Long Covid: What Is Post
Mild or moderate COVID-19 lasts about two weeks for most people. But others experience lingering health problems even when they have recovered from the acute phase of the illness.
In such patients, there is no longer live coronavirus running amok in the body. If tested, the person would test negative for the coronavirus, but they might be severely debilitated nonetheless.
The problem has several names. The National Institutes of Health refer to long-term COVID-19 symptoms as PASC, which stands for post-acute sequelae of SARS-CoV-2. More common terms are post-COVID syndrome, long COVID or long-term COVID. People living with post-COVID syndrome are sometimes known as long haulers.
Can People Without Symptoms Spread The Virus To Others
“Without symptoms” can refer to two groups of people: those who eventually do have symptoms and those who never go on to have symptoms . During this pandemic, we have seen that people without symptoms can spread the coronavirus infection to others.
A person with COVID-19 may be contagious 48 hours before starting to experience symptoms. In fact, people without symptoms may be more likely to spread the illness, because they are unlikely to be isolating and may not adopt behaviors designed to prevent spread.
But what about people who never go on to develop symptoms? A published in;JAMA Network Open;found that almost one out of every four infections may be transmitted by individuals with asymptomatic infections.
We are learning that people who are vaccinated are less likely to infect others. However, even people who are fully vaccinated can carry greater amounts of the Delta variant , making it more likely that they could spread the virus to others. Thats one reason why, in July 2021, the CDC advised people who are fully vaccinated to wear masks in public indoor places in areas of the country with substantial or high transmission of the virus.
People who are not vaccinated remain at increased risk for becoming infected and infecting others. For this group, the CDC continues to recommend mask wearing and other preventive measures in some outdoor settings and in most indoor settings.
If Someone Is Experiencing Neurological Symptoms From Covid
For most of the post-COVID neuro symptoms, we use a symptomatic approach, said Dr. Sanghavi. For example, for a headache, the approach is usually symptomatic treatment except for if the headache becomes intractable. In that case, you need further imaging and consultation with a specialist.
For symptoms such as anxiety, depression and PTSD, the diagnostic approach usually starts with standard screening tools to see if that patient would need help from a therapist and treatment of this condition with pharmacological agents, he added.
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Will My Sense Of Taste And Smell Ever Return
I had Covid-19 symptoms back in March, and have yet to fully recover both senses. Do you have any suggestions on how I can get my smell and taste back, or could this be permanent? Alexandra Geca, fraud investigator, London
Loss of smell and taste are common features of Covid-19, affecting around 60% of those infected, and lasting for longer than a month in about 10% of cases. Some completely lose these senses, others report a partial loss, phantom smells, or a distorted sense of smell . Sometimes this is described as a smell of burning rubber, a pungent chemical smell or raw sewage, said Prof Carl Philpott, director of research and medical affairs for Fifth Sense, a charity supporting people with smell and taste disorders.
The good news is that parosmia is often a sign that your sense of smell is slowly returning and that the body is repairing any nerve damage caused by the virus.
Fifth Sense has developed a toolkit to help people rebuild their sense of smell through smell training, which involves doing regular and repetitive smell exercises. We encourage people to choose a range of smells that they are familiar with so that they will recognise any changes or improvements, and to use their other senses to support them, said Nina Bleasdale, Fifth Senses director of development and operations. For instance, you might grate an oranges skin to release its scent, as touching it, and using your memory of what an orange smells like.
Q: How Are Healthcare Providers Treating And Managing Coronavirus Long
A: Many health systems are starting to streamline care for this group of patients. Long-haulers should go through testing involving behavioral, pulmonary, respiratory, cardiovascular and neurological health. From there a care path and treatment is recommended and a team of providers will monitor the patient moving forward. Its also important to drink fluids to stay hydrated, rest, focus on sleep, manage stress and eat well.
There is a lot of collaboration and research happening as more data is collected and we start to piece together the long-term effects of COVID-19 on the body. The team is there to identify symptoms that worsen and get them to the right level of care. Were also seeing that depression and anxiety are big issues for these long-haulers, so checking in to see how theyre doing is another important aspect in the monitoring program.
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If People Need To Go Out
To reduce the risk of spreading the virus to vulnerable people, it is best to avoid them entirely and to quarantine per the guidelines above.
People who must go out should:
- Wear a face mask: People should try to
CDC recommends that people wear cloth face masks any time they are in a public setting. This will help slow the spread of the virus from people who do not know that they have contracted it, including those who are asymptomatic. People should wear cloth face masks while continuing to practice physical distancing. Note: It is critical that surgical masks and N95 respirators are reserved for healthcare workers.
One of the challenges of caring for a person with COVID-19 is that by the time they have symptoms, they might have been contagious for a few days.
Nevertheless, a caregiver can reduce their exposure by taking the following precautions:
- Wear a face mask at all times while around the sick person, and ask the sick person to do the same.
