To Your Health: What Is Long Covid All About?

Part-time Telluride local, Dr. Alan Safdi, is a world-renowned internist and gastroenterologist with encyclopedic knowledge of mind-body wellness and preventative medicine. He posts regularly on Telluride Inside… and Out under the banner of “To Your Health.” Dr. Alan’s blogs feature the most current information in his fields: health, wellness and longevity.

Links to Dr. Alan’s podcasts and narratives on COVID-19 are here.

This week, Dr. Alan’s podcast is all about the variation on the theme of Covid-19 called “Long Covid.”

“After the infection has resolved, some terrible symptoms may persist even in the young and people who had only mild disease,” explains Dr. Alan.

The narrative below provides additional information on the subject.

Long COVID is a condition wherein people continue to experience symptoms for longer than usual after initially contracting the SARS-CoV-2 virus – although the virus is no longer detectable. Research has shown that SARS-CoV-2, the virus that causes COVID-19, affects various organs and systems in the body, including the cardiovascular system.

A 2020 survey by the Centers for Disease Control and Prevention (CDC) suggests that it can take weeks, even months, for COVID-19 symptoms to resolve and for people to return to their former state of health. That is also true of young adults with no chronic medical conditions, indicating that even relatively healthy individuals can face long-term impacts from their illness. In contrast, over 90% of people discharged from the hospital with influenza usually recover within 2 weeks.

As reported in the JAMA Network Open research letter, among COVID-19 patients whose infections ranged from asymptomatic to severe, two problems – fatigue and loss of smell or taste – persisted most frequently. In another study early in 2021, researchers in Wuhan, China, reported that 76% of hospitalized COVID-19 patients had at least one symptom that persisted 6 months after acute infection, mostly fatigue or muscle weakness. Studies of non-hospitalized patients have shown that anywhere from 35% to 50% of non-hospitalized patients had symptoms 2 to 4 months later.

Fatigue, breathing issues, and chest pain are common findings, as are neurologic symptoms like brain fog, which means different things to different people, but usually features some combination of short-term memory issues, attention issues, and word-finding difficulty.

Digging deeper into the, ahem, heart of the matter, although many viruses, such as influenza, can cause heart-related issues, SARS-CoV-2 seems to impact the cardiovascular system more frequently. Observational and research data suggest that COVID-19 impacts the heart in hospitalized patients; those with mild cases of the disease; and people with no prior heart-related conditions.

According to an article published in Science, of the family of seven human coronaviruses, scientists know that most affect the lungs, but not the heart. SARS-CoV-2 is different: it appears to have a propensity to cause issues such as inflammation, heart attack-like symptoms, and heart rhythm irregularities. Even young adults may be at risk of COVID-19-related heart complications.

Recent research, also published in JAMA Cardiology, found that out of 26 college-aged competitive athletes who previously tested positive for COVID-19, four (15%) had cardiovascular magnetic resonance (CMR) findings that suggested myocarditis (inflammation of the heart). Eight additional athletes (30.8%) exhibited test results which suggested prior heart muscle injury after their COVID infection had resolved.

Bottom line, whether immune system-related or a result of SARS-CoV-2 directly attaching to receptors in the heart, research has clearly revealed evidence of heart cell damage in people who have had the coronavirus. So with good reason there is concern about these “long haulers” who could face cardiac-related problems that pop up maybe weeks, even months after their acute illness.

There are probably other kinds of secondary effects that we don’t see acutely in the hospital which manifest themselves later, one of the reasons, and one of the great arguments for people getting a vaccine rather than taking the risk of getting COVID-19.

Recovery

There is currently no clear timeline for recovery from long COVID. Symptoms that people most commonly report include:

• fatigue
• shortness of breath
• cough
• joint pain
• chest pain

People may also experience:

• brain fog, wherein they find it more difficult to think clearly and focus
• depression
• muscle pain
• headache
• fever, which may come and go
• heart palpitations, or a feeling of the heart pounding

People may also develop long-term complications that affect the organs. These complications are less common but may include:

• inflammation of the heart muscle
• abnormal lung function
• severe kidney injury
• a rash
• hair loss
• problems with smell and taste
• sleep issues
• memory and concentration difficulties
• anxiety
• mood changes

Dr. Alan, more:

Dr. Alan Safdi is board-certified in Internal Medicine and in Gastroenterology and is a Fellow of the American College of Gastroenterology. A proven leader in the healthcare arena, he has been featured on the national program, “Medical Crossfire” and authored or co-authored numerous medical articles and abstracts.

Safdi, a long-time Telluride local, has been involved in grant-based and clinical research for four decades. He is passionate about disease prevention and wellness, not just fixing what has gone wrong.

Dr. Alan is an international lecturer on the subjects of wellness, nutrition and gastroenterology.

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