WEBVTT - How Does Long COVID Work?

0:00:01.920 --> 0:00:06.440
<v Speaker 1>Welcome to brain Stuff production of I Heart Radio. Hey

0:00:06.480 --> 0:00:10.320
<v Speaker 1>brain Stuff, Lauren Boga bam here by now we know

0:00:10.520 --> 0:00:14.600
<v Speaker 1>the various symptoms, the fever, shortness of breath, the nausea

0:00:14.760 --> 0:00:19.240
<v Speaker 1>and a nasmia, the signature dry cough. Since the COVID

0:00:19.360 --> 0:00:22.680
<v Speaker 1>nineteen pandemic began, more than two d and thirty four

0:00:22.760 --> 0:00:26.720
<v Speaker 1>million people have become intimately familiar with some combination of

0:00:26.720 --> 0:00:30.640
<v Speaker 1>these telltale signs as they grappled with the novel coronavirus.

0:00:31.440 --> 0:00:36.000
<v Speaker 1>For many, recovery began two or three weeks later. For

0:00:36.080 --> 0:00:40.080
<v Speaker 1>some COVID nineteen patients, though the symptoms have never gone away.

0:00:40.600 --> 0:00:44.680
<v Speaker 1>Months after their first positive test, COVID long haulers still

0:00:44.720 --> 0:00:49.720
<v Speaker 1>experienced splitting headaches, nerve and joint pain, fatigue, cognitive sluggishness

0:00:49.760 --> 0:00:53.520
<v Speaker 1>also known as brain fog, and occasionally distortion of smell

0:00:53.600 --> 0:00:58.720
<v Speaker 1>and taste. This experience has been dubbed long COVID, and

0:00:58.880 --> 0:01:01.800
<v Speaker 1>it's an ongoing fight against symptoms from a virus that

0:01:01.880 --> 0:01:05.000
<v Speaker 1>was supposed to have run its course. It's become prevalent

0:01:05.120 --> 0:01:08.400
<v Speaker 1>enough that the National Institutes of Health or NIH, announced

0:01:08.400 --> 0:01:11.479
<v Speaker 1>a one point one five billion dollar four year initiative

0:01:11.520 --> 0:01:17.040
<v Speaker 1>to study the disease in December. So today, let's take

0:01:17.040 --> 0:01:19.679
<v Speaker 1>a deeper look at what we know about long COVID

0:01:19.920 --> 0:01:24.320
<v Speaker 1>and how doctors might go about treating it. We know

0:01:24.520 --> 0:01:27.280
<v Speaker 1>that symptoms of long COVID set in after an initial

0:01:27.319 --> 0:01:32.680
<v Speaker 1>infection with the coronavirus. However, scientists haven't fully uncovered why

0:01:32.760 --> 0:01:37.280
<v Speaker 1>these symptoms persist in some people but not others. That said,

0:01:37.319 --> 0:01:41.320
<v Speaker 1>there are a few hypotheses. The first is that the

0:01:41.400 --> 0:01:45.400
<v Speaker 1>virus simply never leaves the body, known as viral persistence.

0:01:45.520 --> 0:01:48.520
<v Speaker 1>Certain viruses can take up residents in their host's body.

0:01:48.720 --> 0:01:53.320
<v Speaker 1>Once the acute infection cycle is finished. These renegade viruses

0:01:53.440 --> 0:01:56.840
<v Speaker 1>hide out in tissues where they may act like guerilla fighters,

0:01:57.040 --> 0:02:00.480
<v Speaker 1>causing chronic, low to mid level symptoms punctu ated by

0:02:00.520 --> 0:02:05.920
<v Speaker 1>periods of dormancy. For example, the chickenpox virus normally infects

0:02:05.960 --> 0:02:09.280
<v Speaker 1>kids at a relatively young age, causing mild, if incredibly

0:02:09.280 --> 0:02:13.600
<v Speaker 1>annoying symptoms. However, the virus can stay in the infected

0:02:13.600 --> 0:02:17.240
<v Speaker 1>individual's body well into adulthood, re emerging as a nasty

0:02:17.320 --> 0:02:21.079
<v Speaker 1>case of shingles. A research published in the journal Nature

0:02:21.120 --> 0:02:25.480
<v Speaker 1>in September also suggests that the ebolavirus may remain in

0:02:25.520 --> 0:02:28.880
<v Speaker 1>the systems of those who survive their initial infection, leading

0:02:28.880 --> 0:02:32.079
<v Speaker 1>to chronic issues like muscle fatigue and an increased risk

0:02:32.160 --> 0:02:37.560
<v Speaker 1>of miscarriage. Another hypothesis is that in certain cases, COVID

0:02:37.639 --> 0:02:41.640
<v Speaker 1>nineteen can lead to organ or tissue damage. Inflammation is

0:02:41.639 --> 0:02:45.920
<v Speaker 1>one of your body's natural immune responses to viruses like coronavirus,

0:02:46.560 --> 0:02:50.760
<v Speaker 1>but that natural response can go haywire for some patients.

