Authors: MEG WINGERTER<\/a> | mwingerter@denverpost.com<\/a> | The Denver Post PUBLISHED: June 5, 2022<\/p>\n\n\n\n Two years after the first COVID-19 patients raised alarms that symptoms could last for months, it\u2019s clear the phenomenon is common \u2014 but medical experts still don\u2019t know much about what causes it or how to treat it.<\/p>\n\n\n\n A study from the Centers for Disease Control and Prevention<\/a> looking at 353,000 COVID-19 survivors found that about one in four who are 65 or older and one in five adults younger than 65 developed a new health condition that could be related to their bout with the virus.<\/p>\n\n\n\n There\u2019s not much data about why some people are stuck with symptoms months after most COVID-19 patients have recovered, or when they might expect to feel better, though.<\/p>\n\n\n\n Diagnosing what\u2019s become known as long COVID<\/a> is mostly a process of ruling out everything else that could be causing a patient\u2019s symptoms, said Dr. Thomas Campbell, a professor of medicine at the University of Colorado School of Medicine and chief clinical research officer at UCHealth.<\/p>\n\n\n\n The most common reasons that patients seek care at UCHealth\u2019s long COVID clinic are fatigue and respiratory symptoms like persistent coughing or shortness of breath \u2014 all symptoms that can have many causes, he said.<\/p>\n\n\n\n \u201cIt\u2019s not black and white at all,\u201d Campbell said.<\/p>\n\n\n\n It\u2019s not unexpected for people who were sick enough to be treated in an intensive-care unit to have lingering symptoms both from the medical condition itself and from the measures needed to save their lives, such as spending time on a ventilator. Other viruses can also cause prolonged symptoms in people who were mildly ill, but the phenomenon is more common with COVID-19. It\u2019s also unusual to see so many different symptoms.<\/p>\n\n\n\n It still appears women are more likely to have long COVID, but it\u2019s possible that could reflect differences in who seeks care, Campbell said. Data from the United Kingdom<\/a> found the same gender difference, though the American and British studies disagree on whether risk rises with age, or peaks between 50 and 69. The British data didn\u2019t include people living in nursing homes, which may have caused it to underestimate how many people over 70 were affected.<\/p>\n\n\n\n For now, treatment still focuses on addressing specific symptoms, like giving patients medicine to reduce coughing, and gradually building up their strength and endurance through physical therapy, Campbell said. Most patients start feeling better in three or four months, but people who were less healthy before getting the virus or became severely ill from the virus can take longer, he said.<\/p>\n\n\n\n There\u2019s still a process of trial and error for medications, but evidence seems to be growing for a process of increasing people\u2019s activity levels extremely slowly, said Dr. Tod Olin, director of the Exercise and Performance Breathing Center at National Jewish Health in Denver. It\u2019s annoying for people who are accustomed to more strenuous exercise, but overdoing it seems to wipe out much of the progress patients have made, he said.<\/p>\n\n\n\n The National Institutes of Health recently started a study, called RECOVER, to understand why some people develop long COVID symptoms and others don\u2019t, Campbell said. People who had COVID-19 and want to participate can email recover@ucdenver.edu.<\/p>\n\n\n\n \u201cTo effectively treat long COVID, we have to understand it,\u201d he said. \u201cOtherwise, it\u2019s just making guesses.\u201d<\/p>\n\n\n\n Olin said he and his colleagues have observed three general types of long COVID patients: people with excessive fatigue and shortness of breath; those whose heart rates spike erratically, causing them to get lightheaded from even slight activity; and those who have \u201cbrain fog.\u201d<\/p>\n\n\n\n There are many other post-COVID symptoms, but those tend to be the ones that drive people to seek care, he said.<\/p>\n\n\n\n It\u2019s too early to know if those are three presentations of one disorder, or distinct syndromes with different underlying causes, Olin said.<\/p>\n\n\n\n The CDC researchers looked at 26 conditions<\/a> affecting the heart, lungs, kidneys, blood vessels, digestive system, brain and muscular system. While the risk for almost all of the conditions was higher in people who\u2019d had COVID-19<\/a>, the odds of developing a new respiratory condition were especially high.<\/p>\n\n\n\n The study didn\u2019t prove the virus caused all of those conditions, since it\u2019s possible doctors were looking more closely for other problems in patients who\u2019d had COVID-19, or that some people had a condition before they got the virus and were only diagnosed after.<\/p>\n\n\n\n Some researchers think long COVID could be caused by an immune response gone awry, while others think fragments of the virus could be lurking somewhere in the body, keeping it in a chronic state of inflammation. Some think both could be correct, and that some patients could be dealing with still another underlying problem.<\/p>\n\n\n\n Researchers at National Jewish<\/a> also found that in patients reporting excessive fatigue, cells didn\u2019t seem to be using the available energy well. It\u2019s an intriguing finding, since they typically only see that pattern in people with certain rare diseases, but it\u2019s far too early to say that\u2019s what is causing long COVID, Olin said.<\/p>\n\n\n\n \u201cIt\u2019s a really preliminary signal,\u201d he said.<\/p>\n\n\n\nOne cause or several?<\/h3>\n\n\n\n
Vaccines help \u2014 but how much?<\/h3>\n\n\n\n