The "long COVID" life
If you have had COVID and have certain symptoms that began four weeks or more after the infection or have persisted that long, you likely have “long COVID," officially known as “post-COVID-19 condition." The most common symptoms are fatigue, diminished taste or smell, difficulty breathing, brain fog, or changes in memory.
A new study shows that lifestyle has a big effect on who gets it. Thirty-two thousand nurses were assessed for their diet, weight, smoking status, exercise, alcohol use, and sleep. Those with favorable assessments of all these factors developed long COVID only about half as often as those that had none.
The virus can cause fatty liver and kidney damage that have been linked to long COVID suggesting the condition is the product of more severe disease.
We know the virus is somewhat unique in its ability to directly infect fat cells, so losing weight with a good diet and engaging in regular exercise improves fat metabolism and its resistance to the virus. Sleep disturbances have hormonal effects that contribute to weight gain. Excess alcohol alters cell membrane function decreasing resistance to infection. Smoking paralyzes the hair cells that sweep our upper airways making it easier to get a big viral load into our lower lungs and overwhelm our basic immunity.
The infection can be indolent in organs like the brain, kidney, and gut replicating at a slow rate causing a chronic inflammatory state that may linger or wax and wane for weeks, months, or even years.
Some research suggests that the virus disrupts the immune system long after the initial infection is gone, revving it for an excessive response.
Fortunately, the number of people developing long COVID has decreased. From June 2022 to this January, those that have had COVID that develop long COVID dropped from 19% to 11%. Half of those that have ever had long COVID have now recovered.
Some preventives and treatment options have emerged. Metformin - an inexpensive first-line treatment for Type II diabetes - can reduce the occurrence of long COVID by about 40%. Paxlovid - a combination of two drugs for early treatment of COVID in high-risk people - may reduce it by 25%.
Even though the vaccine is very effective at preventing serious COVID, only 15% of the population is up to date on their vaccines and there is mixed evidence of its efficacy in preventing long COVID. Most hospitalizations and deaths from COVID are still in those without adequate vaccination.
Regardless of the severity or duration of long COVID, working on a healthy lifestyle can only help, and the benefits will accrue toward a longer and more healthy life - even if the symptoms resolve.
William Culbert is a retired physician who lives in Oak Ridge.
This article originally appeared on Oakridger: The Long COVID life
