Long-Term COVID-19 Could Affect Millions, Especially Young Adults | New

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As COVID-19 infections decline in Santa Clara and San Mateo counties, the medical profession grapples with another facet of the disease – mysterious symptoms that researchers say can linger for months.

Called “long COVID-19,” the syndrome can cause a constellation of symptoms: difficulty breathing, headaches, debilitating fatigue, brain fog, and organ damage.

It will take time to figure out whether COVID-19 will last a few months, a few years or a lifetime, a group of medical professionals and researchers said at a special hearing of the County Health and Hospitals Committee. Santa Clara on Tuesday October 26. Many COVID-19 long-haul travelers cannot work or go to school. It is not yet clear how younger populations, including children, will fare in the long term or whether they will develop learning skills and health issues with societal impacts.

To truly treat people with the disease, local and national governments will need to develop policies and multidisciplinary teams of physicians to address the physical, cognitive and psychological challenges posed by the long COVID-19, the researchers told the committee. health and hospitals.

What is a long COVID?

Long COVID-19 can be a lot. Just exactly where the dividing line lies between recovery from the lingering symptoms of COVID-19 and the long term COVID-19 syndrome is not easily defined.

It is not unusual for COVID-19 patients to show symptoms that persist for two weeks to two months after an acute infection, said Dr. Brian Block, assistant professor at the University of California, San Francisco, School of Medicine Division of Pulmonary, Allergy, Critical Care and Sleep Medicine and the Associate Director of the Medical Intensive Care Unit. But COVID-19 is not long.

Long COVID-19 is a syndrome of persistent symptoms that lasts at least two or three months after the initial infection. Typically, people have breathing problems and cognitive dysfunction, but it often affects organs, Block said. Doctors should first rule out other diseases with similar symptoms, such as cancer or hypothyroidism, before making a long diagnosis of COVID-19, he added.

Long COVID-19 mainly affects hospitalized people. People who are obese or who had five or more symptoms during their initial infection have a higher risk of developing a lengthy COVID-19, Dr Hector Fabio Bonilla, Clinical Associate Professor of Infectious Diseases at Stanford Hospital and Clinics who also practices at the Post-COVID-19 Syndrome Clinic, said.

But the long COVID-19 can affect people with mild symptoms of COVID-19. Patients may also make a full recovery, and then symptoms of long COVID will appear later.

People between the ages of 25 and 50 and women are most likely to have long-term complications from the virus, the researchers said. Many young people who have long since developed COVID-19 were presumed to have underlying conditions such as diabetes or asthma, but that did not turn out to be the case, Bonilla said. Studies have shown that COVID-19 has long affected the healthy population. Research on Italian and German footballers, a normally robust population, found that their performance declined in football matches if they had ever had COVID-19, he said.

Concern for societal impacts and development of care strategies

The researchers said they were particularly concerned about younger populations, including children, who develop a lengthy COVID-19. It is not known if this will affect their lifelong learning abilities and their ability to hold a job. It will take time to see what happens in five years and how that will affect high school and college youth and the next generation of workers, Bonilla said.

Currently, around 20% of patients have long-term COVID-19.

“They have a hard time getting back to work, school and chores around the house,” said Emily Hough, Harkness Fellow in Health Care Policy and Practice at the Commonwealth Fund. Policymakers and the medical profession will need to find a way to create a support system for these people at local and national levels, she said.

With 125 million people in the United States having been infected with COVID-19, the number of people who could potentially face COVID-19 in the long term in this country is staggering: 15 million to 25 million people, Block said. .

“Tens of millions of people are at risk for this. We don’t have the multidisciplinary teams that may be needed,” he added.

Santa Clara County Director Jeff Smith, a doctor, said the county is considering developing a clinic to specifically treat COVID-19 along.

The medical profession also needs to develop criteria to help doctors identify long cases of COVID-19 and how they can be treated, Bonilla and Block said. Some patients have their symptoms ruled out and many doctors do not yet understand the syndrome.

A survey of doctors at the Santa Clara Valley Medical Center found that only 5% of those polled had made referrals for a suspected COVID-19 long, and most of them were for lung problems, the report said. Dr Angela Suarez, Medical Director of Primary Care.

Because long-lasting COVID-19 can affect multiple parts of the body, multidisciplinary teams will be needed to deal with physical and other impacts, such as a patient’s cognition, mood, and well-being. It is important for patients to see clinicians they trust and have a relationship with. Having a therapist work with doctors can help treat symptoms, Block added.

The medical profession has not yet developed diagnostic criteria for COVID long. Its complexity makes it difficult to understand. Santa Clara Valley Medical Center only recently added a diagnostic code for long-term COVID, said Dr Supriya Narasimhan, head of the infectious disease division.

Early treatments with steroids, monoclonal antibodies and, if approved by the federal government, the oral drug Merck, to reduce the effects of the virus, can reduce the inflammatory response that causes severe COVID-19 and the risks of long COVID, said Narasimhan.

The best strategy to prevent long COVID is not to contract COVID-19 at all, she said. The best way to prevent infection with COVID-19 is to get vaccinated. Getting vaccinated can prevent 50% of long cases of COVID, she said.


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