0:02:50.919 --> 0:02:55.440
<v Speaker 1>COVID nineteen infection can trigger a severe, cascading inflammatory response

0:02:55.520 --> 0:02:59.440
<v Speaker 1>in multiple organ systems, including the lungs, brain, and blood vessels,

0:02:59.760 --> 0:03:03.120
<v Speaker 1>lead in to what's known as a cytokine storm. This

0:03:03.160 --> 0:03:05.320
<v Speaker 1>can result in scar tissue build up in the lungs,

0:03:05.560 --> 0:03:11.280
<v Speaker 1>long term heart complications, or even an elevated risk of stroke. Finally,

0:03:11.600 --> 0:03:14.079
<v Speaker 1>it could be the case that long COVID is triggered

0:03:14.120 --> 0:03:18.920
<v Speaker 1>by other opportunistic viruses. In fact, a June study in

0:03:18.960 --> 0:03:22.520
<v Speaker 1>the journal Pathogens found that COVID nineteen patients are more

0:03:22.560 --> 0:03:26.640
<v Speaker 1>susceptible to infection by a reawakened epstein bar virus, the

0:03:26.680 --> 0:03:31.560
<v Speaker 1>same pathogen that causes mononucleosis. For the article of this

0:03:31.560 --> 0:03:33.960
<v Speaker 1>episode is based on how stuff Work. Spoke with Michael

0:03:34.040 --> 0:03:37.920
<v Speaker 1>van Elzacker PhD, a neuroscience researcher at Harvard Medical School.

0:03:38.720 --> 0:03:42.520
<v Speaker 1>He explained, when there's an acute infection, other viruses can

0:03:42.600 --> 0:03:45.120
<v Speaker 1>often take advantage of that and sort of start to

0:03:45.120 --> 0:03:50.240
<v Speaker 1>do their own thing. These hypotheses and others are being

0:03:50.280 --> 0:03:55.200
<v Speaker 1>investigated by various research groups, including Van Elzecker's. However, he

0:03:55.320 --> 0:03:58.640
<v Speaker 1>cautions that long COVID is likely not a one size

0:03:58.640 --> 0:04:02.040
<v Speaker 1>fits all diagnosis. He said, we have to be a

0:04:02.080 --> 0:04:05.360
<v Speaker 1>little bit careful that we don't consider this some unique,

0:04:05.440 --> 0:04:08.720
<v Speaker 1>standalone problem. It's probably not going to be the same

0:04:08.760 --> 0:04:13.840
<v Speaker 1>thing for every single person. Due to the relatively recent

0:04:13.920 --> 0:04:17.039
<v Speaker 1>emergence of the novel coronavirus, it's difficult to say with

0:04:17.080 --> 0:04:20.479
<v Speaker 1>certainty who is at most risk for long COVID, but

0:04:20.800 --> 0:04:24.240
<v Speaker 1>thanks to the efforts of scientists and statisticians across the globe,

0:04:24.480 --> 0:04:28.560
<v Speaker 1>a much clearer picture is beginning to emerge. In a

0:04:28.600 --> 0:04:31.160
<v Speaker 1>study published in September of twenty twenty one in the

0:04:31.240 --> 0:04:35.560
<v Speaker 1>journal Plos Medicine, researchers found that about thirty six percent

0:04:35.640 --> 0:04:39.280
<v Speaker 1>of patients studied were still experiencing COVID like symptoms three

0:04:39.320 --> 0:04:42.479
<v Speaker 1>and six months after they initially tested positive for the virus.

0:04:43.520 --> 0:04:46.839
<v Speaker 1>Most previous studies have estimated lingering COVID nineteen symptoms in

0:04:46.880 --> 0:04:50.080
<v Speaker 1>between ten and thirty percent of patients, including in April

0:04:50.720 --> 0:04:53.600
<v Speaker 1>one UK study of more than twenty thousand patients, which

0:04:53.640 --> 0:04:56.680
<v Speaker 1>found that thirteen point seven percent of participants were still

0:04:56.720 --> 0:05:01.760
<v Speaker 1>experiencing symptoms at least twelve weeks after diagnosis. The new study,

0:05:01.839 --> 0:05:04.640
<v Speaker 1>which was led by scientists at the University of Oxford,

