April 17, 2024 – Four years in the past in Spring 2020Doctors and sufferers coined the time period “long COVID“to describe a form of viral infection from which a cure seemed impossible.
What started as a pandemic that almost killed people 3 million people In 2020 alone, the global disease would become a chronic disease, causing a long list of symptoms from extreme fatigue to brain fog, tremors, nausea, headaches, heart palpitations and more. Today, many Americans are reporting symptoms of long COVID, and many have never recovered.
But today, four years later, we have come a long way, even if there is still much we don't understand about the disease. Doctors have a much greater understanding that long COVID exists and can cause serious long-term symptoms.
While doctors may not have a blanket diagnostic tool that works for all long-COVID patients, they have refined existing tests to produce more accurate results, said Nisha Viswanathan, MD, director of the UCLA Long-COVID program. A number of new treatments have emerged that are currently in clinical trials and have been shown to be effective in treating long-term COVID symptoms.
For example, tests for a class of compounds known as catecholamines are now widely used to diagnose long-COVID, particularly in patients with dYsautonomy, a condition caused by dysfunction of the autonomic nervous system and characterized by dizziness, low blood pressure, nausea, and brain fog. Examples of catecholamines are dopamine and adrenaline.
For example, a study published in the journal in January 2021 showed that very high levels of the neurotransmitter in patients indicate long COVID Clinical medicine.
Certain biomarkers have also been shown to be associated with the condition, including low levels of serotonin. A groundbreaking study was published this year in cell found lower serotonin levels in long-COVID patients due to low levels of circulating SARS-CoV-2, the virus that causes the disease.
Still, Viswanathan said, long COVID is a disease that is diagnosed by finding out what a patient doesn't have – by ruling out other causes – rather than what they do. “It’s still a moving target,” she mentioned, that means the illness is consistently altering relying on the acute COVID variant.
Promising therapy strategies have emerged
DYsautonomy, and particularly the related mind fog, fatigue and dizziness, are actually widespread diseases. As a outcome, medical doctors have develop into higher at treating them. The vagus nerve is the principle nerve of the parasympathetic nervous system managementIt's about all the things from digestion to psychological well being. A February 2022 pilot The examine instructed a hyperlink between vagus nerve dysfunction and a few lengthy COVID signs.
OThis type of therapy makes use of a tool to stimulate the vagus nerve with electrical impulses. Viswanathan has used the therapy on sufferers with fatigue, mind fog, nervousness and melancholy – and the outcomes have been constructive, she mentioned.
“This is something tangible we can offer patients,” she mentioned.
A treatment for lengthy COVID stays elusive, however medical doctors have many extra instruments to handle signs than earlier than, mentioned Ziyad Al-Aly, MD, a world skilled on lengthy COVID and head of analysis and growth at Veterans Affairs St. Louis Health Care System.
Doctors use beta blockers for therapy, for instance postural tachycardia syndrome (POTS), a symptom of lengthy COVID that happens when the guts charge will increase quickly after somebody stands up or lies down. Beta-blockers sometimes used to decrease blood stress or management irregular heartbeats, such because the off-label drug ivabradine, have been used clinically to regulate coronary heart charge, in keeping with a examine revealed in March 2022 within the journal HeartRhythm Case Reports.
“It's not a cure, but beta blockers can help patients manage their symptoms,” he mentioned Al Aly.
In addition, some sufferers reply effectively to low doses of the addictive drug NAltrexone to deal with excessive fatigue related to lengthy COVID. An article within the journal from January 2024 Clinical therapeuticsdiscovered that fatigue signs improved in sufferers taking the drug.
Al Aly mentioned Doctors treating sufferers with lengthy COVID are getting higher at pinpointing it Phenotype or manifestation of the illness and analysis of acceptable therapy. Treating persistent COVID fatigue is just not the identical as treating POTS or signs of complications and joint ache.
It's nonetheless all about treating the signs, and medical doctors lack FDA-approved drugs particularly for this situation.