Covid-19 News and Discussions


Study finds that COVID infection increases risk of new-onset dementia among elderly people​

Benjamin Mateus
12 February 2024​

The release of a study in pre-print form, pending peer review and publication in The Lancet, by investigators from the US and UK, found that COVID-19 infections among the elderly, those 60-years-of-age and older, caused a 60 percent increased risk of developing new-onset dementia (NOD) within a year of infection compared to controls without any other respiratory infections.
The systematic review and meta-analysis were conducted by scientists at Columbia’s Biobehavioral Sciences Department, the University of Oxford’s Department of Psychiatry, and Lancaster University’s Centre for Ageing Research, looking at the temporal association between COVID-19 and subsequent development of NOD.
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A doctor looks at PET brain scans in Phoenix. [AP Photo/Matt York]
Their review incorporated 11 studies from North America, Europe and Asia, involving close to 940,000 positive COVID-19 cases and more than 6.7 million controls for comparison. Overall, when compared to an elderly population that never contracted COVID-19 or other respiratory infections, those with prior COVID-19 infections had a nearly two-fold increased risk of NOD at one year after infection.
The authors also compared COVID-19 patients to those without a prior COVID-19 infection but who had documented exposure to other respiratory pathogens like influenza or RSV. Significantly, in this comparison there was no difference between the groups regarding developing NOD, underscoring the danger posed by most pathogens considered “endemic” and a permanent feature of society. The implication of this finding is that among the elderly, infection with these respiratory pathogens, including SARS-CoV-2, substantially increases one’s risk of developing NOD.
Most disconcerting was the finding that those with severe COVID-19 were much more prone to developing neurocognitive disturbances, with a 17-fold rise in the risk of acquiring NOD compared to non-severe infections. Severe COVID-19 was defined as anyone with COVID-19 who had a respiratory rate greater than 30 breaths per minute, severe respiratory distress, or oxygen saturation that dropped below 90 percent while on room air.
As the authors note in their discussion, “We believe it is among the first studies to explore the impact of COVID-19 infection on NOD risk in older adults aged 60 and above. It also proposes the protective benefits of being free from COVID-19 and other types of respiratory infections in reducing the risk of NOD.”
The study underscores the totally criminal character of the policies pursued by the capitalist ruling elites and the political establishment, who have largely dismantled public health infrastructure, insisting that COVID-19 be accepted as part of the “normal” array of pathogens that infect, sicken, and kill people each year.

The link between COVID-19 infections and Long COVID, also known as post-acute sequelae of COVID-19, has been well established and accepted by all health authorities and sectors of society. Beyond the substantial morbidity and mortality burden, the economic impacts of what they define as “endemic COVID” i.e., perpetual mass reinfection with COVID-19, are forecast to remain colossal for the foreseeable future.
A recent report by McKinsey’s COVID-19 Epidemiological Scenario Planning Tool, advising economist and financial shareholders, anticipates that the annual costs of “endemic COVID” could range between $137 to $379 billion with estimates of 110 to 220 million COVID infections and 20 million Long COVID cases annually. The long-term health impacts caused by repeated COVID-19 infections, of which the neurocognitive damage is but one, will simply become accepted as the normal state of sickness which are preventable.
From the beginning of the pandemic, it has been understood that COVID-19 infections can cause more than pulmonary complications. The virus’ impact on the immune system and pro-inflammatory drive, in particular small vessel disease and the formation of small blood clots, can wreak havoc on every organ system in the body.
The triggering of autoimmune responses can lead to inflammation in the central nervous system which causes debilitation with symptoms of brain fog, loss of memory, and even psychosis with delusional thoughts and agitation. Other theories speculate that vascular inflammation due to the formation of microscopic blood clots that deprive blood and needed oxygen to parts of the brain can contribute to these symptoms. Previous evidence has demonstrated an association between COVID-19 and the precipitation of Alzheimer’s disease and other forms of dementia.
The finding that other respiratory pathogens can cause NOD similar to COVID is in congruence with findings from other researchers who found older adults admitted for flu, whether they had pneumonia or not, had a two- to seven-fold greater risk of developing Alzheimer’s disease, all-cause dementia, and vascular dementia. Whether these respiratory infections use similar biological mechanism remains unknown, but studies have shown that vaccinations against these pathogens appeared to reduce the risk of developing neurodegenerative diseases like Parkinson’s and Alzheimer’s.
Another pressing question that remains to be answered is the impact of repeat COVID-19 infections on younger people in the long-term over the period of their lifetime. Many scientists who have studied the impact of these infections have found that COVID-19 appears to age the organ systems. Will this lead to an epidemic of neurocognitive disease and every other chronic ailment in even younger people? These same principled scientists have warned against following this dangerous track and to attempt to prevent as many COVID infections as possible.
The ongoing global wave of COVID-19 infections caused by the highly infectious JN.1 subvariant of Omicron may well infect over a third of the world’s population, virtually all of which are reinfections. Yet not one public entity in any major country has raised a breath to sound the alarm.
Instead of protecting the remaining years of older people, whose lives and experiences should be highly valued by society, the capitalist elites are allowing a virus that can cause them severe cognitive impairment to circulate unimpeded. This is in fact a eugenicist policy that condemns those who are “unproductive” to die off sooner than later, or in the words of Anthony Fauci, to “fall by the wayside.”

