Stanford medical specialists tackle long-term COVID and its public implications

For some people, symptoms of COVID-19 may persist well beyond their initial recovery from illness. Months after contracting the virus, a COVID-19 survivor may still experience symptoms of discomfort and exhaustion that hamper their return to a pre-COVID routine, Stanford researchers said.

While post-viral symptoms are not new, the problem has come into the limelight due to the widespread nature of COVID-19.

“It’s no surprise that COVID caused this post-viral syndrome. Post-viral symptoms have also been known and described for many other infections, ”said Hector Bonilla, clinical associate professor of infectious diseases, adding that herpes and Epstein-Barr are examples of viruses that show symptoms of. long duration.

In May, Stanford Health Care‘s COVID-19 Post-Acute Syndrome (PACS) Clinic opened to specifically treat patients with this new disease described as post-COVID-19, more commonly known as long -COVID.

The co-directors of the PACS Clinic, Bonilla and Linda Geng, clinical assistant professor of medicine, are experts in post-viral syndromes.

For long COVIDs, the severity of the initial illness does not predict or necessarily correlate with the likelihood of developing post-COVID conditions, according to Geng.

“There is a propensity for acute COVID-19 to be very severe for the elderly population with certain risk factors. However, the population most at risk for long-term COVID may include younger patients, ”she said.

According to Geng, the average patient with long COVID is in their 30s or 40s, and there is a higher percentage of women being treated for long COVID at the PACS clinic.

In terms of the long-lasting frequency of COVID, study reports vary.

“The prevalence in the general population is around 1.5%, but for COVID-19 hospital patients, the range can be anywhere from 30 to 50%,” Bonilla said.

For hospitalized COVID-19 patients, the conservative estimate is around 10-20%, but there are studies reporting 70-80%, according to Geng. A Stanford School of Medicine study published in the Journal of the American Medical Association Network Open estimated the prevalence of COVID-19 long for hospitalized COVID-19 patients at more than 70%.

Geng added that the varying results mean that some of the symptoms may not be severe enough to be reported, leading to a long underdiagnosis of COVID.

The symptoms of long COVID are complex. Although the symptoms most frequently reported by patients include fatigue and shortness of breath, Geng noted that many exhibit multisystem symptoms that appear simultaneously in the respiratory, cardiovascular, neurological and cognitive regions. Bonilla also stressed the importance of recognizing the different definitions of long COVID. While some professionals define long COVID as symptoms lasting 30 days, others define it as lasting more than 12 weeks.

With a wide array of protracted symptoms, Geng stressed that patients need to watch themselves after having had a COVID-19 infection, and she urges them not to be afraid to discuss these symptoms with their doctor.

As long-COVID is an active area of ​​ongoing research, much remains unknown. Bonilla stressed the importance of vaccines, as more research is needed to understand the long-term effects of COVID.

“A study done in the UK showed that vaccination decreased symptoms of COVID-19 and the prevalence of COVID-19 long,” Bonilla said. “This study shows the importance of getting vaccinated if you haven’t already, then [getting] following boosters as shown.

In addition to the PACS clinic, Stanford Medicine announcement on Nov. 22 that its researchers embarked on a four-year-long COVID study sponsored by the National Institutes of Health (NIH).

As part of the NIH’s Researching COVID to Enhance Recovery initiative, the Stanford team – which includes Stanford medical professors Upinder Singh, PJ Utz, Catherine Blish, and Yvonne Maldonado – are expected to receive nearly $ 15 million in funding. funding for the study of prevention and treatment. long-COVID. Stanford Medicine will also recruit 900 COVID-19 survivors and COVID-19 patients in the four-year watch study.

Singh, one of the study’s lead researchers, said there is no definitive study yet that attempts to define the epidemiology as well as the pathophysiology of long COVID.

For the researchers, they hope their funding and patient pool will help them answer critical questions about the long COVID.

“How often does this happen? Who is this happening in? Can we predict who will be long-COVID? Can it be treated or prevented? These are the questions this study aims to answer, ”Singh said. She said she hopes to find answers as a team with researchers across the country.

“Stanford Medicine will be part of a big national effort to understand the length of COVID. Our contributions will focus on recruiting people who have had COVID, as well as on appropriate controls and to help answer questions, ”Singh added. “We have a lot to learn.

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