Long COVID: Are you still be feeling the effects of your COVID-19 infection?

Submitted by Stephanie Paulmeno, Greenwich Health Dept, Submitted by Dr. Stephanie Paulmeno, DNP, RN, NHA, CPH, CCM, CDP, Public Health Promotion Specialist

Perhaps you had a COVID-19 infection earlier this year, or possibly back in 2020, 2021, or 2022, but your symptoms continue to linger; you just can’t seem to bounce back.

The confirmed Public Health COVID-19 Emergency was declared over on May 11, 2023, but the SARS-Co-V-2 virus neither knows that nor cares. It just keeps doing what viruses do to survive and thrive; they mutate and change in small ways (drifts) and sometimes in very significant ways (shifts), and they survive and evolve as ongoing mutations of the original virus.

Numerous COVID-19 variants and subvariants were identified and named since COVID-19 emerged. These many mutations continue to circulate and infect people every day, right here in Connecticut and Fairfield County.

How can we know if the symptoms we see and feel are truly long-term lingering COVID-19 symptoms or just newly emerging symptoms resulting from becoming infected with another SARS-CoV-2 variant? As a Greenwich Contact Tracer I’ve had many patients who had multiple episodes of COVID-19 infections. Many were vaccinated, far too many were not; most survived, but way too many were lost. Many recovered, but many of those just can’t seem to return to their prior states of health.

A National Institute of Health (NIH) study of approximately 10,000 post-COVID-19 Americans examined the impact of Long-COVID, a condition they describe as being capable of affecting nearly every organ and tissue in the body (Large study provides scientists with deeper insight into long COVID symptoms | National Institutes of Health (NIH)). They made several important findings; Long-COVID was more severe and more common in people who were infected with the pre-OMICRON variants of SARS-Co-V-2 (like Delta, Alpha, and Iota). Long-COVID was more likely in the unvaccinated, those who had multiple re-infections, those with underlying health conditions, those who had multisystem inflammatory syndrome, and those who had more severe cases.

So, how big is this problem of Long COVID? Dr. Akiko Iwasaki, the Sterling Professor of Immunobiology at Yale University was invited by the American Medical Association (AMA) to speak to this issue last month. She noted that there are over 200 Long-COVID symptoms that involve an estimated 65 million people across the world, including tens of thousands of people here (May, 2023. Long COVID: New research, common symptoms, long-term effects and treatments with Akiko Iwasaki, PhD | AMA Update Video | AMA (ama-assn.org)).

Dr. Iwasaki (see prior link) and the CDC elaborate on the observed and reported symptoms of Long-COVID, as well as new and persistent health conditions that have emerged in people following their COVID-19 illness. These include newly diagnosed diabetes, cardiac, blood vessel and clotting disorders, and neurological conditions. (Long COVID or Post-COVID Conditions | CDC)

The most commonly reported symptoms include persistent fatigue, depression and anxiety, an inability to think clearly, and having rapid and pounding heart palpitations; along with chest pains, and respiratory problems like coughing and shortness of breath with even minor exertion. Others report a persistent loss of taste and smell, sleep problems, lightheadedness or feeling dizzy upon standing, and feelings of “pins and needles” in their extremities. Many experience lingering joint and muscle pains, rashes, gastrointestinal symptoms, and hair loss.

Some have complained of sexual dysfunction and women have reported menstrual cycle changes. Of
confounding interest is that diagnostic and laboratory tests may remain normal.

Dr. Iwasaki pondered whether Long-COVID was one disease, or an overriding term covering multiple illnesses. COVID-19, after all, affects multiple organs in our bodies. Research is still going on to identify why some people become impacted over years while others get infected, recover, and go on without apparent long-term effects.

Knowing that SARS-Co-V-2 continues to circulate here and beyond, and is still resulting in hospitalizations and deaths, albeit to a far lesser degree, what can we do to protect ourselves? The best protection is to avoid contracting the illness, especially if you are in the high-risk groups. If you have not gotten vaccinated, it is not too late to do it now. If you were not boosted, get boosted. If you are indoors in crowds of people, maintain social separation or wear a mask for your sake or theirs. If you are sick, it is best to stay home and away from others. If your children are sick keep them home.

If you have Long-COVID and would like to be evaluated or explore being part of a study to add to our collective knowledge on Long-Haul COVID-19, you can contact:

• The Yale New Haven Health System: https://www.ynhhs.org/patient-care/covid-19/patient-care/long-covid
Stamford Hospital: COVID-19 Recovery Program | Stamford, CT | Stamford Health