Nearly three years into the pandemic and researchers are still trying to get a better grasp of what causes long COVID and how to treat people with lingering symptoms.
Long COVID symptoms can continue for months and even years, experts said.
A study released this week by scientists in Israel indicates that most patients who suffer from long COVID tend to have their symptoms resolve within a year. The researchers used electronic medical records in coming to their conclusion.
Dr. Aaron Friedberg treats patients at the Ohio State University Wexner Medical Center's Post-COVID Recovery Program. He said that based on his experience, many patients see their symptoms resolve within a year.
Friedberg said he tends to see some of the more severe cases of long COVID, given his position.
"The overall path in post-COVID is one of improvement," he said. "There is a pretty big chunk of folks who have symptoms longer than you would normally expect for a viral infection. Most people, after a week or 10 days, start to feel better."
Margaret O'Hara is a trustee for Long COVID Support, a group that has advocated for more research. She is skeptical of the study. She said she's been infected with COVID-19 three times, with all three instances resulting in prolonged symptoms. Before the pandemic, O'Hara, who works in the medical field, said she was active and would often cycle to work, but COVID-19 changed that.
She said others have dealt with non-stop long COVID since 2020.
"Some of your symptoms might resolve in the first months, but really, there are very persistent symptoms," O'Hara said. "We were quite surprised by the Israeli study. Part of the limitation with it is it is based on electronic record instead of a self-report."
While some might be encouraged to hear long COVID could resolve within a year, she noted, "A year is still a long time."
While Friedberg agrees with the study's findings, he also has seen many long COVID cases since the onset of the pandemic in 2020.
"They're still having functional limitations," he said. "Those people with yearslong long COVID, it's a tiny percent of the population."
The Centers for Disease Control and Prevention lists 19 different ailments as common long COVID symptoms. The symptoms can range from prolonged coughs and fevers, symptoms common in primary COVID infections, to neurologic and cardiovascular symptoms. Many people with long COVID complain of persistent fatigue, drowsiness and brain fog.
Friedberg said long COVID symptoms can depend on the person. He said things like a fast heart rate and cardiovascular symptoms are normally the first to improve.
"For the folks who have really persistent symptoms, it's more common to see persistent fatigue or brain fog than severe shortness of breath," he said.
O'Hara's first bout with COVID came in March 2020 and resulted in her having lingering symptoms for a year. Her most recent infection from COVID came in July. O'Hara said for six months, she has encountered persistent fatigue, but she feels fortunate to walk 4,000 steps in a day.
"For most people, recovery means I am the person I was before and I am able to do all things I was able to do," she said. "Most people I know from the first wave, in the circles where we're trying to help people, we are not the person we were before. We're edging closer to that, maybe, but we're not there."
Friedberg said he often has to take a team approach with other doctors to treat patients. In some cases, patients come in with just one symptom; in others, they have dozens, he said.
"When you have 14 problems, how do you deal with 14 problems?" he said. "What we try to do is find out as much as we can about each one and try to figure out the best plan."
Treating long COVID causing frustration
Due to the sheer number of illnesses and their complexities, it can take up to two months before patients are seen by Friedberg's team. By then, frustration can set in.
The process of getting treatment has frustrated O'Hara.
"You go to your doctor, and you kind of just give up because the doctor can't do anything for you," O'Hara said. "You go to the doctor every few months and say, 'I'm still here; I'm still struggling.'"
O'Hara said long COVID has put a strain on friendships and relationships.
"People don't want to talk about it, people don't want to hear how COVID is not over and it is not just a problem for elderly people," she said. "We say this a lot in our support group. People are losing relationships, losing friends, no longer talking to family because the other friend or family doesn't accept that there is something wrong with them or they're just being lazy or doing it for attention. People feel like they're being gaslit."
It's something Friedberg sees among patients. He said because post-COVID is not as evident as something like a broken leg, it can be challenging.
"They have a cardiovascular system, respiratory system, a nervous system that is not working correctly, which hopefully would improve," he said. "Because often there are no visible signs of this illness, someone just sitting there might look fine. It doesn't look like anything is going on with them when they're suffering from all of these symptoms on the inside. So there is this expectation from employers, from friends, family members, loved ones, they'll say, 'Just do what you normally do.' For these people with post-COVID, just like asking a person with a broken leg to hop up and get walking because what's the problem, they can't see it, so there is a lot of frustration, a lot of loneliness that can be associated with that."
While doctors have been left with few answers for long COVID, Friedberg said he is hopeful for better treatments in the coming years for people like O'Hara.