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In the last five weeks in the US, more than 10,000 Americans perished from COVID-19, of which the significant majority were among those 75 years of age and older. With close to 1.2 million official COVID deaths since the start of the pandemic, three-quarter of these have been among older Americans.
A recent CNN report on the state of the pandemic response accurately stated, “The decisive actions that advocates had hoped for haven’t materialized. Today, most people—and government officials—appear to accept COVID as part of ordinary life. Many seniors at high risk aren’t getting antiviral therapies for COVID, and most older adults in nursing homes aren’t getting updated vaccines.”
They added, “Efforts to strengthen care quality in nursing homes and assisted living centers have stalled amid debate over costs and availability staff. And only a small percentage of people are masking or taking other precautions in public despite a new wave of COVID, flu, and respiratory syncytial virus infections hospitalizing and killing seniors.”
In 2017, neurodegenerative diseases impacted upwards of six million people and were responsible for more than 272,000 deaths and three million disability-adjusted life years. These disabling conditions do not only affect the patients but also families and their caregivers.
As Ken Thorpe, Chairman of the Partnership to Fight Chronic Disease, said back in 2021, at the height of the pandemic, “The vulnerability of people living with these conditions, the increasing demands of their illness and the prevalence projections we are seeing all point to a dire need for reforms to support those diagnosed and their caregivers and to encourage and prioritize research and innovation that leads to new treatments and cures.”
However, the call for reforms, especially regarding the pandemic, has simply fallen on deaf ears. The White House summit on improving indoor air in October 2022, and more recently the congressional hearing led by Senator Bernie Sanders in January 2024 on Long COVID, are political theater signifying nothing.
The only solution to these dilemmas is the global elimination of COVID-19 and numerous other pathogens. This requires the immediate redirection of the trillions squandered on the military and financial elite to the health system and public health infrastructure to address this pressing question, which requires the building of a revolutionary socialist movement to confront the financial aristocracy and the state apparatus.
 

Normalizing mass infection and death, CDC to scrap COVID-19 isolation guidelines​

Evan Blake@evanblake17
a day ago​

On Tuesday, the Washington Post reported that the US Centers for Disease Control and Prevention (CDC) intends to scrap its COVID-19 isolation guidelines, which currently recommend that infected patients isolate for five days to avoid transmitting the virus to others.
This unscientific policy change is part of the total abandonment of public health at the center of world capitalism. In effect, the CDC is providing explicit sanction for the Biden administration’s policy of letting COVID-19 spread entirely unimpeded, infecting, debilitating and killing masses of Americans for the foreseeable future.
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Patient Mike Camilleri works with physical therapist Beth Hughes in St. Louis, Missouri, on March 1, 2023. After contracting COVID-19 Camilleri was left with dangerous blood pressure spikes, a heartbeat that raced with slight exertion, and episodes of intense chest pain. [AP Photo/Angie Wang]
Ignoring the fact that a large percentage of COVID-19 transmission is through asymptomatic patients—which has been known since the very beginning of the pandemic—the new guidelines will only recommend that patients isolate if they are symptomatic. Diagnosing themselves, patients can leave isolation once they are “fever-free for at least 24 hours without the aid of medication and their symptoms are mild and improving,” the Post reports, based on discussions with three anonymous CDC officials.
These same officials state that the CDC began planning to change the isolation guidelines last August, but “paused in the fall as covid cases rose.” In January, CDC Director Mandy Cohen sent staff a memo noting that the new policy would be released in April.
Evidently, the CDC had hoped to remove its toothless public health guidance shortly after the Biden administration and World Health Organization (WHO) ended their respective COVID-19 public health emergency (PHE) declarations last May. They were prevented from doing so due to the steady rise in COVID-19 wastewater levels beginning last July, as well as the global spread of the highly mutated Omicron BA.2.86 subvariant, nicknamed “Pirola,” first identified last August.
Since then, Pirola evolved into the JN.1 variant, which quickly became dominant globally and has caused a massive ongoing wave of infections, hospitalizations and deaths throughout the world. Wastewater estimates in the US indicate that upwards of 150 million Americans will have been infected by the end of this wave in the coming weeks, while global estimates of excess deaths indicate that over 700,000 people have died during the ongoing JN.1 wave.

