The Week (US)

Covid-19: When the illness doesn’t go away

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For an “overlooked” group of patients, Covid19 doesn’t end after a few weeks of illness, said

Ed Yong in TheAtlanti­c.com. Months into the pandemic, reports are emerging of thousands of patients who “have been wrestling with serious Covid-19 symptoms” for months. These people— most of them under 50 and previously fit and healthy—have had their lives upended “by relentless and rolling waves of symptoms that make it hard to concentrat­e, exercise, or perform simple physical tasks.” Their fluctuatin­g symptoms subside for brief spells and then come crashing back, and include breathless­ness, racing heartbeat, and neurologic­al problems such as “brain fog” and short-term memory loss. Among the so-called long-haulers is Vonny LeClerc, a formerly fit 32-year-old who, 66 days after falling ill, can’t “stand up in the shower without feeling fatigued.” The virus, she said, “has ruined my life.” Unsure what’s happening to them, “long-haulers are navigating a landscape of uncertaint­y and fear.”

Why these patients aren’t improving is “one of the ongoing mysteries of Covid-19,” said Fiona Lowenstein in Vox.com. One theory is that “the virus might be reactivati­ng,” a syndrome seen in illnesses such as herpes, which “remains dormant between outbreaks.” It may just “be the normal course of Covid-19,” consistent with milder viral illnesses that can return or worsen after seeming recovery. More worrisome, it may be a chronic postviral condition that lasts even after the virus is no longer detectable. While some doctors are confident these patients will recover, others have doubts—as does Susan Nagle of Massachuse­tts, who’s on her third month of symptoms. “My fear is that ‘relapses’ are my new normal,” she said.

Long-term illnesses sparked by viral infections

“are devastatin­gly common,” said Brian Vastag and Beth Mazur in The Washington Post. The biggest is myalgic encephalom­yelitis/chronic fatigue syndrome (ME/CFS), a disease that’s often triggered by infection and may affect up to 2.5 million Americans. Its symptoms—fatigue, muscle pain, cognitive problems—mirror those of Covid long-haulers. Even patients who largely recover from Covid may carry “persisting symptoms,” including breathless­ness and loss of smell, said Georgina Hayes in The Daily Telegraph (U.K.). The virus’ long-term impact “is being underestim­ated,” says epidemiolo­gist Tim Spector, of King’s College. Covid-19, he said, is one of “the strangest diseases I’ve ever come across.”

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