Last time, we looked at long COVID – what it is and how Dr. Joe has been helping patients who present with its many varied symptoms. No sooner had we hit “publish” than news dropped of more research on this troubling consequence of SARS-CoV-2 infection.
So this week, a quick overview of this new info…
How Long Is Long COVID Really?
A new study in The Lancet aimed to give a clearer picture of how long symptoms can persist after the initial infection. About half of long-haulers – 49% – were still experiencing them after a full year. While reports of fatigue dropped off sharply between 6 months and 1 year, anxiety, depression, and shortness of breath were all actually higher at 1 year – particularly the anxiety and depression.
Co-author Xiaoying Gu, MD, also of China-Japan Friendship Hospital, said the authors did not yet understand why psychiatric symptoms were more pervasive at 1 year compared with 6 months.
“These could be caused by a biological process linked to the virus infection itself, or the body’s immune response to it. Or they could be linked to reduced social contact, loneliness, incomplete recovery of physical health or loss of employment associated with illness,” Gu said in a statement.
Similarities with Chronic Fatigue
A new review by Johns Hopkins researchers suggests that long COVID and chronic fatigue syndrome (more formally known as myalgic encephalomyelitis) have some things in common. Symptoms shared by both, they suggest, “may involve a biological response that goes haywire when the body encounters certain infections or other environmental hazards.”
In particular, the researchers suggest a central role for the way cells behave when too many oxygen molecules pile up in a cell—a process called oxidative stress or redox imbalance. The team describes how redox imbalance may be connected to the inflammation and disorders of metabolism that are found in the two diseases.
A Possible Connection with Epstein-Barr
Yet other research shows that the vast majority of long-haulers also test positive for Epstein-Barr virus reactivation – over 73% vs. just 10% among those without persistent COVID symptoms.
What’s more, many of the reported symptoms are very similar to those that arise from EBV reactivation, including extreme fatigue, frequent skin rashes and Raynaud’s phenomenon, which causes decreased blood flow to the fingers and toes. In the past year, long haulers have even taken to calling their swollen and red extremities ‘COVID toes’.
Although the size of the sample studied here is very small, the results suggest many long COVID symptoms may not actually arise from SARS-CoV-2 itself, but from EBV reactivation, potentially triggered by the widespread inflammation of COVID-19.
There wasn’t much difference whether the patient had persisting symptoms for just a few months or much longer. The reactivation rate was about the same.
Interestingly, earlier research showed that a certain subset of patients with chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) similarly experienced reactivation of the Epstein-Barr virus, potentially suggesting another way in which CFS/ME and long COVID may be similar.
Such overlap is one of the key reasons why Dr. Joe stresses the importance of looking for potential co-infections when treating patients with long COVID. As in treating chronic Lyme or other persistent health issues, it’s crucial to identify any contributing barriers to health, including low grade chronic viral infections.
Where Are the Most Cases of Long COVID Found?
Recently, the American Academy of Physical Medicine & Rehabilitation unveiled a dashboard for tracking cases of long COVID – or, as they prefer to call it, Post-Acute Sequelae of SARS-CoV-2 infection (PASC, for short). According to their data, California leads the way in total cases, with 1,301,678.
That’s roughly 30% of all COVID cases in our state since the pandemic began. The situation is much the same in the next three states ranked below our own: Texas, Florida, and New York.
Which is all to say that if you’ve been infected with COVID and find your symptoms persisting, you’re hardly alone. If you want help in dealing with those symptoms, just give us a call. We’re here to help.