Even according to official figures, which are known to be significant under-counts, roughly 2,300 Americans are officially dying from COVID-19 each week, while over 1,000 have died weekly for the past 22 weeks straight.
Despite being either the largest or second-largest wave of infections in most countries where wastewater levels of COVID-19 are tracked, the JN.1 wave has gone almost entirely unreported by the corporate media internationally. Throughout this time period, the CDC, WHO and every other public health agency globally did nothing to stop the spread of COVID-19 or protect the world’s population. But clearly the CDC understood that scrapping its isolation guidelines under these conditions would be bad PR and decided to wait until the wave began to recede.
In justifying the policy change, the Post repeats the Biden administration’s propaganda that COVID-19 is now essentially harmless, writing, “The new reality — with most people having developed a level of immunity to the virus because of prior infection or vaccination — warrants a shift to a more practical approach, experts and health officials say.”
But this supposed “new reality” of stable immunity is belied by the fact that the entire planet just experienced the fourth winter of mass reinfection, debilitation and death of the pandemic, precisely because SARS-CoV-2, the virus that causes COVID-19, has evolved to circumvent immunity from vaccination or prior infection. Indeed, the CDC’s new policy will only further facilitate viral evolution, which threatens to produce a catastrophic variant that is more lethal, infectious and immune-resistant.
Following a pattern throughout the pandemic, the change in federal policy was preceded by similar changes in two Democratic-led states, California and Oregon, during the past year.
This policy change is the latest in a continuous stream of attacks on science and public health by the CDC, which has wholly discredited itself over the course of the pandemic after once being the world’s preeminent public health agency. From the first year under Robert Redfield and the Trump administration, to the disastrous tenures of Rochelle Walensky and Mandy Cohen under Biden, the CDC has steadily wound back the clock on centuries of public health knowledge and understanding.
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Dr. Robert R. Redfield at a coronavirus briefing Wednesday, April 22, 2020. (Official White House Photo by D. Myles Cullen)

