As COVID-19 infections continue to rise around the globe, so has the number of people diagnosed with Long COVID. According to the Centers for Disease Control (CDC), “Long COVID is a wide range of new, returning, or ongoing health problems that people experience after being infected with the virus that causes COVID-19.” A survey conducted by the CDC last June showed that one in 10 U.S. adults who reported having COVID-19 in the past had Long COVID symptoms at the time of data collection.
Still, Long COVID symptoms, such as fatigue and a range of mental symptoms given the umbrella label “brain fog” has led to the disease being often dismissed as a psychological issue. Dr. Michael Peluso, a physician and infectious disease researcher at the University of California, San Francisco, discussed the myth of Long COVID being a psychological issue in an interview with the AmNews.
When asked whether Long COVID is a psychological issue, Peluso stated that “the broad answer is no…Medicine has always been very bad at addressing issues that it doesn’t understand, and often those issues get kind of dismissed as either issues that people are imagining or making up.”
As the pandemic progressed, scientists and doctors began to better understand what Long COVID is and how it occurs. Peluso explained that the current understanding has shifted beyond a purely psychological origin of the condition.
“The important message is…that is not our current biological understanding of it,” said Peluso, but notes that “that is the way, unfortunately, that people who are skeptical of the condition or don’t want to deal with someone who has the condition try to dismiss it.”
While many questions regarding Long COVID and its treatments remain unanswered, Peluso emphasized that significant progress has been made toward our understanding of the biological mechanisms underlying this syndrome. He explained that Long COVID can develop in several different ways, including persistence of the SARS-CoV-2 virus, or malfunctions of the body’s normal processes, such as the immune system and blood clotting system, among others. However, he added that despite this progress, physicians do not currently have ways to test patients suffering from Long COVID symptoms.
Long COVID has entered the mainstream conversation as a disease that comes after recovering from a viral infection—a so-called post-viral disease—but it’s not unique.
To learn more about how the symptoms of Long COVID come about, the AmNews also spoke with Dr. Douglas B. Kell, a professor of systems biology at the University of Liverpool. Dr. Kell is an expert in blood clotting and has been researching Long COVID since the early days of the pandemic.
“SARS-CoV-1 had post-viral syndromes. It’s likely that Gulf War syndrome was a post-viral [disease] … post-Dengue as well, so these diseases aren’t nearly as common or prevalent as COVID, but it’s clearly Long COVID that has brought this into prominence,” Kell explained.
He added that when SARS-CoV-2, the virus that causes COVID-19, gets into the blood, proteins on the surface of the virus start to interfere with the body’s normal systems that control the clotting of blood. In particular, this leads to the formation of small persistent clots, called ‘microclots’, which are “clots that have clotted into an anomalous form…[making] the clots more resistant . . . so that’s why they’re hanging around,” he added.
These stable clots then travel throughout the body through the bloodstream. Sometimes, they can get stuck, blocking blood vessels and preventing oxygen-rich blood from getting to tissues in the body. The cells that end up being starved of oxygen stop working normally, leading to the symptoms of Long COVID.
“Which ones in particular are most starved are the ones that manifest the particular subset of symptoms that you happen to have,” Kell explained. “If [microclots] are in the CNS [Central Nervous System], it’s brain fog, and if they’re in the muscles, it’s muscle fatigue, and so forth.”
Researchers, including Dr. Kell, are currently working on developing treatments for Long COVID that tackle the varied origins of the disease. But even though treatments for the physical symptoms of Long COVID are still under development, “we do have good treatments for mental health symptoms,” said Peluso, “but people are often hesitant to seek care for those things…because they don’t want their physical symptoms to be dismissed.”
If you are recovering from #COVID19 or experiencing #longCOVID, you can call 212-COVID19 to receive specialty care, or visit www.nychealthandhospitals.org/services/covid-19 to learn more about NYC’s COVID-19 Centers of Excellence. For additional resources about COVID-19, visit www1.nyc.gov/site/coronavirus/index.page. COVID-19 testing, masks, and vaccination resources can also be accessed on the AmNews COVID-19 page: www.amsterdamnews.com/covid.