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“The frustrating thing is that there is no silver bullet.” Doctors say “long COVID” patients do not forge it.




WATERLOO — So-called “long COVID” patients, who continue to have symptoms weeks or months after a coronavirus-positive diagnosis, are expected to recover. Dr. Raul Villacreses saw it in person.

Clinical Associate Professor of Internal Medicine is one of the doctors working at University of Iowa Healthcare Respiratory Disease Follow-up ClinicThe only clinic in the state dedicated to studying the ongoing symptoms of people who have acquired COVID-19.

According to Villacres, several patients with acute respiratory distress syndrome caused by COVID (a fatal condition in which fluid accumulates in the air sacs of the lungs) have improved, and CT scans and lung function tests have shown that the lungs have recovered. Shown.

“Even ARDS, the most serious lung damage you can have, we’ve seen them improve over time,” he said.

He said it hadn’t received much treatment. Some patients were given an inhaler to help breathe. Others have improved “because their bodies are just recovering from it,” he said.

“So far, the frustrating thing is that there is no silver bullet,” said Dr. Pradeep Ramesh, medical director of hospital doctors at Unity Point Waterloo. “There are many things we don’t know about COVID.”

Healthcare providers want other doctors and the general public to know why some patients do not recover from COVID-19 immediately, while others are trying to figure out why. thinking about. These people haven’t forged it. Long COVIDs are genuine and affect non-essential parts of people infected with the virus.

“It’s not just them,” said Villacreses. “There are definitely people working on it and trying to reach the bottom of it.”


The Respiratory Disease Clinic opened in June, just months after the first diagnosis of Iowa, and soon found demand for its service. Other healthcare providers were wary of seeing patients who might still be infected with COVID-19 or who didn’t know what to say about persistent symptoms, Villacreses said.

“We went from a couple of patients a day to 20 patients a day,” he said. They also went to 4 to 8 doctors.

Patients over the age of 16 who recovered from their first illness complained of ongoing respiratory symptoms such as shortness of breath, cough, and chest pain.

They also experienced what Villacreses calls “nerve cognitive problems” and nervous system problems such as chronic fatigue, headaches, brain fog, arthralgias, and long-term loss of taste and smell. Some “long-haul carriers” interviewed by The Courier a few weeks ago had similar problems.

“We are aware that there are patterns now,” said Villacreses, who said, for example, patients tend to complain of headaches in one place on their head.

Other viruses, such as the flu, can cause confusion, agitation, and even neurological problems such as stroke, according to Ramesh, but they are more likely to have COVID.

“These things are very common in COVID patients — more than any infection I’ve seen,” he said. It is unclear whether it is related to blood vessel, leg or lung coagulation, or the reaction of the brain itself. “It’s very frustrating. There is no answer to most of these.”

However, there is not always a pattern. Ramesh has seen patients with long COVID who had to be hospitalized, but some were at home and took a nap.

“There’s no reason some people get it and some don’t,” Ramesh said.

Also, the various studies Ramesh have not been able to determine how many people have long COVIDs. In some surveys it is 10% and in others it is up to 60%. He believes that when more research is done, it will be a smaller number.

“Even if the dust subsides and you come up with how often this happens, it’s a lot of patients, even if it’s 5% of all COVID patients,” Ramesh said. “It’s a lot of people in the United States who are dealing with many symptoms even after recovery.”

Study the problem

To come up with a cure, doctors first need to understand exactly what they are against. Is the virus just hanging out for a long time in some people, known as inadequate virus removal? Is the immune system of some people overactive long ago trying to fight the virus?

“These are some of the theories that came to mind,” Ramesh said. “But again, no one knows.”

Therefore, in addition to treating patients, the Respiratory Disease Clinic requires patients to analyze CT scans, respiratory function tests, and blood samples to determine the cause.

“We realized that we needed to be able to obtain information for research purposes and share it within the institution,” said Villacreses.

Ultimately, Villacreses wants to include in their research how the virus affects the brain and focus on the most common neurocognitive symptoms. Some of the patients in the clinic had cramp-like symptoms, or what he said was “serious neurological symptoms,” but more generally, loss of taste and smell.

“Really, it’s a syndrome that is better explained and needs more research,” Villacreses said.

What you can do

But healthcare providers say you don’t have to suffer alone. The more patients visit a doctor, the more doctors will be familiar with it and the more research they can do.

“First, you ask for help-don’t keep it on yourself-because we may be able to find an explanation of how you feel and reach the bottom of it. “Villa creses said.

Providers can also rule out other illnesses or conditions that may have occurred by accident or have been exacerbated by COVID diagnosis, Villacreses said.

“We are lung doctors, but we are broad,” he said.

Ramesh shared Villacreses’ optimism that most patients will see most of their symptoms disappear over time.

“Make sure you are well hydrated, eat well, sleep well, and exercise well. I hope things get better,” Ramesh said.

But just because there is no cure doesn’t mean that healthcare providers don’t believe in you, he said.

“Maybe people … dismiss these symptoms, but they are very realistic and can be quite debilitating,” Ramesh said.

And know that Villacreses is studying, at least for some people, long COVIDs are not permanent.

“It’s encouraging to see improvements not only in respiratory symptoms, but also in patients complaining of brain fog,” said Villacreses. “I think it’s too early to say, but I hope this becomes a trend.”


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