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From botching the initial rollout of mass testing and contact tracing, to actively discouraging testing, to encouraging the premature reopening of schools, to covering up the science of airborne transmission, to denigrating masking, to reducing isolation and quarantine guidelines in response to the Omicron variant, to embracing eugenicist conceptions, to repeatedly covering up the evolution and spread of new variants, the CDC has proven itself to be a pliant tool of Wall Street and the corporations, which are unwilling to accept the most minimal public health measures seen as impingements on profit-making.
The underlying aim of the CDC’s latest policy change is to normalize COVID-19 and treat it as equivalent to the flu and other respiratory pathogens, which are deemed “endemic” and therefore permanent features of modern social life. A massive state and media conspiracy has been developed to try to condition the population into accepting this narrative, while covering up the science of elimination, which proves that through a comprehensive global public health program, COVID-19, influenza, RSV and numerous other pathogens could be eliminated globally, saving millions of lives each year.
Significantly, just one week before the Post article was published, a pre-print study was released which found that infection with COVID-19, as well as other respiratory pathogens like influenza and RSV, substantially increases one’s risk of developing new-onset dementia (NOD), with COVID-19 increasing this risk by 60 percent within a year of infection. Those with severe COVID-19 infections demonstrated a 17-fold rise in the risk of acquiring NOD compared to non-severe infections.
The study does not delve into this, but raises the concern that multiple annual reinfections of the entire population with COVID-19 will very likely cause substantial population-level increases in rates of dementia, Parkinson’s, Alzheimer’s and other neurological disorders in the years and decades ahead.
This is just one facet of the systemic health risks posed by COVID-19 and Long COVID, which can damage virtually every organ in the body and cause long-term debilitation, with each reinfection only heightening these dangers. Experts estimate that hundreds of millions of people are now suffering from Long COVID globally, while McKinsey’s COVID-19 Epidemiological Scenario Planning Tool estimates that the annual costs of “endemic COVID” could range between $137 and $379 billion in the US alone.
The pro-capitalist logic of the CDC’s policy is that society must accept unending waves of infection with COVID-19 and all other respiratory pathogens, about which nothing much can be done. Owners of public and private buildings should not be required to install HEPA filters or Far-UVC lamps, which have been proven to reduce airborne transmission. Workers must return to work and children to school while sick, to ensure that capitalist production proceeds unmolested.
The global abandonment of public health by every capitalist government over the course of the ongoing COVID-19 pandemic is a devastating indictment of this bankrupt social order, which subordinates all social needs to the private profit interests of a tiny corporate-financial oligarchy. It must be overthrown and replaced with a planned world socialist economy, the only means through which humanity can shape its future and ensure that future generations are guaranteed the rights to health, high-quality housing and social equality.
 

The Unseen Battle: Understanding Long COVID in Vaccinated Individuals

COVID-19

The Unseen Battle: Understanding Long COVID in Vaccinated Individuals​


By
Dr. Jessica Nelson
3 min read
Published Feb 14, 2024 at 6:43 am EST | Updated Feb 14, 2024 at 6:43 am EST

The Silent Sufferers of Long COVID​

Even as COVID-19 vaccinations continue to roll out worldwide, there’s a growing concern about a condition known as long COVID. The experience of individuals, including those who have been vaccinated, developing long COVID is a stark reminder that the pandemic is far from over. A case in point is Maria Maio, a 55-year-old celebrity makeup artist who developed long COVID after missing her latest booster shot. Despite being vaccinated, she fell victim to the painful and debilitating effects of long COVID, highlighting the fact that the fight against the pandemic is still very much ongoing.

Understanding Long COVID​

Long COVID refers to a range of symptoms that linger or develop after the acute phase of a COVID-19 infection. A study published in BMC Infectious Diseases revealed an increased risk of specific post-acute sequelae in individuals, particularly those requiring hospitalization, after a SARS-CoV-2 infection. These findings were based on a significant sample size, including over 3 million adults and 675 thousand children, indicating a direct link between acute SARS-CoV-2 infection and the likelihood of experiencing long COVID symptoms.

The Varied Symptoms of Long COVID​

The symptoms of long COVID vary widely among patients. These can range from fatigue and breathing problems to more severe conditions like type 1 diabetes in children. Pregnant women are also at risk, with studies showing that 9.3% reported symptoms six months or more after being infected. Factors such as obesity, chronic anxiety, or depression, and the need for supplemental oxygen during the illness, increase the risk of developing long COVID.

The Impact of Vaccination​

Vaccination has been shown to play a crucial role in reducing the risk and severity of post COVID-19 syndrome. A systematic review and meta-analysis, including 13 articles analyzing over 10 million patients, showed that vaccination before infection significantly reduced the risk of long COVID. Vaccinated individuals showed a lower prevalence of symptoms, faster recovery, and a quicker return to work. This study, however, also emphasized the need for more research with standardized methods to fully understand vaccine efficacy against long COVID.

Vaccination Apathy and its Consequences​

Despite the clear benefits of vaccination, vaccination apathy poses a significant challenge. As highlighted in the case of Maria Maio, skipping booster shots can lead to severe long COVID symptoms. Even fully vaccinated individuals, like a 74-year-old biochemist and professor of medicine, can develop long COVID, illustrating the need for continued vigilance and adherence to recommended COVID-19 vaccination schedules.

Treating Long COVID​

Treatment for long COVID remains a challenge, with various methods, including exercise and physical therapy, being explored. The antiviral medication Paxlovid has shown effectiveness for those with mild or moderate symptoms. As research continues, it’s crucial for people to prioritize vaccination and follow preventive measures to avoid the pain and suffering associated with long COVID.

