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Speaker 1: Welcome to brain Stuff production of I Heart Radio. Hey

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Speaker 1: brain Stuff, Lauren Boga bam here by now we know

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Speaker 1: the various symptoms, the fever, shortness of breath, the nausea

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Speaker 1: and a nasmia, the signature dry cough. Since the COVID

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Speaker 1: nineteen pandemic began, more than two d and thirty four

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Speaker 1: million people have become intimately familiar with some combination of

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Speaker 1: these telltale signs as they grappled with the novel coronavirus.

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Speaker 1: For many, recovery began two or three weeks later. For

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Speaker 1: some COVID nineteen patients, though the symptoms have never gone away.

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Speaker 1: Months after their first positive test, COVID long haulers still

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Speaker 1: experienced splitting headaches, nerve and joint pain, fatigue, cognitive sluggishness

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Speaker 1: also known as brain fog, and occasionally distortion of smell

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Speaker 1: and taste. This experience has been dubbed long COVID, and

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Speaker 1: it's an ongoing fight against symptoms from a virus that

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Speaker 1: was supposed to have run its course. It's become prevalent

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Speaker 1: enough that the National Institutes of Health or NIH, announced

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Speaker 1: a one point one five billion dollar four year initiative

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Speaker 1: to study the disease in December. So today, let's take

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Speaker 1: a deeper look at what we know about long COVID

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Speaker 1: and how doctors might go about treating it. We know

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Speaker 1: that symptoms of long COVID set in after an initial

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Speaker 1: infection with the coronavirus. However, scientists haven't fully uncovered why

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Speaker 1: these symptoms persist in some people but not others. That said,

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Speaker 1: there are a few hypotheses. The first is that the

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Speaker 1: virus simply never leaves the body, known as viral persistence.

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Speaker 1: Certain viruses can take up residents in their host's body.

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Speaker 1: Once the acute infection cycle is finished. These renegade viruses

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Speaker 1: hide out in tissues where they may act like guerilla fighters,

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Speaker 1: causing chronic, low to mid level symptoms punctu ated by

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Speaker 1: periods of dormancy. For example, the chickenpox virus normally infects

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Speaker 1: kids at a relatively young age, causing mild, if incredibly

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Speaker 1: annoying symptoms. However, the virus can stay in the infected

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Speaker 1: individual's body well into adulthood, re emerging as a nasty

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Speaker 1: case of shingles. A research published in the journal Nature

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Speaker 1: in September also suggests that the ebolavirus may remain in

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Speaker 1: the systems of those who survive their initial infection, leading

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Speaker 1: to chronic issues like muscle fatigue and an increased risk

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Speaker 1: of miscarriage. Another hypothesis is that in certain cases, COVID

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Speaker 1: nineteen can lead to organ or tissue damage. Inflammation is

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Speaker 1: one of your body's natural immune responses to viruses like coronavirus,

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Speaker 1: but that natural response can go haywire for some patients.

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Speaker 1: COVID nineteen infection can trigger a severe, cascading inflammatory response

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Speaker 1: in multiple organ systems, including the lungs, brain, and blood vessels,

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Speaker 1: lead in to what's known as a cytokine storm. This

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Speaker 1: can result in scar tissue build up in the lungs,

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Speaker 1: long term heart complications, or even an elevated risk of stroke. Finally,

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Speaker 1: it could be the case that long COVID is triggered

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Speaker 1: by other opportunistic viruses. In fact, a June study in

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Speaker 1: the journal Pathogens found that COVID nineteen patients are more

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Speaker 1: susceptible to infection by a reawakened epstein bar virus, the

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Speaker 1: same pathogen that causes mononucleosis. For the article of this

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Speaker 1: episode is based on how stuff Work. Spoke with Michael

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Speaker 1: van Elzacker PhD, a neuroscience researcher at Harvard Medical School.

