Dear Doctors: I had the omicron variant of COVID-19, and even though it was mild, I’m not back to normal. I am tired all the time, my joints ache and my sense of smell is still gone. I’ve been told that this could be long COVID-19. I thought that only happened if you got really sick. Why did I get long COVID-19? When will we see a cure?
Dear Reader: We are receiving letters from a number of readers who, after dealing with COVID-19, find themselves facing a new health concern. Technically known as post-acute sequelae of SARS-CoV-2 infection, or PASC, it’s more commonly referred to as long-haul COVID-19, or long COVID-19. This refers to the symptoms that persist for weeks, and even months, after an initial coronavirus infection has passed.
These symptoms include the exhaustion, joint pain and loss of taste and smell that you are experiencing. Additional symptoms can include fever, headache, dizziness, racing heartbeat, poor concentration, chronic cough, shortness of breath, insomnia, changes to mood, stomach pain, gastroenteritis and changes to menstrual cycle.
At the start of the pandemic, it did appear that long COVID-19 occurred most often in those who had been gravely ill. However, it has since become evident that anyone who has been infected with SARS-CoV-2, which is the coronavirus that causes COVID-19, is at risk of experiencing ongoing symptoms. A study published last fall by researchers at the University of Michigan estimated that more than 40% of COVID-19 survivors experience long-term effects.
As for why it occurs, the answer remains unclear. One line of inquiry has tied long COVID-19 to something known as “viral load.” That is the amount of virus that is found in an infected person’s blood. When someone has a high viral load at the start of their infection with SARS-CoV-2, even if they go on to have only a mild illness, they may be at increased risk of developing long COVID-19. There continues to be evidence that fragments of the virus may persist in organs and other parts of the body, and thus drive an ongoing immune response. Some studies are uncovering genetic factors that may play a role in long COVID-19, while others are targeting the gut microbiome. There is also initial evidence that being fully vaccinated may lower the risk of developing long COVID-19 after a breakthrough infection.
At this time, treatment for long COVID-19 continues to be a multidisciplinary approach to manage each person’s specific set of symptoms. This includes the use of medications, as well as physical and occupational therapy. However, research into a cure is ongoing. In a new study published in the Journal for Nurse Practitioners, two women with long COVID-19 symptoms got significant relief with the use of over-the-counter antihistamines. This echoes previous findings that showed antihistamines played a beneficial role in the treatment of severe COVID-19.
This may all sound like slow progress, but it’s important to put things into perspective. During the first two years of the pandemic, much of the focus was on halting the spread of the virus. Now, with infection rates dropping, attention can shift to decoding and curing long COVID-19.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health. Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.