A Plea for Vigilance​

While the world looks forward to a post-pandemic era, the threat of COVID-19 and long COVID remains. As Maria Maio’s experience illustrates, the fight against COVID-19 is not just about surviving the infection but also about preventing and managing the long-term effects. As we navigate the ongoing pandemic, it’s crucial to prioritize vaccination, adhere to health guidelines, and remain vigilant to the threat of long COVID.
 

How Protected Am I Against the Covid Variant JN.1?​

JN.1 accounts for nearly all U.S. Covid cases. Here’s what to know about the risk of a new infection.


A woman holds a Covid-19 rapid test next to a window.

Credit...Getty Images


Dani Blum
By Dani Blum
Feb. 14, 2024
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Over the last few years, the general assumption has been that a Covid infection — or vaccination — is likely to buy you a few months of protection. But any time we get a new variant that is especially adept at evading the immune system, like JN.1, that assumption gets thrown into question.
JN.1 currently accounts for about 93 percent of cases nationwide, according to data from the Centers for Disease Control and Prevention. It’s unusual for a single variant to make up almost all cases, but JN.1’s dominance gives us a unique window into the risk of reinfection for many people.
If you had Covid when cases rose over the summer, or if you received the updated vaccine in the fall, here’s what to know.

If I had Covid during the summer, how much protection do I have now?​

You may be vulnerable to reinfection if you were infected over the summer, when earlier variants drove an uptick in cases.

That doesn’t mean you’ll definitely get sick. “You should have some protection, for sure,” said Aubree Gordon, an infectious disease epidemiologist at the University of Michigan. Immunity is an individual cocktail that stems from how many times you’ve been previously infected, your vaccination history, underlying medical conditions and more. People who are 65 and older, immunocompromised or who have underlying medical conditions are generally at greater risk of reinfection, said Fikadu Tafesse, a virologist at Oregon Health & Science University.

More on Covid-19​

If a person is exposed to the same variant or a very similar one in the months that follow a bout of Covid, their body is often equipped to recognize and combat it before it can cause an infection. Scientists disagree on exactly how long that protection lasts, but estimates range from around two to six months.

But JN.1 has “many more mutations than we’re used to seeing,” said Dr. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center in Chicago. That’s why people who were recently infected with another variant, even one that was previously dominant, may get infected again.

What if I got the booster in the fall?​

A C.D.C. report published this month showed that people who received the updated vaccines that came out in the fall had 54 percent more protection against a symptomatic case of Covid than people who did not get the shot. The vaccines were formulated to target XBB.1.5, an earlier variant, but they still offer some protection against JN.1, said Ruth Link-Gelles, the lead author on the study. “They’re all very closely related,” she said.
But even though a vaccinated person is less likely to develop symptomatic infections, that person is still not completely protected from the virus.

That said, there is still “quite a lot of benefit” from the updated vaccine, he said. Notably, vaccines reduce the risk of severe disease and hospitalization, he said. Experts urged people who are 65 or older or who are immunocompromised, in particular, to get the shot. As of late January, only about 12 percent of eligible children and 22 percent of adults had received an updated vaccine, according to the C.D.C.
For many people, the more immunity you’ve built up — through infection, vaccination or both — the milder your symptoms will probably be, Dr. Gordon said. Some people may become infected with JN.1 and experience such mild symptoms that they don’t even realize they are ill, she said. People with compromised immune systems or underlying medical conditions, though, may still have strong symptoms.
And those who do get infected with JN.1 will likely find themselves well protected for as long as it remains the dominant variant. Right now, it isn’t showing any signs of slowing down.
 

Study: COVID-19 Associated With Quadrupled Risk of Chronic Fatigue​

Post-COVID fatigue was more common among women than men.

By Cecelia Smith-Schoenwalder
|
Feb. 14, 2024, at 3:06 p.m.
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COVID Tied to Higher Fatigue Risk
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FILE - A pedestrian wears a heavy coat against the cold in New York, Tuesday, Jan. 11, 2022. January can be the worst month for respiratory illnesses and vaccination rates are low. When relatives, friends and co-workers are coming down with coughs, nasal congestion, fatigue and fever, keeping viruses at bay means thorough hand-washing, good ventilation and wearing a mask in crowded areas. (AP Photo/Seth Wenig, File)

SETH WENIG|AP-FILE
A pedestrian wears a heavy coat against the cold, Jan. 11, 2022, in New York.
COVID-19 is associated with quadruple the risk of developing chronic fatigue, according to researchers at the Centers for Disease Control and Prevention and University of Washington.


