How long will it take to figure out the long COVID?

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Rachel Robles contracted COVID in March 2020. The 27-year-old data analyst hasn't gone a single day without symptoms since. Most doctors didn't believe her when she described how she went from running the Brooklyn Half Marathon the previous year to enduring fatigue so crippling her couch felt like quicksand. How she suddenly found it difficult to put numbers together, despite her technical background. How no matter how many breaths she took, she always felt starved for air.

Three months later, a doctor told him, "COVID doesn't last 90 days. Either you get over it or you die."

This dichotomy, in which the only possible outcomes of COVID are either full recovery or death, has proven to be anything but true. Between 8 and 23 million Americans are still sick months or years after being infected. The confusing array of symptoms known as long COVID has left around 1 million of these people so disabled they are unable to work, and those numbers are likely to rise as the virus continues to evolve and spread. spread. Some who escaped long COVID the first time around catch it after their second or third infection. "This is a huge public health crisis following an acute COVID infection," says Linda Geng, physician and co-director of Stanford Health Care's long-running COVID clinic.

Although there has long been no debate that COVID is a real phenomenon - the Centers for Disease Control and Prevention and the World Health Organization have acknowledged its existence - the science is so new that many questions remain about how to define the condition, what causes it, and how to treat it effectively. It has become clear, for example, that the long COVID can take different forms. "Not everyone has the same disease," which means there are different causes, says Yale School of Medicine immunologist Akiko Iwasaki.

Scientists have offered several different, yet interconnected, origin stories to explain these far-reaching symptoms: the coronavirus could damage organs, cause tiny blood clots, trigger autoimmunity, hide in tissues or cause new and persistent symptoms in other, more subtle ways. To complicate matters further, these stories are not mutually exclusive: several may occur at the same time in a particular patient, or one may trigger another in an unfortunate sequence of events that keeps the patient in perpetual poor health. By deconstructing theories one by one, researchers are gaining a better understanding of this enigmatic disease and getting closer to therapies that not only mask the symptoms, but eliminate the root cause.

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Listen to patients

Many of the earliest insights into the long COVID were gleaned from experiences shared by patients. A survey by the Patient-Led Research Collaborative, a team of long-term COVID patients researching their condition, compiled a list of over 200 different symptoms across 10 organ systems. These range from the most common complaints like fatigue, cognitive impairment, shortness of breath, irregular menstruation, headaches, heart palpitations, sleep problems, anxiety and depression, to others conditions like double vision, peeling skin, hair loss, tinnitus, tremors. ,...