- Try caring for the person through a door. Leave food outside the door, then walk away before they open the door.
- Help the person quarantine in an isolated part of the house.
- Use video chat to stay connected, rather than talking in person.
- Wipe down all surfaces the person touches using bleach or alcohol wipes.
- Wash the hands frequently.
It may also be helpful to prepare for the possibility of illness.
Try placing a large grocery order, structuring a home quarantine area, and stocking up on medical supplies.
Long After The Fire Of A Covid
A physician assistant dismissed her concerns once he learned she had tested negative for coronavirus and was not having breathing difficulties, recalled Talkington. He refused to refer her to a cardiologist for her racing heartbeat, gave her pamphlets on anxiety and perimenopause, and advised her to ignore social media posts about post-Covid syndrome, she said.
He said, what youre reading is giving you ideas, said Talkington. He also said it could be my hormones. I was mortified and humiliated. He didnt believe me. It was awful.
Finally, after contacting a Stanford;Blood Center program seeking donations of plasma from recovered patients, Talkington took an antibody test and it was positive, indicating that she had previously been infected with the coronavirus. It was very emotional to finally have validation, I sat down and cried for an hour, said Talkington. The positive antibody test also cleared the way for her to get a cardiology referral, she said.
Talkingtons dilemma is being replicated all across the country. Although tests for antibodies which show evidence of an immune response to the infection after the fact are now widely available, they are known to be of varying accuracy. Negative antibody tests, like negative viral tests, are not considered conclusive.
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How Reliable Are The Tests For Covid
Two types of diagnostic tests are currently available in the US. PCR tests detect viral RNA. Antigen tests, also called rapid diagnostic tests, detect specific proteins on the surface of the coronavirus. Antigen test results may come back in as little as 15 to 45 minutes; you may wait several days or longer for PCR test results.
The accuracy of any diagnostic test depends on many factors, including whether the sample was collected properly. For PCR tests, which are typically analyzed in a laboratory, test results may be affected by the conditions in which the test was shipped to the laboratory.
Results may also be affected by the timing of the test. For example, if you are tested on the day you were infected, your test result is almost guaranteed to come back negative, because there are not yet enough viral particles in your nose or saliva to detect. The chance of getting a false negative test result decreases if you are tested a few days after you were infected, or a few days after you develop symptoms.
Generally speaking, if a test result comes back positive, it is almost certain that the person is infected.
A negative test result is less definite. There is a higher chance of false negatives with antigen tests. If you have a negative result on an antigen test, your doctor may order a PCR test to confirm the result.
Biggest Study On Long Haulers Finds 23% Had At Least One Post
The largest study to date covering long haul symptoms has found that nearly a quarter of COVID patients, or 23.2 percent, had at least one post-COVID condition 30 days or more after their initial diagnosis.
Many patients who recover from COVID-19 exhibit persistent or new symptoms more than four weeks after first being diagnosed. These patients are sometimes referred to as long haulers or those with long COVID.
Drawing from a database of over 34 billion private healthcare claim records, the nonprofit organization FAIR Health studied nearly 2 million patients for the prevalence of post-COVID conditions. This is considered the largest population of COVID-19 patients, so far, studied for post-COVID conditions.
Among the key findings:
- Post-COVID conditions were found to a greater extent in patients who had more severe cases of COVID-19, but also in a substantial share of patients whose cases lacked symptoms.
- Of patients who were hospitalized with COVID-19, the percentage that had a post-COVID condition was 50 percent
- Of patients who were symptomatic but not hospitalized, 27.5 percent had a post-COVID condition;
- And of patients who were asymptomatic, 19 percent suffered at least one long haul condition.
- The five most common post-COVID conditions across all ages, in order from most to least common, were pain, breathing difficulties, hyperlipidemia, malaise and fatigue, and hypertension (high blood pressure.
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Will The Vaccine Help
Its unclear how the COVID-19 vaccine;is helping patients with long-lasting symptoms, but early research suggests positive results.;
In May, the Yale School of Medicine began a study to research long-haul symptoms. Patient feedback and initial research determined as many as 30 percent to 40 percent of long haulers who received the COVID-19 vaccine saw a decrease in symptoms.;
Thus far, researchers have several possible explanations: vaccines help reset the immune system or boost the immune system in fighting off leftover COVID-19 virus in the body.
Once vaccinated, your body creates antibodies and produces an immune system response that can reduce inflammation responsible for causing long-term symptoms. The vaccine may also keep your immune system from going into overdrive, which is another possible explanation for long symptoms.
Even without the vaccine having an effect, many experts remain confident long haulers will eventually recover. The bigger question is the timeline. Lung recovery could take months to return to normal.
