By Jennifer Preucil, M.D., St. Luke’s Health System
As we greet spring and celebrate National Doctor’s Day, March 30, we are filled with hope for the future. In the medical community, we are all hoping that between natural immunity and vaccination, we may have achieved herd immunity in the COVID-19 pandemic. This may offer us the opportunity to not operate in crisis care, and as a family physician, I am certainly enjoying the luxury of returning to primary care.
As we move forward, we turn our attention to all the people in our community who may be suffering from long-haul COVID. Studies show us that as many as one in four people who have had COVID suffer from long-haul COVID symptoms. Vaccination prior to having COVID most likely reduces these numbers, but it has been difficult to quantify how much.
There have been more than 600 symptoms associated with long-haul COVID. The most common symptoms include fatigue, depression and anxiety, shortness of breath, chest pain, problems with memory and concentration, changes in taste and smell, joint pain, elevated heart rates, and exercise intolerance. One study even suggests COVID-19 may affect the brain with a slight shrinkage of size visible after infection.
Women are more affected than men. The most common age of people being affected is 27 to 59 years of age. It is not known what causes long-haul COVID. It was believed at first that possibly elevated inflammatory levels caused by acute COVID infection may be the culprit, but that has not proven to be true. Inflammatory markers in the blood do not remain elevated despite symptoms continuing. It has also been hypothesized that it is a reactivation of the original infection. However, this is difficult to measure as there is not a test to see if the infection is in fact reactivated and resurgent.
One of the many challenges of long-haul COVID is that very few patients have similar experiences with the illness. It is an incredibly personal experience and journey. As stated above, there are as many as 600 different symptoms associated with long-haul COVID. People can experience symptoms for just six weeks or less and others are still having difficulty with symptoms at the 24-month mark. There have been many different treatments that have been used to try and help with long-haul COVID, most of which are focused on managing the individual symptoms. Antidepressants, acid-reducing medications, and nonsteroid anti-inflammatories have all been used to help treat long-haul COVID.
Pulmonary rehabilitation has been shown to be quite helpful with long-haul COVID. The rehabilitation program will tailor an exercise program to the patient’s ability level and very slowly increase the intensity. It has also been shown that stress reduction, good quality sleep, moderate exercise, yoga and meditation are integral in improving long-haul COVID. The reduction that these interventions cause in stress hormone levels is very important for the healing process. A good way to think about long-haul COVID is that it reduces the number of brain/energy dollars a person has to spend each day. If you expend more dollars than your allotment, you get worse. As long as you stay under your allotment, you improve. Self-care is the very cornerstone of improvement of the disease.
As we move forward, all are hopeful that the surges, full hospitals and ICUs, and too-busy emergency rooms are behind us. For those who have had COVID-19 and continue to feel poorly, even weeks or months after the illness has subsided, seek medical care and discuss long-haul COVID with your trusted medical provider. Focus on taking good care of yourself—eat well, sleep well, reduce stress, spend time with those you love. Words to live by!
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