Prolonged COVID is not inevitable. it just feels like this

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“Long-haul” sufferers seemed like an aberration early in the COVID pandemic: an unlucky few who, for some reason, couldn’t seem to beat the disease.

Nearly three years later, we know better. Prolonged COVID is far from rare, and the ranks of those affected are growing.

According to the US Centers for Disease Control and Prevention, as many as one in five American adults who have had COVID-19 are living with prolonged COVID, a condition loosely defined as symptoms that persist or appear long after it goes away. the initial COVID infection.

Many have accepted COVID infection as inevitable, and are now even repeating COVID infection. It can also be tempting to accept prolonged COVID as inevitable, especially given studies that have found that contracting the virus multiple times can increase your risk of contracting it.

But such fatalistic thinking isn’t logical, Dr. Alexandra Brugler Yonts, an infectious disease specialist who runs a long-running COVID clinic at Children’s National Hospital in Washington, DC, says. Fortune.

“That’s like saying everyone is going to get the flu,” she says. “Absolutes are dangerous.”

Dr. Panagis Galiatsatos, an assistant professor in the Johns Hopkins Division of Pulmonary and Critical Care Medicine who treats long-standing COVID patients, says COVID doesn’t have a “binary outcome.”

“There’s a spectrum of how people get it,” he says. Fortune, adding that “how you get COVID” can determine if you develop prolonged COVID. For example, those who vaccinate and/or treat their infection with the antiviral Paxlovid may have a lower risk of developing the new disabling condition, some studies suggest.

Statistics like the CDC’s claim that one in five American adults who have had COVID have long-term COVID are generally based on surveys, with self-identified individuals not necessarily having been diagnosed.

These surveys basically ask, “Do you have any new health problems since you had COVID?” Brugler Yonts says. “Which is a challenge, because life goes on and people still develop health problems.”

It’s often impossible to tell whether a post-COVID health condition would have occurred without an infection, or whether the infection accelerated a disease process that was already occurring, he adds.

Still, there is no official consensus on how to define the condition, which has more than 200 potential symptoms and can range from onset immediately after the infection resolves to months later.

“We are still struggling as a medical entity to properly define prolonged COVID,” says Galiatsatos. “There is no biomarker, there is no test.”

These factors lead Galiatsatos and Brugler Yonts to believe that true prolonged COVID is probably less common than we think, a reassuring thought.

All viruses are capable of causing complications after an infection is over, “and we need to make fun of those [cases] out,” says Galiatsatos.

“It’s no different than scraping your leg. The initial impact of the scrape is gone, but the scar will take time to heal. Patients who are still coughing at two months, that’s part of the cure.”

COVID, like other viruses, can cause organ damage that “may take some time to get better,” he says.

But that’s not much COVID, in his estimation. He defines true long COVID as new symptoms persisting six months or more after infection for which no other cause can be found. Such patients tend to have symptoms of dyspnea, chest discomfort, and fatigue, but without obvious organ damage, he says, and they often had neurological symptoms, such as headache and loss of taste and smell, during their acute infection.

“Prolonged COVID is a diagnosis of exclusion,” says Galiatsatos. “There are a lot of potential symptoms that are more incidental than anything else.”

Vaccination and antivirals like Paxlovid “can keep the viral load low enough that it doesn’t develop into neurological complications,” says Galiatsatos. “It’s hard for me to believe that something so common is going to produce prolonged COVID for everyone.”

Is the long duration of COVID an inevitability or a personal impossibility? It is impossible to know, and such uncertainty can be demoralizing.

But don’t throw your hands up in the air and watch out for the wind, Brugler Yonts advises.

“Just because I probably have the flu at some other point in my life doesn’t mean I’m licking the subway rails.”

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