Either way, dont ignore loss of smell, depression, anxiety or insomnia, or write these off as unimportant. Any symptom that interferes with your daily life is worth a call to your primary care physician, who can help you address these problems and improve your quality of life.
Is It Safe For People With Long Covid To Have The Vaccine
Will it be OK for people still suffering from long Covid symptoms to have the vaccine or would that risk worsening the symptoms? Robert Fletcher, retired teacher, Sheffield
As with many so things Covid-related, were in uncharted territory. None of the Covid vaccines in late stage clinical trials have yet been tested on people who have already had Covid-19 let alone those still experiencing symptoms. However, as an immunologist, I can see no reason at all why a vaccine should make them worse, said Altmann. The vaccines being developed contain no SARS-CoV-2 virus, just the spike antigen from its surface. If I had long Covid, I wouldnt want to risk becoming one of the reinfection cases, so Id get vaccinated.
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Smokers Are Likeliest Among Young People To Contract Acute Covid
Usually the people that Im seeing have very mild, persistent symptoms and theyre certainly able to get about their day and go through their day, Bogoch said.
Thats not to say people arent experiencing severe long-term effects, he added. More research is needed to determine what symptoms are caused by COVID-19 and what might come from pre-existing conditions.
I think were gonna find that some individuals had COVID-19 and truly have lingering symptoms, and other people might not have had COVID-19 but unfortunately, believe that theyve had the infection and have lingering symptoms, he said.
Most people who get this seem to recover and seem to have no lingering side effects. Its clear that there is still a percentage of people who have prolonged effects from this virus.
– Dr. Isaac Bogoch
Several studies are being conducted in Canada with COVID-19-positive patients. Experts like Bogoch hope this will help researchers understand the difference between pre-existing conditions and the true effects of the virus.
But ultimately, COVID-19 or not, properly caring for people is whats most important.
At the end of the day, whether people have had documented infection or not, everybody needs care, Bogoch said. Everybody needs to be listened to and everybody needs to be taken seriously.
WATCH: COVID-19 symptoms may last beyond two weeks. Story continues below.
If I Have Long Covid Does That Mean I’m Still Contagious
No. Once your body has cleared the virus and you test negative for COVID-19, you won’t spread it. Long COVID is also a different condition than a longer-than-normal COVID-19 infection, where the virus is still active in a person and making them sick.;
However, note that it’s possible to get COVID-19 more than once, and testing negative doesn’t mean you’ll never test positive again.
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Who Is Experiencing Covid
Long-haul symptoms are defined as having symptoms for 28 days or more after recovering from the novel coronavirus. This has been found to occur in 10% of people who have had a COVID-19 diagnosis and involve prolonged symptoms for several months. Theyve been reported to have had both mild and severe cases of initial COVID-19 infectionaffecting the young, old, healthy, and those with chronic conditions.
Chest tightness is one such symptom that some long-haulers experience.
Still So Much We Dont Know
Dr. Isaac Bogoch, an infectious disease specialist at the University of Toronto, said long-lasting fatigue, along with a change in taste or smell, is one of the most common long-term symptoms experienced by long-haulers.
Most people who get this seem to recover and seem to have no lingering side effects. Its clear that there is still a percentage of people who have prolonged effects from this virus, Bogoch told HuffPost Canada.
He said the sample size of true COVID-19 long-haulers is so small at this point, the medical community is still working to understand what that group actually looks like.
Mental Health Issues After Covid
After surviving COVID-19, some people are left with lingering anxiety, depression and other mental health issues. Physical changes such as pain and weakness can be complicated by long periods of isolation, stress from job loss and financial difficulties, and grief from the deaths of loved ones and the loss of good health.
Patients who were hospitalized have a particularly challenging recovery. Brigham says Post-intensive care syndrome, or PICS, puts COVID-19 survivors and other people who have spent time in the ICU at a higher risk for problems with mental health, cognition and physical recovery.
Megan Hosey, Ph.D., a rehabilitation psychologist, says that prolonged time in the ICU can cause delirium. The strange surroundings, multiple mind-altering medications, isolation and loss of control can leave patients with lasting and recurrent sensations of terror or dread, including post-traumatic stress disorder .
Many patients have hallucinations where they believe that medical providers are trying to harm them, Hosey says. We’ve had patients tell us things like I thought I was being buried alive when they were being put into an MRI.
What Causes Long Covid
Like everything else involving the coronavirus, research is underway. Information reported by Healthline suggests that there may be long-term changes in gene expression, and that the spike protein made when someone is infected with COVID-19 can affect healthy cells, causing lasting symptoms.;
Other theories include inflammation of the immune system, decreased function of the immune system and post-traumatic stress from illness. Lasting symptoms may also be due to organ damage caused by COVID-19, in addition to the organ damage itself. For example, the coronavirus weakens blood vessels and causes them to leak, which can cause long-term problems with the kidneys and liver, according to the Mayo Clinic.;
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