0:05:04.640 --> 0:05:08.359
<v Speaker 1>searched anonymized data for millions of electronic health records to

0:05:08.440 --> 0:05:10.560
<v Speaker 1>identify a study group of more than two hundred and

0:05:10.560 --> 0:05:15.840
<v Speaker 1>seventy three thousand patients with COVID nineteen. Survivor bias might

0:05:15.920 --> 0:05:19.760
<v Speaker 1>also skew the age numbers for long COVID. A separate

0:05:19.760 --> 0:05:23.640
<v Speaker 1>September one study by the UK Office of National Statistics

0:05:24.080 --> 0:05:26.960
<v Speaker 1>found that people between the ages of fifty and sixty

0:05:27.040 --> 0:05:30.680
<v Speaker 1>nine were most likely to report long term symptoms, especially

0:05:30.680 --> 0:05:34.160
<v Speaker 1>if they had other pre existing health conditions, but as

0:05:34.200 --> 0:05:37.039
<v Speaker 1>other research has pointed out, this might be because older

0:05:37.080 --> 0:05:41.520
<v Speaker 1>folks are more likely to die from the disease. So far,

0:05:41.800 --> 0:05:44.800
<v Speaker 1>it seems that vaccination cuts the risk of developing long

0:05:44.880 --> 0:05:49.880
<v Speaker 1>COVID roughly in half. Unfortunately, treatment options for long COVID

0:05:49.960 --> 0:05:53.400
<v Speaker 1>are fairly limited. At the moment. Because the source of

0:05:53.440 --> 0:05:56.160
<v Speaker 1>long COVID is much trickier to pin down than an

0:05:56.200 --> 0:05:59.880
<v Speaker 1>acute COVID nineteen infection, it puts doctors and patients alike

0:06:00.040 --> 0:06:03.840
<v Speaker 1>in a difficult bind, and without a standard treatment protocol

0:06:03.880 --> 0:06:07.320
<v Speaker 1>in place, medical providers often feel helpless to recommend a

0:06:07.320 --> 0:06:12.279
<v Speaker 1>course of action while their patients continue to suffer. The

0:06:12.400 --> 0:06:15.880
<v Speaker 1>other issue is that chronic conditions are often complex and

0:06:16.000 --> 0:06:19.119
<v Speaker 1>resource intensive to treat, and they come with a certain

0:06:19.120 --> 0:06:23.960
<v Speaker 1>amount of stigma. Study published in Pain Medicine found that

0:06:24.040 --> 0:06:27.159
<v Speaker 1>eighty eight percent of patients who had chronic pain reported

0:06:27.200 --> 0:06:30.719
<v Speaker 1>being disbelieved by their primary care provider about their experience.

0:06:32.320 --> 0:06:34.760
<v Speaker 1>But some hospitals, such as U C. L A Health,

0:06:34.960 --> 0:06:38.760
<v Speaker 1>are beginning to offer long COVID treatment plans accustomized for

0:06:38.800 --> 0:06:42.320
<v Speaker 1>each individual patient, and some of these plans include input

0:06:42.360 --> 0:06:47.000
<v Speaker 1>from psychologists and other mental health professionals in addition to neurologists, cardiologists,

0:06:47.000 --> 0:06:51.159
<v Speaker 1>and infectious disease experts. Health care providers hope that these

0:06:51.240 --> 0:06:54.840
<v Speaker 1>more robust mental health resources will help long COVID patients

0:06:55.000 --> 0:06:58.320
<v Speaker 1>not only manage their cognitive symptoms, but also the emotional

0:06:58.320 --> 0:07:07.359
<v Speaker 1>distress and fatigue that accomp niece chronic illness. Today's episode

0:07:07.400 --> 0:07:09.920
<v Speaker 1>is based on the article one in three who had

0:07:09.960 --> 0:07:13.760
<v Speaker 1>COVID nineteen have long COVID symptoms, says Oxford study on

0:07:13.760 --> 0:07:16.960
<v Speaker 1>how stuff works dot Com written by Joanna Thompson. Brain

0:07:17.040 --> 0:07:19.000
<v Speaker 1>Stuff is production of by Heart Radio in partnership with

0:07:19.040 --> 0:07:21.320
<v Speaker 1>how stuff Works dot Com, and it's produced by Tyler Clain.

0:07:21.920 --> 0:07:24.280
<v Speaker 1>Four more podcasts from my heart Radio, visit the i

0:07:24.320 --> 0:07:27.080
<v Speaker 1>heart Radio app, Apple Podcasts, or wherever you listen to

0:07:27.080 --> 0:07:27.920
<v Speaker 1>your favorite shows.