A woman sleeps soundlyShare on Pinterest
Fatigue is a common symptom of long COVID, but there are also lingering mental health effects. Miquel Llonch/Stocksy United
  • Long COVID remains a bit of a mystery to researchers who are studying why it happens to some people and how to treat it.
  • Researchers say that there appears to be four factors that can lead to a higher risk of long COVID, including type 2 diabetes and a reactivation of the Epstein-Barr virus.
  • Experts say that it appears there won’t be a single treatment for long COVID since it manifests itself differently in different people.
  • They do say that most people with long COVID seem to eventually recover from it.

Until recently, there were no large-scale studies addressing the physical and mental health effects that persist in people long after they’ve been treated for COVID-19.

Experts say that there are two primary groups of people who are dealing with lingering symptoms after recovering from the disease:

  1. those who had mild-to-serious COVID-19 but who weren’t placed in the intensive care unit (ICU) and, for the most part, weren’t hospitalized
  2. those who did spend time in the ICU and were seriously ill with COVID-19

Those in the first category have what medical experts call post-acute coronavirus disease 2019 syndrome (PACS), a condition more commonly referred to as long COVID.

This group experiences a wide range of new, returning, or ongoing health issues.

Long COVID remains only vaguely understood by scientists. The condition has no diagnosis or dedicated treatments to date.

However, researchers are getting closer to understanding when and why it occurs.

A new study noted that post-acute sequelae of COVID-19, also known as PACS, represent an “emerging global crisis.”

In the study, researchers identified four factors in people that appear to be linked to an increased risk of having long COVID:

  • type 2 diabetes
  • the reactivation of Epstein-Barr, a virus that is present in most people but remains dormant in many
  • the level of coronavirus RNA in the blood early in the infection, an indicator of viral load
  • the presence of certain autoantibodies, which mistakenly attack tissues in the body as they do in autoimmune diseases such as lupus and rheumatoid arthritis

Physicians and researchers worldwide are working to better understand why long COVID appears in some people and not others and how best to treat it.

At the University of California San Diego, infectious disease specialist Dr. Lucy Horton and others are treating this population as best they can.

Horton told Healthline that it’s been challenging trying to figure out how to treat people with long COVID.

Most of the time, individual symptoms call for individual treatments, she explained.

“There isn’t any one pill that can address all the symptoms of long COVID, and there won’t be,” Horton said. “It has been a really unique experience to learn about all these new conditions, mostly through patients and their explanations.”

Horton noted that the first 6 months of treating long COVID was a learning experience.

“No one else was acknowledging these patients. It was all new data. As specialists, we have learned from each other and from our patients,” she said.

But Horton says that there are still many unknowns.

“Many of these patients with long COVID had no major health issues before getting the virus,” she said. “That makes it challenging and individually devastating for these patients. They have gone from a normal life to being really sick.”

The good news, Horton said, is that many people with long COVID will recover and resume their lives.

“If you look at other post-viral syndromes, the majority have a meaningful recovery and will feel well,” she said.

“It may take many months to a couple years, but many will feel better. But there is a subset who will have these symptoms indefinitely. We just don’t know yet who they are.”

Meanwhile, another study published last week of people with COVID-19 in 11 Dutch hospitals assessed the occurrence of physical, mental, and cognitive symptoms one year after ICU treatment.

Among the 246 participants in the study, 74 percent reported physical symptoms, 26 percent reported mental health symptoms, and 16 percent reported cognitive symptoms.

Many of these participants experienced a weakened condition or musculoskeletal problems and had work-related problems.

The study showed that three out of four COVID-19 patients treated in ICU were still experiencing fatigue, impaired fitness, and other physical symptoms a year later.

One in four reported anxiety and other mental health symptoms.

“COVID-19 patients who were in the ICU have had a harder time returning to their full-time jobs than non-COVID-19 patients who have survived ICU,” Marieke Zegers, PhD, a senior researcher at Radboud Institute for Health Sciences in the Department of Intensive Care Medicine in the Netherlands, told Healthline.

Among non-COVID-19 patients who survived ICU, Zegers said that 58 percent of them could return to the same level of work that they were doing before they became ill.

However, just 43 percent of the people in the ICU who had COVID-19 could return to the level of work that they had before they became sick.

“It’s because of the impact COVID-19 has on the body, the severity of the illness, and the long duration of treatment in the ICU,” Zegers said.