{"id":5249,"date":"2022-08-05T06:00:00","date_gmt":"2022-08-05T06:00:00","guid":{"rendered":"http:\/\/wp.cov19longhaulfoundation.org\/?p=5249"},"modified":"2022-08-05T06:00:00","modified_gmt":"2022-08-05T06:00:00","slug":"long-covid-study-looks-at-why-some-cant-shake-dizziness-fatigue-and-more","status":"publish","type":"post","link":"https:\/\/cov19longhaulfoundation.org\/?p=5249","title":{"rendered":"Long COVID study looks at why some can\u2019t shake dizziness, fatigue and more"},"content":{"rendered":"\n<p>Authors:&nbsp;<a href=\"https:\/\/www.ajc.com\/staff\/helena-oliviero\/\">Helena Oliviero<\/a>, The Atlanta Journal-Constitution<\/p>\n\n\n\n<p>Georgia residents among thousands needed for a massive study to discover how the virus causes lingering symptoms.<\/p>\n\n\n\n<p>Back in the summer of 2020, when the pandemic was still new and hospitals were overflowing, Emory Healthcare opened a facility to treat a perplexing group of COVID-19 survivors.<\/p>\n\n\n\n<p>The patients had withstood the virus\u2019s initial onslaught but couldn\u2019t shake some of the symptoms.<\/p>\n\n\n\n<p>At the time, Dr. Alex Truong thought the long COVID clinic might be needed for a year, maybe two.<\/p>\n\n\n\n<p>But long COVID \u2014 a mysterious constellation of ailments that can go on for many weeks or months \u2014 has become a bigger problem than Truong could have ever imagined.<\/p>\n\n\n\n<p>In the U.S. alone, 1 in 5 of the adults stricken with COVID-19 have developed conditions that could be considered long COVID, according to a recent study by the Centers for Disease Control and Prevention. Symptoms range from brain fog and unrelenting fatigue to gastric and cardiac issues. Among those 65 and older, the estimates are even higher \u2014 1 in 4.<\/p>\n\n\n\n<p>That translates into millions of Americans and more than 300,000 Georgians.<\/p>\n\n\n\n<p>Other estimates vary wildly. There is no test for long COVID. No official statistics exist.<\/p>\n\n\n\n<p>Clinicians at the Emory clinic have treated more than 1,000 COVID survivors. There\u2019s now a four-month waiting list to be seen at the clinic.Explore<a href=\"https:\/\/www.ajc.com\/news\/coronavirus\/\">Complete coverage of COVID-19 in Georgia<\/a><\/p>\n\n\n\n<p>\u201cIt\u2019s been shocking,\u201d said Truong, who is co-director of the clinic,located at Emory University Hospital Midtown. \u201cI\u2019ve never seen, with other infections, such widespread, all-over-the-body symptoms for this long.\u201d<\/p>\n\n\n\n<p>COVID can wreak havoc on a person\u2019s body and damage organs \u2013 the lungs, heart, kidneys and liver. Experts worry that people who are infected multiple times have increased chances of developing long COVID.<\/p>\n\n\n\n<h1 class=\"wp-block-heading\">How is long COVID defined?<\/h1>\n\n\n\n<p>A recent CDC study says that 1 in 5 of U.S. adults stricken with COVID-19 have developed conditions that could be considered long COVID, which the agency defines as symptoms lasting at least four weeks after infection.<\/p>\n\n\n\n<p>The CDC says the following symptoms are the most common for this complex and poorly understood condition:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Tiredness or fatigue that interferes with daily life<\/li><li>Difficulty breathing, shortness of breath, chest pain<\/li><li>Difficulty thinking or concentrating (sometimes referred to as \u201cbrain fog\u201d)<\/li><li>Headache<\/li><li>Sleep problems<\/li><li>Anxiety<\/li><li>Digestive issues<\/li><li>Joint or muscle pain<\/li><\/ul>\n\n\n\n<p>\u201cWith COVID, we tend to think about the hospitalizations and deaths, and then we kind of stop there sometimes,\u201d said Dr. Tiffany Walker, who has treated long COVID patients at Grady Memorial Hospital. \u201cI don\u2019t want to paint the picture of everybody\u2019s debilitated, but some people are, and it\u2019s people that don\u2019t expect it. The times that people have cried in my office because they\u2019re just so overwhelmed is like more than anything I\u2019ve experienced before in clinical practice.