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Speaker 1: He explained, when there's an acute infection, other viruses can

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Speaker 1: often take advantage of that and sort of start to

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Speaker 1: do their own thing. These hypotheses and others are being

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Speaker 1: investigated by various research groups, including Van Elzecker's. However, he

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Speaker 1: cautions that long COVID is likely not a one size

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Speaker 1: fits all diagnosis. He said, we have to be a

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Speaker 1: little bit careful that we don't consider this some unique,

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Speaker 1: standalone problem. It's probably not going to be the same

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Speaker 1: thing for every single person. Due to the relatively recent

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Speaker 1: emergence of the novel coronavirus, it's difficult to say with

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Speaker 1: certainty who is at most risk for long COVID, but

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Speaker 1: thanks to the efforts of scientists and statisticians across the globe,

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Speaker 1: a much clearer picture is beginning to emerge. In a

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Speaker 1: study published in September of twenty twenty one in the

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Speaker 1: journal Plos Medicine, researchers found that about thirty six percent

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Speaker 1: of patients studied were still experiencing COVID like symptoms three

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Speaker 1: and six months after they initially tested positive for the virus.

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Speaker 1: Most previous studies have estimated lingering COVID nineteen symptoms in

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Speaker 1: between ten and thirty percent of patients, including in April

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Speaker 1: one UK study of more than twenty thousand patients, which

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Speaker 1: found that thirteen point seven percent of participants were still

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Speaker 1: experiencing symptoms at least twelve weeks after diagnosis. The new study,

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Speaker 1: which was led by scientists at the University of Oxford,

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Speaker 1: searched anonymized data for millions of electronic health records to

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Speaker 1: identify a study group of more than two hundred and

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Speaker 1: seventy three thousand patients with COVID nineteen. Survivor bias might

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Speaker 1: also skew the age numbers for long COVID. A separate

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Speaker 1: September one study by the UK Office of National Statistics

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Speaker 1: found that people between the ages of fifty and sixty

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Speaker 1: nine were most likely to report long term symptoms, especially

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Speaker 1: if they had other pre existing health conditions, but as

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Speaker 1: other research has pointed out, this might be because older

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Speaker 1: folks are more likely to die from the disease. So far,

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Speaker 1: it seems that vaccination cuts the risk of developing long

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Speaker 1: COVID roughly in half. Unfortunately, treatment options for long COVID

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Speaker 1: are fairly limited. At the moment. Because the source of

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Speaker 1: long COVID is much trickier to pin down than an

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Speaker 1: acute COVID nineteen infection, it puts doctors and patients alike

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Speaker 1: in a difficult bind, and without a standard treatment protocol

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Speaker 1: in place, medical providers often feel helpless to recommend a

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Speaker 1: course of action while their patients continue to suffer. The

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Speaker 1: other issue is that chronic conditions are often complex and

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Speaker 1: resource intensive to treat, and they come with a certain

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Speaker 1: amount of stigma. Study published in Pain Medicine found that

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Speaker 1: eighty eight percent of patients who had chronic pain reported

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Speaker 1: being disbelieved by their primary care provider about their experience.

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Speaker 1: But some hospitals, such as U C. L A Health,

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Speaker 1: are beginning to offer long COVID treatment plans accustomized for

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Speaker 1: each individual patient, and some of these plans include input

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Speaker 1: from psychologists and other mental health professionals in addition to neurologists, cardiologists,

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Speaker 1: and infectious disease experts. Health care providers hope that these

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Speaker 1: more robust mental health resources will help long COVID patients

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Speaker 1: not only manage their cognitive symptoms, but also the emotional

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Speaker 1: distress and fatigue that accomp niece chronic illness. Today's episode

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Speaker 1: is based on the article one in three who had

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Speaker 1: COVID nineteen have long COVID symptoms, says Oxford study on

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Speaker 1: how stuff works dot Com written by Joanna Thompson. Brain

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Speaker 1: Stuff is production of by Heart Radio in partnership with

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Speaker 1: how stuff Works dot Com, and it's produced by Tyler Clain.

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