Dear Doctors: I have had long COVID since my initial infection in November 2020. I have air hunger and tachycardia, have been bedbound and have had recoveries and relapses. My life has not been the same since this horrible illness, and I am desperate. Is there any new research?
Dear Reader: It has been nearly three years since the United States declared the federal COVID-19 public health emergency to be over. But for millions of Americans like you, struggling with the syndrome known as long COVID, the challenges continue.
Long COVID refers to the collection of symptoms that persist for months, and sometimes years, after recovery from COVID-19. These include the heart arrhythmia, shortness of breath and fatigue that you describe. Other symptoms include brain fog, headache and cognition changes. Some people may experience muscle and body aches. Loss of sense of smell and taste and a range of gastrointestinal problems can be symptoms. Even insomnia and depression can be symptoms. The symptoms and duration vary from person to person. The one common thread for people with long COVID is an initial SARS-CoV-2 infection.
Despite ongoing research all over the world, the cause of long COVID is not yet clear. A leading theory is that fragments of the SARS-CoV-2 virus stay in the body after the initial infection. These rogue particles may carry enough of the viral imprint that, as they move around the body, they trigger an immune response. A recent study, including a bioengineer here at UCLA, found that these so-called "zombie remnants" activate immune cells and impair them. This revs the immune response and weakens it at the same time. Researchers suspect this plays a role in long COVID symptoms. It may also leave the person more vulnerable to future infections.
Without a clear cause, health care providers focus on managing each person's specific symptoms and conditions. Some of these are linked to the effects that SARS-CoV-2 can have on the cardiovascular and immune systems. Effects include increased clotting of the blood and severe systemic inflammation. These have been associated with stroke, heart attack and pulmonary embolism, particularly during or soon after acute infection. In some patients, the inflammatory response may lead to skin rashes. It may affect the heart or the membrane that surrounds the heart. It could also affect the brain. Care for long COVID often involves multiple specialists from neurology, cardiology, pulmonology, immunology, psychiatry and physical therapy.
Your frustration and exhaustion reflect the profound toll this illness takes. The physical effects are often debilitating. The disruption of daily life can be even worse. People often lose the ability to work, exercise, pursue hobbies, socialize and care for their home and family.
Please know that long COVID remains a major focus of national research efforts. Targeted treatments are still in development. Researchers continue to make progress toward clearer answers and more effective care. To learn more about that research, visit the federal database of clinical trials at ClinicalTrials.gov. Another excellent resource is the research information portal RecoverCOVID.org.
(Send your questions to [email protected], or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)