\u201d<\/p>\n\n\n\n<p>Walker now leads a long COVID study at Grady, which is part of a massive National Institutes of Health effort to find the connection between seemingly unrelated symptoms that have afflicted patients and confounded physicians.<\/p>\n\n\n\n<p>Scientists still do not know how the virus triggers such a wide range of problems, from minor to incapacitating, or why issues emerge in some patients but not in others, or what exactly the risk factors are for developing them.<\/p>\n\n\n\n<p>What\u2019s more, there is no specific treatment for longCOVID. Instead, the current approach is to deal with each symptom individually.<\/p>\n\n\n\n<p>It\u2019s often hard to offer satisfying answers to patients. \u201cIt\u2019s just very upsetting and really challenging,\u201d Walker said. \u201cAs a physician, you really want to be able to provide a prognosis at least, at a minimum to be able to express to them, this is what you can expect.\u201d<\/p>\n\n\n\n<p>But doctors \u201cdon\u2019t know enough to know what the course is going to be and who\u2019s going to get better and who isn\u2019t, and you don\u2019t know enough about how to treat those that aren\u2019t getting better,\u201d she said.<\/p>\n\n\n\n<p>And the world\u2019s leading health organizations don\u2019t even have a standard definition of what constitutes long COVID, Truong said. The CDC defines long COVID, which it calls&nbsp;<a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/long-term-effects\/index.html\">Post-COVID&nbsp;<\/a><a href=\"https:\/\/www.cdc.gov\/coronavirus\/2019-ncov\/long-term-effects\/index.html\">Conditions<\/a>, as symptoms lasting four weeks or longer after infection. The&nbsp;<a href=\"https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Post_COVID-19_condition-Clinical_case_definition-2021.1\">World Health Organization<\/a>&nbsp;says people cross over into long COVID after symptoms persist for at least three months.<\/p>\n\n\n\n<p>In 2021, 60% of patients at the Emory and Grady long COVID clinics enrolled in a study aimed at gathering more information on the illness. At the time of their enrollment, patients had already been dealing with COVID symptoms for an average of 107 days.<\/p>\n\n\n\n<p>Even people who have mild or asymptomatic COVID-19 infections can have new health problems crop up months after they\u2019ve tested negative.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Remaining vigilant<\/strong><\/h2>\n\n\n\n<p>The CDC\u2019s study evaluated electronic medical records for nearly 2 million people. The agency compared those who had been infected with the coronavirus and those who had not. The analysis found 38% percent of the COVID patients developed one or more new health problems, compared to 16% percent of the non-COVID patients. The health problems of about 21% of the younger COVID patients in the study, those ages 18 to 64, and nearly 27% of the older people, 65 and up, could be attributed to long COVID. The study did not look at vaccination status.<\/p>\n\n\n\n<p>A growing number of studies suggest that getting a COVID vaccine can reduce \u2014 though not eliminate \u2014 the risk of longer-term symptoms.<\/p>\n\n\n\n<p>Some experts think that today\u2019s omicron strains pose a lower risk for long COVID than previous variants. But they caution: Even if omicron is less likely to cause long-lasting symptoms, particularly for people who have been vaccinated, the actual number of long COVID sufferers will still grow due to the high infection rate.<\/p>\n\n\n\n<p>It\u2019s often hard to determine whether health problems that emerge after a case of COVID are truly triggered by the virus.<\/p>\n\n\n\n<p>Lead Nurse Practitioner Lori Reed, who works at the Piedmont Pulmonary COVID Recovery clinic, said some patients dealing with preexisting conditions may be more aware of them after coronavirus infections. That means it\u2019s important for clinicians to obtain thorough medical histories to pinpoint when symptoms, such as dizziness, memory loss and headaches, started and when they worsened, she said.