Long-term COVID paves the way for recovery

June 30, 2021 – Thoughts of getting sick were the furthest thing from Paul Garner’s mind when symptoms of COVID-19 turned his life upside down. “It blew me away,” says Garner, a public health doctor specializing in infectious diseases. He says he never dreamed it would become a high-profile COVID-19 case, documenting his struggle for a medical journal and speaking on television.

Garner assumed he would likely feel sick for a few weeks and then recover. But 8 weeks later, he still felt like he had been hit with a bat, with body aches, muscle twitching, a pounding heart and diarrhea. “It was like being in hell,” he says.

He began to recount his painful illness of COVID in a blog post series for the British medical journal. In one of the his messages, he shared how mortified he was for infecting staff at his workplace for over 20 years. “I imagined their vulnerable loved ones dying and never forgiving me. My mind was in a mess,” he wrote.

Garner couldn’t do most of the things he used to love, and he cut his working hours at the Liverpool School of Tropical Medicine in the UK. During the first 6 months of his illness, he struggled with cycles of wellness, overdoing it and then crashing again. He found the disease difficult to manage. He tried everything: using his smartwatch to track his activities, measuring how long he slept, checking if the food he ate was affecting the sudden worsening of symptoms, but nothing worked.

The cyclical illness turned into weeks of exhaustion when Garner couldn’t even read and struggled to speak. At 7 months old, he wondered if he would ever get over it. “I thought the virus had caused a biomedical change in my body and paralyzed my metabolism one way or another, ”he says. “I felt insecure and I was afraid of the future.

The change occurred when someone in their professional network who had recovered from chronic fatigue syndrome offered help. “I learned how the brain and the body’s stress response to infection can sometimes be disrupted,” he explains, “and the symptoms I was experiencing were actually wrong. tired alarms.

“These meaningful explanations, along with sensitive coaching to change my beliefs about my illness, really helped me.”

He realized that there was probably no physical damage to his tissues, so he had to stop constantly monitoring his symptoms, find diversions when he was not feeling well, and hope to recover and resume his life. in hand.

COVID brought Garner to the brink and hung him over a precipice of terrifying unknowns, but he regained his balance. “There is post-COVID life. People are finding their own way, but they are improving. There is hope,” he says.

Life after COVID

Garner is not alone in his coronavirus trip. At least 33 million Americans have been infected with COVID-19, and some still have symptoms more than 4 weeks later, according to the CDC.

A preprint study of half a million people in the UK, where Garner lives, reports that one in 20 people with COVID-19 suffer from persistent symptoms. About 6% of people in the study – who has yet to be peer reviewed – said their recovery was delayed by at least one symptom that persisted for 12 weeks or more.

Shortness of breath and fatigue are among the most common problems reported after COVID-19. Even people who have no symptoms when first infected can feel bad afterwards.

Congress is providing $ 1.15 billion to the National Institutes of Health (NIH) to fund research into symptoms that persist after COVID-19.

“Considering the number of individuals of all ages who have been or will be infected, the impact on public health could be profound,” NIH Director Francis Collins said in a statement. declaration when funding was announced in February. “Our thoughts are with the individuals and families who not only went through the difficult experience of acute COVID-19, but who now find themselves struggling with persistent and debilitating symptoms.”

A wide range of physical and mental health consequences are linked to long-haul COVID-19, According to the CDC, and people report different combinations of many symptoms.

Although most people infected with COVID-19 are never hospitalized, many experience life-threatening symptoms and traumatic events without any medical support.

COVID-19 disproportionately affects communities of color, and it stands to reason that this will also be the case for post-COVID conditions, says Sabrina Assoumou, MD, of the Boston University School of Medicine.

Addressing health care disparities will be crucial as post-COVID cases increase. Diversifying the workforce will be vital, she explains, as diagnoses can depend on how a doctor listens to patients describe their symptoms.

Persistent symptoms can be vague, Assoumou says, and some people who have never been diagnosed, for whatever reason, are now having post-COVID effects.

“Long COVID will force us to go back to basics, like really listening,” she says. “We’re definitely going to need to be more empathetic.”

Why is this happening?

Scientists are studying the many people who continue to have symptoms or develop new ones after infection. They research the cause of prolonged illness, try to understand why some people are more vulnerable to long-term COVID than others, and assess whether COVID-19 triggers changes in the body that increase the risk of other conditions, such as as heart or brain disorders. .

The best defense is to get vaccinated and not get COVID-19, according to the CDC. But when people report a disease that persists, doctors are asked to consider measures of well-being beyond objective laboratory results and to focus treatment on specific symptoms.

COVID rehabilitation clinics are opening in medical centers across the United States. But will aid efforts be hampered by the absence of a clear explanation of symptoms that will not go away? And will people feel in disbelief in the face of a healthcare system that is not prepared for something that it cannot really measure?

Early indications suggest this is the case, according to Greg Vanichkachorn, MD, family physician and founder of the COVID-19 Activity Rehabilitation Program at the Mayo Clinic in Rochester, MN.

“If there is one universal truth among all the patients I have interviewed, it is that they are often dismissed, labeled or, frankly, abandoned,” he says.

Some experts believe Doctors need to screen patients for mental health symptoms after the initial phase of COVID and provide early and ongoing care.

Early help in mental health with therapy could play “an important role,” says Mauricio Castaldelli-Maia, MD, of the epidemiology department at Columbia University Mailman School of Public Health in New York City.

“It’s important that we recognize that the symptoms are real, imagined, or the result of stress,” Garner said. “And too much rumination about the disease and the constant search for a biomedical cause can be detrimental.

“The fear of not recovering was a huge barrier to managing symptoms. Conversations with others about their symptoms simply remind you of them and can strengthen an identity as a sick person. Drop it. Finding good things in life – positive thoughts have really helped me – but it takes time, there can be setbacks. It is not easy.”

Garner says he found his way listening to other people who had recovered.

“I couldn’t do this on my own,” he said. “I had a lot of friends, people who had recovered from fatigue syndromes and viral infections and help from professional colleagues. “

Garner dusted off his bike and started cycling through his favorite parks in Liverpool. And now he’s running again and leaving COVID behind.

WebMD Health News


Paul Garner, MBBS, Liverpool School of Tropical Medicine, UK.

thebmjopinion: “Paul Garner: on his recovery from a long covid”, “Paul Garner: For 7 weeks I have been on a roller coaster of ill health, extreme emotions and utter exhaustion.”

CDC: “Post-COVID Conditions,” “United States COVID-19 Cases, Deaths, and Laboratory Tests (NAAT) by State, Territory, and Jurisdiction,” “Assessment and Management of Patients with Post-COVID Conditions COVID: interim advice. “

Imperial College London: “Persistent symptoms following SARS-CoV-2 infection in a random community sample of 508,707 people. “

JAMA: “Symptoms that persist in patients after acute COVID-19. “

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