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What Experts Know About ‘Long Covid’ and Who Gets It

0 2 years ago

Most people who suffer from Covid-19 fully recover. Millions of other survivors find complete healing to be frustratingly elusive, in what’s often referred to as “long Covid.” Some experience extreme fatigue, shortness of breath and body aches, while others struggle with “brain fog” or haven’t regained their sense of smell or taste. More disturbingly, a subset become gravely ill much later, likely because of complications from their infection. The picture emerging from experience is that no single definition, explanation, diagnosis or treatment can be applied to the growing group, colloquially known as long-haulers, who reflect the pandemic’s lasting burden on societies and economies.

1. What is long Covid?

There’s no universally accepted definition yet. According to the World Health Organization, people with what it calls “post Covid-19 condition” have symptoms usually three months after an initial bout of Covid that last for at least two months and can’t be explained by an alternative diagnosis. The prolonged symptoms — sometimes entirely new to the patient — include pulmonary, cardiovascular, gastrointestinal and nervous-system problems as well as neurological effects, such as cognitive impairment. Ailments may persist from the initial illness or appear after the acute phase of the disease — even one with no noticeable symptoms. The symptoms may also fluctuate. Other groups have proposed alternative definitions. The U.K.’s National Health Service, for example, suggests referring to symptoms that last more than four weeks as “ongoing symptomatic Covid” and “post-Covid syndrome” if they persist for longer than 12 weeks and can’t be otherwise explained. Another definition may be needed for children.

2. How often does it occur?

Researchers haven’t studied enough cases over a long enough period to gauge the full range of effects, what proportion of patients will suffer from them or for how long. The lack of a single definition and standardized way of identifying cases makes it even harder. A large study published in November, using data from the U.S. Department of Veterans Affairs, estimated that about 7% of people had at least one symptom of long Covid six months after their infection. It also found differences in symptoms by age, race, sex and baseline health status. A much smaller study from February 2021 that followed people for as long as nine months after illness found about 30% of people reported persistent symptoms. Although these ailments can occur regardless of the initial severity of the infection, individuals who had severe or many symptoms initially are more likely to be affected. For instance, the study based on the VA database found the burden of long Covid beyond the first 12 weeks of illness was 4.1% among those never hospitalized for Covid, 16% among those who were hospitalized and 23% among patients who were admitted to intensive care. Other studies have found the likelihood of long Covid is greater among women, the middle-aged and the obese.

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