What We Know About Long COVID So Far

While the World Health Organization says long COVID starts three months after the original bout of illness or positive test result, the Centers for Disease Control and Prevention sets the timeline at just after one month.

Among the many confounding aspects of the coronavirus is the spectrum of possible symptoms, as well as their severity and duration. Some people develop mild illness and recover quickly, with no lasting effects. But studies estimate that 10% to 30% of people report persistent or new medical issues months after their initial coronavirus infections — a constellation of symptoms known as long COVID.

People who experience mild or moderate illness, as well as those without any underlying medical conditions, can nonetheless experience some debilitating long-term symptoms, including fatigue, shortness of breath, an erratic heart rate, headaches, dizziness, depression and problems with memory and concentration.

Such lingering medical issues are so varied that one study by a patient-led research group evaluated 203 symptoms that may fluctuate or even appear out of the blue after people seem to have recovered.

As Dr. Ziyad Al-Aly, the chief of research and development at the VA St. Louis Healthcare System and a clinical public health researcher at Washington University in St. Louis, said, “If you’ve seen one patient with long COVID, you’ve seen one patient with long COVID.”

How doctors currently diagnose long COVID

There is little consensus on the exact definition of long COVID, also known by the medical term PASC, or post-acute sequelae of COVID-19. While the World Health Organization says long COVID starts three months after the original bout of illness or positive test result, the Centers for Disease Control and Prevention sets the timeline at just after one month.

Some researchers and health care providers use other time frames, making efforts to study and quantify the condition more difficult, said Al-Aly, who has conducted many studies on long-term post-COVID issues.

When patients experiencing persistent symptoms go to their doctors, tests like electrocardiograms, chest X-rays, CT scans and blood work don’t always identify physiological problems, Al-Aly said. Researchers are working to pinpoint certain biological factors, called biomarkers, that correlate with persistent COVID symptoms. These could include signs of inflammation or certain molecules produced by the immune system that might be measured by blood tests, for example.

Long COVID is defined as symptoms that cannot be explained by an alternative diagnosis and last at least two months following an initial COVID-19 infection. It is usually after three months (12 weeks) of persistent symptoms when a patient is suspected of having long COVID.

Long COVID can affect anyone of any age, including children and adolescents. Even if you had mild or no symptoms when you were first infected, you can be impacted by long COVID.

For some, long COVID symptoms can be more severe than the acute COVID-19 infection itself. According to the World Health Organization (WHO), symptoms can persist from the initial illness or begin after recovery, and they may come and go or improve over time.

Long COVID can interfere with a person’s ability to perform normal, everyday activities, like work and household chores. With children, it can affect their ability to do their schoolwork. While it cannot be predicted how long a given patient may experience long COVID, some research has shown that patients can get better over time.

Long COVID Symptoms

Long COVID symptoms are different from acute COVID symptoms. Conditions can include, but are not limited to:

  • Persistent cough
  • Loss of (or changes in) taste and smell
  • Depression
  • Difficulty breathing or shortness of breath
  • Sleeping problems
  • Lightheadedness
  • Diarrhea
  • Fatigue
  • Anxiety
  • Chest pain
  • Palpitations
  • Headache
  • Joint and muscle pain
  • Poor appetite

How Does Long COVID Affect Children?

Some common symptoms seen in children include fatigue, headache, trouble sleeping and concentrating, muscle and joint pain, and cough. As with other medical conditions, young children may have trouble describing the problems they are experiencing.

According to the Centers for Disease Control and Prevention (CDC), information on long COVID in children and adolescents is limited, so it is possible other symptoms may be likely in younger age groups.

If your child is suffering from long COVID and is unable to complete their normal school assignments, it might be best to ask school administrators about accommodations such as extra time to complete tests and assignments, rest periods throughout the school day and modified class schedules, says the CDC.

What Causes Long COVID?

It is unknown why people experience long COVID. The cause is still an active area of research. Some experts believe the cause is potentially due to the body’s hyper-inflammatory immune response to a new germ.

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Source: What We Know About Long COVID So Far

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