Cosmopolitan (USA)

about the long-term effects of COVID-19

It’s going to be a while before we have all the answers, but this is a start.

- By ROZALYNN S. FRAZIER

In March 2020,

Isabela Pauer, 22, was living in Barcelona when she contracted COVID-19 at a music festival.

The symptoms hit hard. Her throat felt sore on the inside and itchy on the outside. She was nauseated, and her arms and legs ached all day long. Heart palpitatio­ns and migraines struck without warning. Shortness of breath kept her up at night. “For two weeks, I’d get up and stick my head out the window,” she says. “It felt like there wasn’t enough oxygen in the room to breathe.”

One year later, now living with her parents in Ohio, Isabela can breathe again. But she’s still dealing with daily reminders of the virus: Her nausea is constant, clumps of her hair have fallen out, and she can’t shower or even brush her teeth without feeling light-headed. The collection of seemingly random symptoms— something those with similar experience­s are calling “long-haul Covid”— has transforme­d every aspect of Isabela’s life.

And she doesn’t even have a name for what’s happening. Long-haul Covid is not an actual medical diagnosis, despite the fact that, she says, “I’ve had every test imaginable and there’s nothing else going on.” Her doctors think her lingering symptoms may be connected to Covidinduc­ed inflammati­on. And they’ve told her

they see more and more cases like hers every day.

Which isn’t completely surprising, given the numbers. So far, 4.7 million 18- to 29-year-olds in the U.S. have been diagnosed with COVID-19, more than any other age group. And the majority of those people have been women.

Of course, not everyone who gets infected will develop long-term symptoms. Some patients seem to recover fairly quickly, while 35 percent experience coughing, fatigue, and shortness of breath for up to three weeks after testing positive, according to a CDC survey of people with milder cases of the virus.

Why certain people fall into certain recovery categories remains unknown as scientists scramble to better understand COVID-19. Here’s what their research has revealed so far.

About 10 percent of Covid-positive patients feel sick for months on end.

That estimate comes from Marc Sala, MD, a pulmonolog­ist and critical-care doctor at Northweste­rn Medicine in Chicago.

“We’ve seen people who were not even hospitaliz­ed, let alone in the intensive care unit, who developed protracted symptoms for many months,” he says. Those symptoms span a confusingl­y wide range, from daily nausea and dizziness to a perma-cough to chest tightness to mental fog to neverendin­g joint pain. And the virus is considered “prolonged” if they last a month or longer, says Purvi Parikh, MD, an allergist, immunologi­st, and infectious­disease specialist at New York University’s Langone Health. The majority of longterm patients she’s seen have suffered for at least six months, usually longer.

But doctors still can’t diagnose them with long-haul Covid. Because, again— and despite plenty of anecdotal evidence— it’s not an official medical term. This and other phrasing like “post-COVID-19 syndrome” were born on social media, coined by frustrated patients looking for answers versus by those studying the virus, says pulmonolog­ist Nir M. Goldstein, MD, codirector of the Post COVID-19 Clinic at National Jewish Health in New York City. So even though most doctors agree this is very much a thing, they can’t *technicall­y* tell a patient that they have long-haul Covid, leaving lots of people, including Isabela, feeling confused and hopeless. “It’s all just a guessing game right now,” she says.

It might be years before we get more answers.

Researcher­s will need to follow patients with long-term Covid symptoms for years to understand exactly what’s going on, says Daniel B. Fagbuyi, MD, a former Obama administra­tion publicheal­th appointee. “Data from over a year to five years is really what will give us clarity,” he adds. For now, just know that COVID-19 can impact the body in the short and long terms—and that it’s definitely not only a respirator­y thing.

And the most intense side effects could strike later.

Okay, feel free to take a moment because this has already been a lot to digest (on top of, well, the entire past year) and because there’s a little more you should know: Some patients who feel mostly normal after recovering from COVID-19 could potentiall­y see serious health issues down the line, according to the Mayo Clinic. This may stem from any longterm damage COVID19 might do to organs like the lungs, heart, and brain. (It’s important to note that while this may happen to some people, there is absolutely no guarantee atm that it will.)

So, yes, all of this uncertaint­y can feel scary and dishearten­ing. But there is some hope, says Dr. Sala. In his experience, many patients with long-term symptoms gradually improve. Experts are currently looking into treatments like antiinflam­matory drugs to help with prolonged cases. And if the speed with which COVID-19 vaccines were developed is any indication, more help will be on the way soon.

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