Sept 3 2020
Nearrly a year into the global coronavirus pandemic, scientists, doctors and patients are beginning to unlock a puzzling phenomenon: For many patients, including young ones who never required hospitalization, Covid-19 has a devastating second act.
Many are dealing with symptoms weeks or months after they were expected to recover, often with puzzling new complications that can affect the entire body—severe fatigue, cognitive issues and memory lapses, digestive problems, erratic heart rates, headaches, dizziness, fluctuating blood pressure, even hair loss.
What is surprising to doctors is that many such cases involve people whose original cases weren’t the most serious, undermining the assumption that patients with mild Covid-19 recover within two weeks. Doctors call the condition “post-acute Covid” or “chronic Covid,” and sufferers often refer to themselves as “long haulers” or “long-Covid” patients.
“Usually, the patients with bad disease are most likely to have persistent symptoms, but Covid doesn’t work like that,” said Trisha Greenhalgh, professor of primary care at the University of Oxford and the lead author of an August BMJ study that was among the first to define chronic Covid patients as those with symptoms lasting more than 12 weeks and spanning multiple organ systems.
For many such patients, she said, “the disease itself is not that bad,” but symptoms like memory lapses and rapid heart rate sometimes persist for months.
Another possibility is that the virus causes some people’s immune systems to attack and damage their own organs and tissues, researchers said. A June study found roughly half of 29 hospitalized ICU patients with Covid-19 had one or more types of autoantibodies—antibodies that mistakenly target and attack a patient’s own tissues or organs.
Doctors say some patients appear to be developing dysautonomia, or dysregulation of the autonomic nervous system, the part of the nervous system that regulates involuntary functions like breathing, digestion and heart rate, some researchers and doctors said.
David Putrino, director of rehabilitation innovation at Mount Sinai Health System in New York City, said the majority of the more than 300 long-Covid patients being seen at its Center for Post-Covid Care appear to have developed a dysautonomia-like condition. About 90% of such patients report having symptoms of exercise intolerance, fatigue and elevated heartbeats. About 40% to 50% also report symptoms such as gastrointestinal issues, headaches and shortness of breath.
WIND: worth a read, if you are a sufferer of long-haul COVID, like me.
I am not alone—sharing these things with an MD acquaintance also suffering from it, we share many of the same issues. Like me, his EBV was a post-COVID nuke to his system.
I have had six months of many symptoms:
- Exercise intolerance — initial recovery was OK, but each time I went to normal baseline, I get whacked really hard for days or a week. I am weaker now than 5 months ago. A one-mile walk is sometimes too much, two miles is a strain unless it’s a strong day—and I pay dearly for it (for days) if I misguage.
- Highly distrupted sleep — needing to sleep, unable to sleep. Sometimes a need for two naps per day up to two hours each.
- Extreme fatigue — needing to sleep 14 hours a day or more.
- Entire body aches (especially the back, vey bad recently), joint aches (mostly resolved).
- Motivation — wanting to just sit and do nothing
- Attentional issues — concentration.
- Unexplained shortness of breath (no environmental causes). Fortunately, magnesium deals with it longer and better than any prescription inhaler.
- Gastrointestinal issues — diarrhea and loose stools for months, then resolving but being intolerant of some foods.
- Total loss of appetite, apathy towards any food for up to 30 hours (twice recently).
- Evolving synmptoms that keep me guessing.
- Cyclical effects that keep me guessing.