Understanding Long COVID
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Photo illustration by Rayne Zaayman-Gallant of the European Molecular Biology Laboratory (Creative Commons CC BY-NC-ND 4.0)
In the last couple of weeks, we’ve been talking about how to avoid getting COVID—or getting reinfected—and about the long-term hazards for people who appear to be ‘over’ a mild case of COVID. But a substantial number of people who get even a mild case of COVID will end up with Long COVID—long term symptoms lasting six months or more. Estimates of how many people are getting Long COVID vary from ‘at least 10%’ at the low end to over 50% according to a recent study. The numbers vary so wildly because this is an emergent situation and because there is not yet a precise definition of Long COVID. And many are suffering at home, their illness going unreported. About 20-30% of children who get COVID are developing Long COVID, whereas older adults are the most likely to get persistent illness. And the fact that omicron has been billed as ‘mild’ does not in any way diminish the likelihood of developing Long COVID after initial recovery.
Data is emerging that points to Long COVID being a multi-organ condition that impairs the heart, pancreas, kidneys, liver, spleen and lungs. A study published in the BMJ concludes that, “In individuals at low risk of COVID-19 mortality with ongoing symptoms, 70% have impairment in one or more organs 4 months after initial COVID-19 symptoms.” In other words, you may be young and healthy, you might feel fed up and ‘done’ with the Pandemic, you might have decided that it’s an elderly person’s problem and you can get a light case and ‘get it over with,’ but this might soon turn out to be the worst mistake you’ve ever made.
So, what’s going on? Why would you feel fatigued and breathless, plagued by aches and pains, palpitations and brain fog months after getting COVID? The little power houses of every cell of your body, your mitochondria, might hold the answer. A groundbreaking study from Mexico suggests that, similarly to people who have Chronic Fatigue Syndrome, in Long COVID there is damage to the membranes of your all-important mitochondria.
In addition, some of you may be familiar with Epstein–Barr virus (EBV), the virus that causes mononucleosis and is implicated in CFS—and more recently has been found to be the cause of Multiple Sclerosis. This virus lingers in your body and can be reactivated by stressors. A number of studies, including one published in the journal Pathogens, indicate that COVID can reactivate EBV. “It is worth considering that a portion of long COVID symptoms may be the result of COVID-19 inflammation-induced EBV reactivation.”
As for the so-called ‘brain fog” experienced by so many Long COVID sufferers—this is better referred to as brain inflammation and is very physical. It’s not laziness or a psychological problem. Studies suggest that Long COVID cognitive issues are caused by disruption of small blood vessels in the brain. The damaged vessels leak protein into the brain, setting up inflammation. And the end result is executive function disorder, with slow processing speed and difficulty holding onto or manipulating information.
When the first patients were lying in ICU in Wuhan with double pneumonia, it seemed as if we might be dealing with something like the 1957 or 1918 Pandemic influenzas. But while we have seen a tremendous amount of severe illness, hospitalization and death, it’s slowly becoming clear that the initial COVID acute infection is only part of the problem. Unlike influenza, SARS-CoV-2 is capable of causing long term morbidity and disability. From a societal standpoint, this means that we are going to be dealing with a huge amount of impaired people who will need support. From an individual standpoint, you face a much greater long-term risk than we initially knew. So, mask up, even if mandates are not in place, and take care. Take care, my friends, even if you are vaccinated. While vaccination has halved your risk of getting Long COVID, it has not removed it.
Next week, we’ll talk about how Ayurveda can help people with Long COVID.
https://bmjopen.bmj.com/content/11/3/e048391
https://jlb.onlinelibrary.wiley.com/doi/epdf/10.1002/JLB.3MA0322-279RRR
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8233978/
https://www.medpagetoday.com/meetingcoverage/aan/98034
Alakananda Ma M.B., B.S. (Lond.) is an Ayurvedic Doctor (NAMA) and graduate of a top London medical school. She is co-founder of Alandi Ayurveda Clinic and Alandi Ayurveda Gurukula in Boulder Colorado, as well as a spiritual mother, teacher, flower essence maker and storyteller. Alakananda is a well known and highly respected practitioner in the Ayurveda community both nationally and internationally.
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