carlos Avila Gonzalez/The Chronicle

What are the long COVID symptoms?

The more common symptoms of COVID over the long haul include brain fog, fatigue, headaches, and symptoms that get worse after physical or mental exertion.

Patients may be surprised that some of these symptoms do not appear until they have recovered from their coronavirus infection.

“The odd thing about COVID being so long compared to other illnesses is that normally if you have the flu, you’ll have a fever and a cough that can last for weeks,” he said. She said: “If COVID lingers, new symptoms may appear after (infection).”

For example, a person with COVID may have a cough, fever, headache, and then recover. Brain fog can then develop as a long-term symptom of COVID.

other prolonged COVID symptoms According to the Centers for Disease Control and Prevention, it can include shortness of breath, coughing, heart palpitations, dizziness, sleep disturbances, depression, and digestive problems.

a Recent reports Published in The Lancet Psychiatry and examined data from 1.5 million patients infected with COVID between January 2020 and April 2022, most of the long-term COVID-related mental health conditions are time consuming. Although it has resolved over time, many of the cognitive and neurological effects of the disease have not.

How is COVID diagnosed?

According to Deeks, a prolonged infection with the novel coronavirus can make it difficult to diagnose. This is because blood tests, his regular x-rays, and other diagnostic tests usually return to normal.

“For now, we diagnose long COVID based on symptoms,” he said. “If there is something new that can be traced back to when COVID was diagnosed, and it has persisted for months, then we can make a diagnosis.”

While some patients may not have symptoms that are of particular concern, for others it is “severe and potentially disabling,” he said.

It’s important for people experiencing symptoms to stay up to date on staying healthy and rule out other possible problems, Singh said.

“I always advise anyone with ongoing or new symptoms that it’s best to see their doctor,” she said. I hadn’t had a formal health check-up, so it needs to be integrated into the system.”

How long do symptoms last to be considered long-term COVID?

According to Singh, experts often use two definitions. Symptoms lasting more than 1 month or symptoms lasting more than 3 months. She said she tends to prefer longer ranges because some symptoms may be left over from the initial infection and not true long-term COVID.

Deeks is even more conservative with his definition.

“We generally don’t say people can linger with COVID until the fourth month,” he said.

What are your current treatment options?

At this point in the pandemic, there is no long-term cure or effective cure for COVID, according to experts. For patients, the immediate approach is to manage symptoms.

“Prolonged COVID is best managed in specialized clinics, but waiting lists can take months, and in some areas a year or more,” said Deeks. “Management is now focused on physical and rehabilitation therapy, which may help.”

But treatment research is ongoing, and trying to find out what works and what doesn’t is part of the RECOVERY study. It includes non-pharmaceutical interventions such as, she said.

Are there people at high risk of long-term exposure to COVID?

An early study of long-term COVID showed that older women who had multiple symptoms during a COVID bout were more likely to have persistent symptoms. I am seeing a patient who does not fit my profile.

results from Survey of 100,000 COVID-19 survivors A study by personal genetics firm 23andMe released in late May showed that women were twice as likely to be infected with COVID as men, and that people with depression and anxiety were also more susceptible. People with autoimmune diseases were more than twice as likely to be diagnosed with COVID-19, and those with heart disease and diabetes were almost twice as likely to be diagnosed.

“Anyone can get COVID,” Deeks said, but said those who weren’t vaccinated were “at a much higher risk.”

“Overweight, asthma and diabetes are other risk factors,” he said. “People who were very ill during the acute infection are at greatest risk.”

CDC’s risk categories also include those who had underlying medical conditions prior to the outbreak of COVID.

Kellie Hwang is a staff writer for the San Francisco Chronicle. Email: [email protected] twitter: @KellieHwang

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