Can Vaccinated People Suffer Long Term Symptoms if They Get COVID?


For a new analysis published Wednesday by the CDC in the journal Emerging Infectious Diseases, researchers examined the electronic health records of more than 4,500 people who had COVID-19 during 2020-2021 and more than 9,000 people who did not have the disease. They found that 9.5% of COVID-19 patients developed fatigue, which is one of the most common symptoms of long COVID, and that patients who’d been infected were 1.68 times more likely to develop fatigue than those who were not.
Researchers found the risk of chronic fatigue after COVID-19 was even greater, with patients who’d had the disease seeing a risk four times higher for the longer-term condition than those who had not.

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“The high incidence rates of fatigue reinforce the need for public health actions to prevent infections, to provide clinical care to those in need, and to find effective treatments for post-acute COVID-19 fatigue,” the researchers wrote.
The researchers found that post-COVID fatigue, encompassing chronic fatigue, was more common among women than men, and was more common among older than younger people in an unadjusted model. It was also more prevalent among those with other medical conditions.

READ:
COVID-19 Hospitalizations Decline

They noted that chronic fatigue diagnoses continued in the 18 months after COVID-19 detection, suggesting a “persistent effect” but also potentially indicating “a delay in diagnosing fatigue as a separate symptom or diagnosis.”

For the study, researchers said they considered chronic fatigue to be “a subset of fatigue,” and noted it was not necessarily the same as myalgic encephalomyelitis/chronic fatigue syndrome, or ME/CFS, which needs additional symptoms for diagnosis. They said their study criteria did, however, include diagnostic codes used for chronic fatigue syndrome.
Related:
What to Know About the U.S. Winter COVID-19 Wave

ME/CFS is an unexplained syndrome that sometimes occurs after infections and comes with severe fatigue. The condition can worsen after activity, and the CDC recently estimated some 3.3 million adults had it in 2021-2022. ME/CFS has garnered increased attention in recent years as its symptoms can overlap with those of long COVID, spurring hopes for more research and insights into the illness.
According to federal survey data, more than 14% of U.S. adults had ever experienced long COVID as of October, and more than 4% faced some level of activity limitation due to the condition. The survey defined long COVID as having symptoms lasting three months or longer that didn’t exist prior to having COVID-19.
 

Scientists grapple with long Covid puzzle as millions fall sick
Sarah Neville in London 17 HOURS

