Explanations for ‘long Covid’ remain elusive. Research in early stages

Explanations for ‘long Covid’ remain elusive. Believing patients helps “The vaccines and therapeutics, they were easy. With this post-acute Covid syndrome ... it's kind of a wild, wild West right now.” Elizabeth Cooney STAT

Nearly a year into the coronavirus pandemic, the perplexing problems of Covid-19 long-haulers seem no nearer resolution — or even explanation — than when they first puzzled doctors and patients in the spring.

This much is known: Long haulers, recovering patients whose symptoms persist after their coronavirus infections disappear, are a mix of younger people who never needed hospital care and older people with chronic conditions that predate Covid. Their symptoms trail the infection’s path through their lungs, hearts, muscles, nerves, and brains. Deadening fatigue can dog them for weeks or months. Sometimes their problems wane, then resurface in a stuttering pattern that leaves them wondering if they’ll ever get over the malaise.

With a growing sense of urgency as cases mount across the U.S., physicians have launched specialized clinics to treat and study these “long Covid” patients, creating registries to track their progress. But answers are elusive: Why does brain fog or muscle weakness or shortness of breath linger in some people and not others? What can help lift the fog or restore their vigor? Can these people ever resume normal life?

“I don’t think this is going to be easy to figure out,” said Steven Deeks, a professor of medicine at the University of California, San Francisco, who is leading a clinical trial to find answers. “The vaccines and therapeutics, they were easy. With this post-acute Covid syndrome, we have no idea how to measure it. We have no prior experience in terms of defining it or treating it, so it’s kind of a wild, wild West right now.”