Though the great pandemic has supposedly concluded, the symptoms of Covid are still being experienced internationally in the form of Long Covid.
Long Covid is an enigmatic illness, as nobody really understands what is behind it. The sickness lacks a concise definition and has no sort of diagnostic test either. As a result, Long Covid is often diagnosed if symptoms persist for 4-6 weeks after testing positive for SARS-Cov-2. Around 40 million Americans have been diagnosed with Long Covid at some point following their first infection of SARS-Cov-2, with as much as 15 million still yet to recover.
Many of those who get infected experience similar symptoms to that of a severe Covid infection, with flu-like symptoms, but also additional brain fog, constant shortness of breath, or the most universally recorded symptom, post-exertional malaise. Post-exertional malaise is the condition of typically nonstrenuous tasks and other everyday activities such as making your bed, reading, going for a walk, or even scrolling on your phone requiring more energy than the body can handle. In the event that too much energy is exerted, an individual will experience a crash or will have symptoms greatly worsen. Often it can take days to recover from such overexertion.
As a result, many people who struggle with Long Covid can be totally debilitated. This illness can lead to the loss of jobs, exercise, social connections, and the ability to complete daily activities.
It is right to wonder, what causes unfortunate individuals to be bedridden with Covid for months to years after their acute infection? Well, the answer is a lot more complicated than you may expect.
“Most people would consider detectable changes such as new chronic disease or organ damage as a post-covid condition. Long Covid, on the other hand, is more of this syndrome of symptoms in the absence of an identifiable problem on a lab test.” says Michael Brode, medical director of the post-COVID-19 Program at UT Health Austin.
The true causation of Long Covid is yet to be identified, but many theories orbit the prospect.
Some theories think this could be something we have seen before, as post-viral illnesses are not a new phenomenon. Patients of Spanish Flu or the original SARS virus would often experience post-illness fatigue and neurological symptoms. There is one other common virus responsible for post-viral illnesses, the Epstein-Barr Virus (EBV). Ten percent of people recovering from EBV develop a syndrome with shockingly similar symptoms to Long Covid─ Myalgic Encephalomyelitis.
Myalgic Encephalomyelitis, or Chronic Fatigue Syndrome (ME/CFS), is a chronic disease caused by the breakdown of mitochondria and inflammation of the immune system. Most, if not all, who fall ill to ME/CFS lose the ability to operate the way they could prior to their infection. All patients are limited in some way, but in the most severe of cases they may be unable to leave their homes, or even their own beds.
With all of this in mind, how could Long Covid relate to ME/CFS? Though Long Covid itself is not a direct cause for emerging ME/CFS conditions, it could be connected to the reactivation of latent herpes viruses present in the body during infection. Herpes viruses, like EBV, are often the initiators of mitochondrial fragmentation, which then progresses to the development of conditions like ME/CFS.
With both illnesses lacking the quantity of research needed to make concise distinctions between the two, the overlapping symptoms and similar processes of the illnesses could be suggesting a relation.
“We think that 1% or 2% of those who’ve had a mild case of Covid-19 could develop CFS. When we see how dynamic the spread of this virus actually is, there is a great concern we will have a significantly increasing number of chronically ill ME/CFS patients in Germany because of Covid-19,” states immunologist and oncologist Dr. Carmen Scheibenbogen, who leads an outpatient clinic in the Charité Hospital in Berlin, Germany.
An imminent issue that has long persisted alongside ME/CFS is the lack of acknowledgement for the disorder. Though recognized in the official ICD-10, also known as the International Classification of Diseases 10th revision, the existence of the disease has been long doubted and consequently overlooked by medical specialists. Research dedicated towards the illness has always been too deficient on funds for what is needed to discover a treatment to this perpetual sickness. For an accurate comparison, in the United States, where 14.5 million dollars is contributed to the 2.5 million CFS/ME patients of America, there is around 3 billion dollars distributed for the 1.2 million HIV patients of America.
However, the emergence of Long Covid has brought a surge of attention to ME/CFS for their extreme similarities. For the first time since the disease’s recognition, there is new hope ignited in the desperate search to recognize a true diagnostic test and treatments for both Long Covid and ME/CFS.
With the uproar of Long Covid and the profound advocacy of groups like #ME Action and #Millions Missing, the future looks brighter than ever for those who have spent decades mercilessly constrained to the limits of ME/CFS. As for the population to develop Long Covid, thankfully has the pandemic opened new eyes of the unaware world to their need.
“There are several studies coming out. Recover Long Covid is happening now. There are new NIH studies of Long Covid coming out too. That tough to get into study from 2016 on ME/CFS is almost publishing. Dr. Whittemore, an ME/CFS intramural study fellow, said that they’re very close to submitting their publication and they’re going to get multiple papers out of it. But medical journals don’t work very fast. People are arguing that they should release their papers before peer review. That’s called a preprint, but that can affect then if the paper gets picked up by a major journal. And if it’s not in a major journal, it’s not as trusted,” quotes Trace Dominguez, a youtuber who focuses on researching various scientific topics. In this video Dominguez concentrates on Long Covid and interviews Dr. Zayid Al-Aly, a researcher at Washington University in Saint Louis, who is one of the top experts on ME/CFS in the US.
