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Texas Family Medicine October 2022 Blog

What is Long COVID?

Family physicians, including the providers at Texas Family Medicine, are seeing our post-COVID infection patients for symptoms that last weeks or months after the initial infection. It happens in 10-40% of people who get COVID and some of these symptoms are quite unusual.

Both my wife and I experienced brain fog for a couple of weeks after COVID this past summer. I had trouble remembering certain words or names of friends. One of my patients suffered from amnesia for three months.

The CDC defines long COVID as symptoms that carry on or reappear four weeks after the initial infection. There is no laboratory test for Long COVID.

The three main categories of symptoms are neurologic (brain fog or loss of taste/smell), fatigue, and respiratory. These three groups account for over half of all long COVID symptoms.

People who had more severe cases or COVID, who have underlying immune deficiencies such as in diabetes or chronic kidney disease are more likely to become COVID Long Haulers. There is little evidence that people who have taken at least the first dose of one of the COVID vaccines are less likely to have these chronic symptoms.

There is some evidence that though men are more likely to have severe acute COVID symptoms, women are more likely to develop Long COVID.

The symptoms vary in severity from mild to debilitating. The more disabling cases involve the heart or lung and cause significant shortness of breath for the patient.

What causes these symptoms? One theory is that this virus implants itself into our bodies’ tissues and our immune symptoms are unable to dislodge it. Recognizing the virus as foreign, our immune symptoms continue to attack it and in doing so damages the tissue around it. Imagine trying to kill a fly on the wall using a shotgun.

Another theory is that our immune systems never shut off after they eradicate the virus from our bodies. Autopsies have revealed inflammation of heart muscle and lung tissue in long-haulers.

Unfortunately, we have seen lung and heart inflammation in patients after COVID vaccination. Heart inflammation occurs most often in young men aged 13-17, but almost all of these cases resolve without any long-term consequences. Although the studies show that overall the vaccines do much more good than harm, it is worrisome that we have given people a vaccine that caused primary organ damage.

The treatment for Long COVID is not particularly helpful. For folks with shortness of breath due to lung issues, we start respiratory therapy that strengthens our breathing muscles. We might put folks on oxygen or give them powerful cough suppressants if they can’t stop hacking away. But as of now there are no proven treatments for most neurologic, fatigue, or heart issues.

The National Institute of Health (NIH) has commissioned $470 million for the study of Long COVID. They are looking at different options such as treatments that modulate immune system activity.

Though there is a Long COVID specialty clinic in Dallas, your best bet for treatment is to ask for help from your Family Physician’s office.

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