Many patients with long COVID are relatively young
started a post-COVID POTS clinic at Johns Hopkins in the wake of the growing number of referrals he ’ s been receiving .
Until now , the official definitions of long COVID have been pretty general and all-encompassing , such as post-acute sequelae of SARS-CoV-2 infection ( PASC ), which basically refers to any type of symptom experienced weeks after contracting COVID-19 , but they are still a work in progress .
“ PASC is a broad definition of long COVID , and there are lots of different things into that ,” said Dr Chung . He adds that having a name for the plethora of symptoms of long COVID doesn ’ t mean we have a clear idea about it . In fact , “ we created a name so that we can do some research about it .”
Long COVID highlights limitations of industrial approach to medicine That long COVID would emerge as a by-product of COVID-19 , however , shouldn ’ t have surprised the medical community . Even at the onset of the pandemic , guessing that COVID-19 might cause longterm problems in some patients would have been a safe bet .
That ’ s because medical history is replete with similar cases pointing to a common pattern of longlasting symptoms associated with different types of infections .
One example is the Russian flu pandemic that broke out in the last decade of the 19th century . Some scientists believe it was sparked by a coronavirus ancestor to one of the pathogens causing the common cold . One noticeable after-effect of the infection was fatigue , and some Englishmen including then-British Prime Minister Lord Salisbury became invalid , wrote Mark Honigsbaum and Lakshmi Krishnan in The Lancet .
Similarly , persistent fatigue and diffuse pain were two key hallmarks of the chronic form of severe acute respiratory syndrome ( SARS ), a condition caused by another type of coronavirus , as reported in a study of
22 healthcare workers in Canada who were unable to return to work after getting infected with it .
“ Similar lingering fatigue syndromes have been reported in the scientific literature for nearly 100 years , following a variety of well-documented infections with viruses , bacteria , fungi , and even protozoa ,” said Dr Anthony Komaroff , a professor of medicine at Harvard Medical School , at a press briefing held by the international organisation # MEAction to discuss the intersection between long COVID and ME / CFS .
Besides being associated with many cases of ME / CFS , infections are believed to trigger other longlasting syndromes whose manifestations overlap with long COVID , like POTS , fibromyalgia , and posttreatment Lyme .
“ About 40 to 50 percent of POTS patients have some kind of infection and then they have a sudden onset of symptoms ,” said Dr Chung .
Infections like mononucleosis play a role in many cases of fibromyalgia as well , a syndrome characterised by diffused body pain that has been seen in some people with long COVID , though to a lesser extent compared to ME / CFS and POTS .
“ What we see in post-COVID patients is a sort of tingling feeling , and pain doesn ’ t seem to be as prominent as fatigue , difficulty with concentration , and dizziness ,” said Dr Mary-Ann Fitzcharles , a consultant rheumatologist to the McGill Pain Centre in Canada , who nonetheless believes a growing number of COVID-linked fibromyalgia cases may be identified in the next months based on the SARS precedent reported in the Canadian study .
All these conditions share symptoms as well , with fatigue , pain , orthostatic intolerance , and brain fog being some of the most prominent and disabling problems experienced by patients diagnosed with them .
Despite these swathes of evidence pointing to a cluster of long-term syndromes associated with infections , many patients with long COVID were dismissed by doctors and told they simply had psychological problems , a dynamic that is regularly played out with all the chronic conditions connected to long COVID .
When 31-year-old health coach Jasmine Hayer kept suffering from breathlessness , exercise intolerance , and a “ tornado ” of discomfort stabbing her heart months after getting infected with COVID-19 , her respiratory specialist remarked that her X-ray , blood tests , and electrocardiogram were normal and thus “ her lungs were fine and she may be experiencing trauma from COVID ,” she recalled to the BBC .
In response to this dismissive attitude , several patient groups have sprung up to advocate for the needs of those unable to recover from COVID-19 , such as LongCovidSOS , which has been raising awareness with the catchphrase ‘ Recognition Research Rehab .’
From a historical perspective , the current struggle to have long COVID symptoms recognised as a real condition is just “ the most recent exchange in the
“ What we see in post-COVID patients is a sort of tingling feeling , and pain doesn ’ t seem to be as prominent as fatigue , difficulty with concentration , and dizziness ”
GlobalHealthAsiaPacific . com JUNE 2021
33