Two months after contracting Covid-19 in August 2021, Heather Marti, a university programme administrator from West Virginia, began to experience a terrifying array of symptoms that have changed her life.The 52-year-old describes agonising muscle pain, gastrointestinal problems, weeks-long migraine-like headaches, brain fog and “extreme mental fatigue similar to what has been described after a traumatic brain injury” among a litany of other problems. Grasping for an image to explain the devastation, she said: “All of the wires in my body are crossed — if you turn the water faucet on, the door would open. There isn’t a system in my body that has not been impacted.”Marti is far from alone in her search for answers. Four years after the emergence of the Covid-19 pandemic, the quest to uncover the causes of long Covid, and develop treatments for the condition, continues.One Must-ReadThis article was featured in the One Must-Read newsletter, where we recommend one remarkable story each weekday. Sign up for the newsletter hereThe World Health Organization this month estimated that around 6 per cent of those who contract the disease end up with long Covid, defined as the continuation or development of symptoms three months after initial infection with Sars-Cov-2, with these symptoms lasting for at least two months. The global health body estimated that at least 17mn people joined the ranks of the “long-haulers” in Europe alone in the first two years of the pandemic.“We are not expecting a simple cure, a silver bullet, because we know from other complex illnesses that that’s rarely achieved,” said Melissa Heightman, who opened one of the first specialist long Covid clinics at University College London Hospitals in the UK, pointing to the multiple factors behind the condition.For experts striving to unravel its causes, one of the biggest shocks has been that many who have suffered from long Covid were never badly sick with the virus in the first place.Walter Koroshetz co-chairs a nationwide research programme at the US National Institutes of Health, designed to uncover the “biologic mechanisms” behind long Covid and potentially develop a cure.He said hospitals had set up clinics to support those who had ended up in intensive care, believing only the severest Covid cases would need continued attention. But “people started to come who . . . were never in the intensive care unit” — the first sign of the risk of prolonged after-effects even in cases of mild or moderate infections. Although the high number of sufferers may have been unexpected, the notion of a puzzling constellation of symptoms coming hard on the heels of a viral infection was all too familiar to infectious diseases experts.Koroshetz said the NIH’s Recover Initiative, in which Marti is one of almost 30,000 participants, also hoped to provide answers to those living with myalgic encephalomyelitis, another post-viral condition commonly known as chronic fatigue syndrome.Researchers believe long Covid sufferers, at least those who experienced severe infections, may never have managed to fully rid their bodies of the virus, allowing it to continue to replicate, or pieces to be retained, even after they had tested negative. This may lead to “persistent activation of the immune system and cause all these chronic symptoms”, Koroshetz said.An NIH study, based on autopsies, found evidence that some who had lost their lives up to 280 days after becoming infected with severe disease had died with active traces of the Covid virus.A longer course of antiviral drugs could help to wipe out any remaining pockets of the virus. Some patients in the Recover trial are now receiving Paxlovid for up to 28 days — far beyond the customary five-day course prescribed for higher-risk patients when they contract Covid-19.A second approach is based on the theory that long Covid is primarily an autoimmune disorder. This suggests sufferers’ immune systems “rev up” to the point where they move from protect to attack mode, weakening healthy cells. Recover investigators will be testing an autoimmune treatment called intravenous gamma globulin (IVIG), which Koroshetz said “resets the immune system and is kind of an immune suppressant”. Janet Diaz, a critical-care leader for the WHO, noted that alongside these approaches, metabolic drugs like Metformin, used in diabetes, and dietary supplements were being tested in long Covid sufferers to see if they alleviated symptoms.Research published last month in the journal Science, and led by Professor Onur Boyman of Zurich university, reported that changes in blood protein had been found in people suffering from long Covid, offering another avenue for research.Heightman and her UCLH colleagues have focused on helping patients to cope with symptoms such as disordered breathing, and techniques to manage fatigue and the psychological impact of the condition.A long Covid sufferer in Germany undergoes breathing training at the Teutoburger Wald rehab clinic in Lower Saxony © Alamy Stock PhotoThe extreme tiredness that characterises long Covid seems to be one of the most important indicators of how quickly a patient will recover, experts have found. “When they have severe fatigue, recovery can be extremely slow,” Heightman said.While classic long Covid is associated with a particular constellation of symptoms, the mysteries of which scientists are still trying to fathom, some researchers are focused on an apparent link between infection and a rise in all too familiar conditions such as heart disease, stroke and diabetes.Ziyad Al-Aly, R&D chief at Veterans Affairs St Louis Health Care System and clinical epidemiologist at Washington University in St Louis, discovered that patients in the VA’s extensive database who had recovered from Covid were significantly more likely than those who had not contracted the disease to suffer heart attacks and strokes, or to develop diabetes.A similar picture was evident in data from countries including Germany and the UK. “The global evidence woven together suggests that Sars-Cov-2 infection leads to an increased risk of chronic disease,” he added. However, Al-Aly and colleagues are examining whether people infected with Omicron, the dominant variant since the end of 2021, are less likely to face a heightened health risk than those contracting earlier versions of the virus — whether because of mutations, the protection offered by widespread vaccination, or an unknown factor. They plan to publish their conclusions later this year.Heightman said the original “wild type” of the virus “seems to be the worst”, while vaccination not only seemed to reduce the chances of developing long Covid in those with breakthrough infections but “we have increasing signals that it can reduce the severity of [the condition] as well”.While researchers hope this points to an eventual easing of the long Covid burden, Al-Aly fears that Covid’s enduring impact on health is such that the incidence of some diseases such as strokes has now permanently risen.There are few signs that governments have fully grasped the costly implications for healthcare systems, he warns.“We have almost accepted as a fact of life that it is going to be like that,” he said, adding that there is “not a lot of concern as to the level of spending [required] on healthcare resources. People are at a stage where they want to really move on.”
 

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