Medical experts are still baffled by “long COVID.” Between 10-30% of COVID-19 patients experience long-term symptoms for four weeks or longer following a COVID infection. Often, these symptoms persist well after the person has tested negative. The cause behind long COVID remains a mystery, however, leaving doctors uncertain of how to treat it and leaving patients wondering if sufferers of long COVID will ever recover.
Two leading theories exist. One proposes that traces of the virus linger in some people’s bodies longer than others, while the other proposes that exposure to the virus sends some aspects of the immune system into overdrive, causing the body to attack itself.
Other possible causes for long COVID include a reduced or outright lack of response from the immune system, inflammation, a relapse or reinfection of the virus, post-traumatic stress, or the body deconditioning due to bed rest or long periods of inactivity.
Exacerbating confusion over the condition, no two cases of long COVID are exactly alike. Symptoms can range from physical ailments, such as fatigue, shortness of breath, chronic pain, brain fog, skin conditions, hair loss, and gastrointestinal problems. There are also potential mental health disorders, including mood swings, anxiety, sleeping issues, and difficulties with memory and concentration. The severity of these symptoms may likewise vary.
In July 2020, the COVID-19 support group Survivor Corps published a survey report of COVID-19 “long-hauler” symptoms. Among 1,500 long COVID patients, there were nearly 100 different symptoms reported.
Some patients experienced maladies due to organ damage to the lungs or heart, while others had no logical explanations for their lasting symptoms. Regardless of how sick many patients feel, their lab tests and scans tend to come back normal.
Experts initially believed long COVID could last for decades or even the remainder of a patient’s life, indicating that long COVID patients may never recover. But some people are now seeing improvement in their conditions.
Dr. Federico Cerrone, a pulmonologist and the co-medical director of Atlantic Health’s COVID Recovery Center in New Jersey, believes that some patients simply improve gradually, while others have seen progress after working with sleep or behavioral health specialists. The clinic has treated around 500 COVID long-haulers since it opened in October 2020.
The findings are promising, but Cerrone said that there is still no known “cure” for long COVID.
“There seem to be some individual success stories, but I don’t know if I could tell you that one thing fits all,” Cerrone told Time. “Sometimes it works, and sometimes it doesn’t work. We’ve learned a lot, but there’s still a lot to learn.”
Some patients experiencing persistent respiratory symptoms may respond to drugs like steroids and bronchodilators, according to Dr. Gerard Criner, director of the Temple Lung Center in Philadelphia. He added that doctors are also better at identifying conditions that may overlap with long COVID, such as the autonomic nervous system disorder POTS (postural orthostatic tachycardia syndrome), which affects blood flow.
Does getting vaccinated help long patients recover?
Early data and anecdotal evidence seem to indicate that, in some cases, COVID long-haulers see improved symptoms after getting vaccinated.
Akiko Iwasaki, a Yale University School of Medicine immunobiologist, told Time that getting vaccinated seems to lessen symptoms for some sufferers, at least temporarily. But vaccination does not universally alleviate symptoms.
Iwasaki is studying how the current COVID-19 vaccines affect long COVID patients. By taking blood and saliva samples from COVID patients before and after vaccination, Iwasaki and her team can monitor changes in their immune responses. The team plans to compare the results with any changes in symptoms to determine if immunization helps along the road to recovery.
Iwasaki believes it may be possible the vaccine-prompted immune response overrides the body’s attacks on itself, or, conversely, that vaccine-produced antibodies can clear lingering remnants of the virus. For now, however, these are just hypotheses.
If Iwasaki and her team are successful, the research could be impactful not only for long COVID patients, but also for people with chronic fatigue syndrome and other post-viral illnesses.
Therapy and home remedies
In addition to sleep or behavioral health specialists, some long COVID patients have used exercise and physical therapy to aid in their recovery. Rebuilding strength and improving organ health can minimize the risk of complications, according to Dr. Hassan Sajjad, an Iowa Mercy Medical Center pulmonologist specializing in post-COVID care.
Getting plenty of rest and taking over-the-counter pain relievers may also be effective for some long COVID sufferers who need relief from chronic pain or fever.
Other patients are experimenting with home remedies such as elimination diets, restorative yoga, or supplements such as magnesium and glutathione. Experts also stress that general health is essential, and they recommend following a healthy diet and achieving quality sleep, limiting caffeine and alcohol intake, and cutting out smoking entirely.
These treatments are subjective. It’s still unclear why specific remedies help some people while having little to no effect on others, but keeping an eye on general health may help some long COVID patients recover.
Long COVID symptoms vary widely, so a single approach won’t be enough. Most people will require individualized rehabilitation plans, which may involve making significant or long-term lifestyle changes. At least until science can discover the root of the problem.