<\/p>\n\n\n\n<p>\u201cOne that comes up all the time is asthma because asthma can develop at any point in life,\u201d Reed said. \u201cWe know, historically, viral illnesses can cause asthma onset, so COVID can cause asthma onset. But, with women, hormonal changes and menopause can also cause onset.\u201d<\/p>\n\n\n\n<p>Reed recommends patients see a doctor after a COVID infection to rule out COVID-related damage to the body, and she urges people to remain vigilant of any sign of new problems.Explore<a href=\"https:\/\/www.ajc.com\/news\/coronavirus\/georgia-long-covid-patients-fight-for-benefits-legitimacy\/R5D3NXYN4NDXBJZFHRQR2VSLVU\/\">From November: Georgia long-COVID patients fight for benefits, legitimacy<\/a><\/p>\n\n\n\n<p>\u201cPay attention to subtle things that some people may write off,\u201d she said. \u201cTalk to your doctor about brain fog or things like, \u2018I just forgot what I was going to make for dinner,\u2019 or \u2018You know, that bill came in, and I forgot to pay for it.\u2019\u201d<\/p>\n\n\n\n<p>At long COVID clinics, a team of specialists \u2014 cardiologists, pulmonologists, neurologists, psychiatrists and others \u2014 work together to treat patients. Often, the patients undergo a comprehensive evaluation, including a series of lab tests and imaging tests, to rule out other undiagnosed medical conditions.<\/p>\n\n\n\n<p>Lacking established therapies for long COVID symptoms, doctors often rely on approaches that have been used for other ailments with similar symptoms.<\/p>\n\n\n\n<p>\u201cIt&#8217;s been shocking. I&#8217;ve never seen, with other infections, such widespread, all-over-the-body symptoms for this long.&#8221;<\/p>\n\n\n\n<p>&#8211;&nbsp;Dr. Alex Truong, co-director of Emory Healthcare&#8217;s post-COVID clinic<\/p>\n\n\n\n<p>Neurological stimulants such as Adderall have shown to be effective at improving energy and focus. Albuterol, an inhaled medicine frequently used to treat asthma, can improve breathing. Other medications, physical therapy and cognitive programs also can be helpful.<\/p>\n\n\n\n<p>\u201cI would say to people who get COVID, you didn\u2019t ask to get COVID, and you don\u2019t deserve to fall ill and not have answers,\u201d said Reed. \u201cReach out to somebody to at least be seen and evaluated because we can do things to get you feeling better. If we can\u2019t reverse the long-term consequences, we can at least improve your quality of life.\u201d<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>A high-stakes undertaking<\/strong><\/h3>\n\n\n\n<p>Close to 1,000 people in Georgia \u2014 and at least 17,000 adults across the country \u2014 are being recruited for the massive NIH study called&nbsp;<a href=\"https:\/\/recovercovid.org\/\">Researching COVID to Enhance Recovery<\/a>&nbsp;(RECOVER). Its goal is to answer fundamental questions about exactly how the virus causes long COVID, which ultimately could lead to better, more tailored treatments.<\/p>\n\n\n\n<p>The study sites in Atlanta \u2014 Emory Hope Clinic, Grady, Morehouse School of Medicine, the Atlanta Veterans Affairs Healthcare System and Kaiser Permanente of Georgia \u2014 will work together and are slated to receive a total of about$20 million over four years for the high-stakes undertaking.<\/p>\n\n\n\n<h1 class=\"wp-block-heading\">The NIH study<\/h1>\n\n\n\n<p>The Atlanta sites for the NIH are still actively recruiting patients who have had COVID-19 in the past 30 days, as well as those who have never been infected.&nbsp;<a href=\"https:\/\/med.emory.edu\/departments\/medicine\/divisions\/infectious-diseases\/recover-atlanta\/index.html\" target=\"_blank\" rel=\"noreferrer noopener\">Click here for more information.<\/a><\/p>\n\n\n\n<p>Walker, from Grady, said clinicians have been working to recruit a diverse group of adults, and are seeking three categories of participants: those who have COVID right now, those with long COVID, and others who have never had COVID. Finding people who have never had the illness is getting increasingly difficult with an ever-changing virus and continued waves of infections.