The fight against “long-distance” Covid continues as the pandemic in the United States slows

Dr. Michael Saag usually takes care of Covid-19 patients, but in the early days of the pandemic he became a patient. Now he has joined the ranks with protracted symptoms from a state that doctors are still trying to understand.

In the case of Saag, Covid-19 wasn’t too bad and had to be hospitalized, but he was quarantined in his room for 15 days and most of it got better.

The fog in his brain continued. He was easily out of breath. His heart moved violently. These symptoms lasted 6 weeks after infection.

saw He felt good enough to return to the University of Alabama at Birmingham, but even after the other symptoms had subsided, he experienced deafness and is now wearing a hearing aid.

“It’s frustrating,” he said ruining the US Centers for Disease Control and Prevention. Clinical outreach and communication activities Thursday meeting.

Saag said he had met other patients with advanced symptoms.

“They went to their provider who said this was in your head, or this isn’t a worry, but it was pretty profound,” Saag said.

Experience sometimes referred to as a “long-distance carrier” Long covid, Postcovid conditions, Postcovid Syndrome — There is no fixed name. There are no diagnostic tests, no specific treatments, no tablets to take. Also, while research is ongoing, there are no large peer-reviewed gold standard clinical trials yet.

Some people improve naturally over time, while others can treat their symptoms, but for others, recovery remains elusive.

this week, American Medical Association We have adopted a policy of educating doctors and students about post-viral syndromes following Covid-19.

I also posted a CDC this week. Provisional guidance The goal is to help physicians better evaluate patients with post-Covid status.

Almost consistent with 100 symptoms

Postcovid is a comprehensive term for a variety of physical and mental problems that can last more than 4 weeks after a Covid-19 infection. According to the CDC..

There is Potentially hundreds Symptoms include shortness of breath, malaise, headache, fever, anxiety, depression, pain, loss of taste and odor, difficulty thinking, and heartbeat.

Symptoms are inconsistent. Doctors cannot predict what symptoms someone will have or who will. Symptoms can also change over time or disappear and then return.

In some cases, the fix seems relatively easy. Dr. Mitchell MillisAutonomic dysfunction specialists working with postcovid patients in Stanford Healthcare He may remind people to see their salt, increase their fluids, or prescribe beta-blockers, and they said they would eventually get better.

“We first try to control the symptoms, then use it as a bridge to more physically rejuvenate the symptoms and then treat all possible factors,” says Miglis.

However, not all symptoms can be easily dealt with. “There isn’t really a single cure for the underlying disease because we don’t yet know the cause of the underlying disease,” says Miglis.

Millions can be affected

It is not entirely clear how many people have it. April, Director of National Institute of Public Health Dr. Francis Collins A preliminary study by Congress found that about 10-30% of people infected with Covid-19 can develop long-term health problems.

One white paper study from Fair health Examining the private sector insurance records of about 2 million Covid-19 patients released Tuesday, nearly a quarter, 23.2%, were in at least one post-Covid condition more than 30 days after the initial diagnosis. I concluded. Since the inception of the pandemic, more than 33 million cases of Covid-19 have been counted in the United States, and millions of people may be facing ongoing symptoms.

“It’s probably an underestimate,” he said. Leonard JasonProfessor of Psychology working on the problem of Forgetfulness With a post-Pancovid patient at DePaul University in Chicago. He wants doctors to be careful of these patients and receive appropriate treatment.

“There are probably a lot of people who have this and aren’t identified. That’s one question. How do you come up with the criteria for what it means to be a long-haul carrier? ? “Jason said. “There isn’t much consensus at this point. This is a problem.”

Who is the long-haul carrier?

A FAIR Health study examining insurance records from February to December 2020 found that post-Covid conditions were more common in more severe Covid-19 patients, but were “significant” in asymptomatic cases. The proportion also had long-term symptoms. More research is needed, it said.

Most of the postcovid conditions studied were more common in women, yet there were 12 more common symptoms among men.

“I’m amazed at the number of people who don’t have the underlying conditions. In fact, there are two young marathon runners in their twenties and thirties. They have problems just taking a shower. “I’ll be back in the post-Covid state,” Saag said of some of the patients he treated.

What is going on

In February, NIH launched an initiative to identify the cause, prevention, and treatment of post-Covid conditions. During December Parliament provided $ 1.15 billion over four years to support NIH research.

The American Medical Association policy adopted this week also called for more funding for research, prevention, management and treatment.

For now, people with long-term Covid symptoms may be able to get care from a regular doctor or one of the post-Covid care clinics open nationwide.During ~ Call with a clinician This week, the CDC said most conditions can be identified and managed by primary care physicians in collaboration with specialists and such clinics.

Postcovid Clinic sees signs of hope

Mount Sinai Postcovid Care Center in New York, I was busy when I first launched such a clinic. By February, doctors had already seen 1,600 patients. Recently, David Plutino, physical therapist Those who help patients run the clinic feel new hope.

“When I was talking to the media three months ago, I think everyone is improving. I’m encouraged by how they’re improving, but no one has surpassed Covid. “Purtino said. “Now, after months of working and completing this, we say that dozens of individuals who are now discharged feel the same as they did before Covid. This is a new development.”

For many patients, it has never been easier. On average, he said it was 100 days of treatment. “It’s a long process, a very slow, very gradual treatment, twice a week, and people make many behavioral and life adjustments along the way to avoid triggering and exacerbating symptoms. Must be, “Purtino said. “But as you know, we are very encouraged to finally gain traction.”

Not everyone takes so long to heal. Dr. Panagis Galliazzatos, Lung and critical care physician treating patients Johns Hopkins Postcovid-19 Care According to the clinic, some people get better in about three months.

“Tell them it’s a pain. If you remove the cast, you won’t be able to do it right away. You’ll have to rehabilitate it and it will be uncomfortable, but it’s It will be better, “Galiatsatos said.

Another category of patients develops more lung-specific treatable symptoms, such as asthma.

“Everything from the brain to the feet can be affected,” said Galiatsatos. Some people need mental health care.

“Patients in the last category we see have symptoms that do not fit into the actual disease process we are aware of,” said Galiatsatos. He tells them they will understand it together.

One patient he treated was compared to how a good doctor treated AIDS in the 1980s.

“Sometimes we have to think of the best way to help a little out of the box,” said Galiatsatos. “But I’m sure I can.”