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While Covid-19 rapidly emptied cities and shut industries, long Covid has been more stealthy. Its impact in the past two years has been significant: a recent study revealed that the condition is so widespread that the “healthy life years” lost due to it have exceeded those lost to cancer or heart disease.
According to researchers at Washington University School of Medicine and the Veterans Affairs St Louis healthcare system, long Covid caused a loss of 80 healthy life years per 1,000 residents in the first two years post-infection, compared to 50 for cancer and 52 for heart disease.
Ziyad Al-Aly, an epidemiologist at Washington University and co-author of the study, describes the burden of long Covid as “staggeringly high” and notes that unlike cancer and heart disease, there is no known treatment for the condition. Its effects not only impact patients’ quality of life but also contribute to a potential decline in life expectancy, labor participation, economic productivity, and societal well-being.
The estimated 65 million worldwide sufferers of long Covid indicate that it is a public health emergency. However, unlike at the beginning of the Covid-19 pandemic, there is currently limited funding available to find new treatment options quickly.
While widely known as long Covid, the World Health Organization refers to it as “post-Covid-19 condition.” It typically occurs at least three months after the initial infection and is characterized by symptoms that persist for at least two months. Common symptoms include fatigue, shortness of breath, and cognitive dysfunction, often referred to as “brain fog.” However, patients also experience a wide range of other symptoms, and scientists have identified various potential mechanisms behind the condition. These include heart problems, diabetes, and nervous system disorders.
Researchers have discovered radiological abnormalities in the brain, heart, and lungs; evidence of microclots that suggest an inflammatory response; and indications that the virus may persist in certain patients, as reported in a July publication in Nature Reviews Immunology. Another recent journal article explored how the virus could affect the function of mitochondria, the energy factories inside cells.
Despite the complexity of long Covid, some patients and scientists are frustrated by the slow pace of understanding and finding treatments for the condition. The lack of specialists in the field of post-infectious diseases, including chronic disease syndrome, has hindered progress. However, efforts are being made to develop diagnostics, such as scans to detect microclots and assess heart and lung function.
Trials to find treatments for long Covid have been slow to start. Researchers are focusing on repurposing existing drugs to expedite the process. These include diabetes drug metformin, antihistamines, and the anti-gout drug colchicine. Naltrexone, typically used for alcohol and opioid use disorders, is also being studied for its potential benefits in chronic fatigue syndrome.
However, due to the limited size of many studies and the lack of patent protection for these drugs, manufacturers are unlikely to invest in large-scale trials. Research funding from organizations such as the US National Institutes of Health and the UK’s National Institute for Health and Care Research is also becoming scarce.
Patient groups and experts have expressed their frustration with the slow progress in finding effective treatments for long Covid. Some patients have resorted to self-experimentation or fallen victim to those offering unproven and expensive cures. Digital trials and the recruitment of larger patient populations are suggested as potential solutions to accelerate research progress.
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