‘Long Covid’ still confuses doctors, but treatment is possible

“People with long Covid often have reports of severe and persistent fatigue, headaches and cerebral fog, which is defined as mild subjective cognitive impairment, approximately four weeks after the acute illness”, Dr. Alfonso Hernandez-Romieu, member of the Centers Disease Control and Prevention Response Team Covid-19 (CDC) said during a CDC briefing on Thursday.

A study recently published in The Lancet found that of 1,733 coronavirus patients treated in the Chinese city of Wuhan, 76% still had at least one symptom six months after the onset of symptoms.

Doctors have reported that the severity of Covid-19 disease may have little impact on whether patients experience prolonged Covid symptoms, said Hernandez-Romieu.

Dr. Allison Navis, an assistant professor at the Icahn School of Medicine at Mount Sinai in New York City, said that one of the most common symptoms of Long Covid is called “brain fog”.

“Brain fog is a symptom. It is not a diagnosis and it means many different things to different people,” said Navis. “It is often a combination of short-term memory problems, concentration or difficulty finding words.”

Navis said the brain fog does not appear to have a clear connection to the severity of Covid-19 infection, age or other risk factors. She said doctors observed these symptoms in younger patients – including children and adolescents – who had mild coronavirus and were previously healthy.

In the absence of a comprehensive diagnosis or treatment plan for people who have been experiencing Covid for a long time, doctors have been looking for specific symptoms for treatment, said Navis.

Treating symptoms

“For brain fog, we don’t have treatments for cognitive changes, unfortunately, so it’s about any abnormalities in the blood test that may be contributing, addressing other contributing factors like sleep and mood,” she said. “If care is an important problem, medications that can help with care may be needed.”

For problems with the sympathetic nervous system, which controls the body’s “fly or fight” response, Navis said meditation and breathing techniques can be useful. For other issues related to the nervous system, she said that increasing hydration can help.

For fatigue, she advises patients to take it easy with exercise. “Don’t do anything that makes you feel worse afterwards.”

She also emphasized that patients should get enough sleep and take care of their mental health.

“We are seeing many different neurological symptoms in these patients,” said Navis. “I think it is important to get a broad history to try to see if there is a bigger diagnosis that can come up, instead of getting a lot of tunnel vision on a specific symptom.”

CDC is working with the National Institutes of Health and the World Health Organization to better define and understand the long Covid.

“Although we don’t know what is causing these symptoms, they are very real for patients, and we are seeing patients improve,” said Navis.

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