All about "long Covid"

What is the definition of long Covid?

The National Academies of Sciences, Engineering, and Medicine, in June (2024) released a comprehensive definition of long Covid: "an infection-associated chronic condition that occurs after Covid-19 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease that affects one or more organ systems."

According to AARP Bulleting (September 2024 issue), according to that definition, 18 million Americans have experienced long Covid; currently more than 1 in 20 of us are living with its symptoms. Researchers have begun to link long-term Covid with another recent phenomenon: our shrinking life expectancy. 

Some people that were interviewed by AARP Bulletin (September 2024 issue) that experienced long Covid:

(All of what you're about to read is copied word for word from the AARP Bulletin (September 2024 issue):

Chrissy Bernal has caught Covid-19 three times, most recently in October 2023. "My symptoms were always pretty mild," she says. But after her third round of the virus, she developed extreme allergies to foods she used to eat all the time: oats, dairy, gluten, sesame seeds, and peanuts. "I literally have some level of anaphylaxis every single day," she says. In May, Bernal, 46, a public relations professional in Houston, went into anaphylactic shock during a virtual meeting. "I had to inject myself with an Epi while everyone watched in horror on Zoom," she says.

Photo (above) is from AARP Bulletin (September 2024 issue)

Natalie Nichols, 53 has been struggling with debilitating asthma and severe food allergies since she first caught Covid more than three years ago. "Last fall, I spent two-and-a-half months confined to bed, motionless, because moving, including holding a cellphone, made me too short of breath," she says. She's also experienced brain fog, high blood pressure, hyperglycemia, fatigue and gastrointestinal symptoms. Nichols, the founder of a nonprofit in Nacogdoches, Texas recently underwent surgery to repair joint damage caused by Covid-induced inflammation.

Lorraine W., of Clarence Center, New York, was looking forward to an active retirement when she was diagnosed with Covid in March 2020. "I've never returned to my pre-Covid self," says Lorraine, 65. She's on medication to treat small blood vessel damage to her heart and continue to battle a lingering cough, fatigue and breathlessness, as well as kidney disease. Neurological changes have made her legs unsteady when she walks, requiring her to use balance poles. "None of these conditions were present before Covid," Lorraine says.

Stats (above) is from AARP Bulletin (September 2024 issue)

A variety of medical issues as a result of having Covid for those who weren't hospitalized

From this same AARP Bulletin (September 2024 issue all information provided is from this same source): patients who had mild bouts of Covid had an increased risk of respiratory, cardiovascular, metabolic, and neurological issues lingering for three years after the initial infection. Long Covid patients had a significantly increased risk of severe health issues affecting the brain, lungs, and heart.

Even an acute case of Covid can compromise heart health: compared with those who didn't contract Covid, people who caught the virus were 81 percent more likely to die of a cardiovascular complication in the ensuring three weeks, according to a study of 160,000 patients published by the European Society of Cardiology. As quoted from this same source: "But the risk lingers long after the symptoms abate." Those who caught the virus were five times more likely to die from cardiovascular disease as long as 18 months after infection, the same study found. Heart disease deaths, which had been on a downward trend for decades, began to spike in 2020 and remained high through 2022, the last year for which data is available.

Stroke, blood clots in the legs leading to clots in the lungs, abnormal heart rhythm (arrhythmia) and inflammation of the heart are among the challenges Covid poses, says Mohanakrishnan Sathyamoorthy, M.D., professor and chair of internal medicine at the Burnett School of Medicine in Fort Worth, Texas. In long Covid, this collection of cardiovascular disruptions can present as postural orthostatic tachycardia syndrome (POTS), in which patient's heart rates increase abnormally when they go from sitting or lying down to standing up.

"Every time you get infected with Covid, there is a possible increased risk of long Covid, and some cardiac disorders can occur--especially if you have a history of heart disease, including stroke, heart disease, and heart attacks," says Pragna Patel, M.D., senior adviser for long Covid at the CDC. All of these problems can be exacerbated by the virus entering coronary tissue and triggering inflammatory responses that can damage the heart.

Researchers say Covid may also alter the gut microbiome, a primary controller of inflammation, thereby triggering the immune system to rev up the condition. "There is no single agreed-upon mechanism  that's causing the issues," Baratta says. "An individual may have multiple factors going on in their body, and not everyone will have the same underlying mechanism causing their symptoms," which increases the complexity of both research and treatment.

Lastly, this same source (AARP Bulletin - September 2024 issue), "Several studies show that vaccination can decrease the risk of developing long Covid," Patel says. Vaccination rates tend to increase with age, with people 75 and older being the most well vaccinated--hence the most well protected from long Covid, Patel theorizes. That may explain why long Covid most commonly affects people ages 35 to 64; the risk seems to drop for those 65 plus, according to CDC data.