<\/p>\n\n\n\n<p>Plenty of theories have formed around long COVID. Some researchers think people suffer prolonged symptoms because they have never really shaken COVID-19, though they think they have. Instead, the virus is still hiding in their bodies, damaging nerves and other organs. Other research suggeststhe virus may be gone, but it causes the immune system to go haywire and attack the body.<\/p>\n\n\n\n<p>There\u2019s also research that indicates certain medical conditions may play a role in who develops long COVID, such as Type 2 diabetes, or a reactivation of Epstein-Barr virus, which infects most people when they are young.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><strong>\u2018A monster\u2019<\/strong><\/h3>\n\n\n\n<p>In July 2020, Latoshia Allen Perrymond fell ill with COVID. Within a week, the 52-year-old Stone Mountain woman was struggling to catch her breath. She ended up hospitalized \u2014 for four months.<\/p>\n\n\n\n<p>Though she survived, COVID damaged her heart and lungs. She said she\u2019s been struggling mightily ever since. Dependent on oxygen around the clock, the former caregiver now relies on family members to help care for her.<\/p>\n\n\n\n<p>She can no longer go on walks with her husband or cook big meals, or even sleep lying flat.<\/p>\n\n\n\n<p>In late March, she eagerly joined the NIH study at Grady.<\/p>\n\n\n\n<p>Like other participants in the NIH RECOVER study, she\u2019s undergoing physical assessments.<\/p>\n\n\n\n<p>\u201cI feel good about the study because it means that I\u2019m part of the answers,\u201d she said. \u201cI\u2019m willing to do whatever they need because this COVID and long COVD is a monster and it\u2019s still creepy. I\u2019m learning to live with this new norm for me, but I hope that I can get better.\u201d<\/p>\n\n\n\n<p>Doctors are also eager for more answers.<\/p>\n\n\n\n<p>\u201cMy hope is to find a pathology that unifies all of these symptoms,\u201d said Truong. \u201cMy hope is, as the pandemic progresses, the variants become less virulent and less likely to cause long haul issues, and more and more patients are getting vaccinated. I hope we learn from this pandemic so that, when the next pandemic comes, we are a lot smarter, a lot more nimble in our approach, and more aware of the long haul issues.\u201d<\/p>\n\n\n\n<p>For now, the best way to try to avoid long COVID is to try to avoid the virus, Truong said. Get vaccinated and boosted and wear masks \u2013 especially indoors around crowds of people.<\/p>\n\n\n\n<p>\u201cIt\u2019s as simple as that,\u201d he said. \u201cBut, unfortunately, I don\u2019t think people want to hear it.\u201d<\/p>\n\n\n\n<figure class=\"wp-block-image is-style-default\"><a href=\"https:\/\/twitter.com\/holiviero\"><img decoding=\"async\" src=\"https:\/\/www.ajc.com\/pf\/resources\/images\/twitter-burger.svg?d=640\" alt=\"Follow Helena Oliviero on twitter\"\/><\/a><\/figure>\n","protected":false},"excerpt":{"rendered":"<p>Authors:&nbsp;Helena Oliviero, The Atlanta Journal-Constitution Georgia residents among thousands needed for a massive study to discover how the virus causes lingering symptoms. Back in the summer of 2020, when the [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":5251,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[687,59,762,122,787,289,290,344,882,561],"tags":[],"class_list":["post-5249","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-anxiety","category-brain-fog","category-confusion","category-digestion","category-dizziness","category-long-haul-disease","category-long-term-effects","category-muscle-joints","category-myalgia-muscle-pain","category-symptoms-covid-19"],"_links":{"self":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/5249","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=5249"}],"version-history":[{"count":0,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/posts\/5249\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=\/wp\/v2\/media\/5251"}],"wp:attachment":[{"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=5249"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=5249"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cov19longhaulfoundation.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=5249"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}