What is persistent COVID

The World Health Organization (WHO) since October 2021 recognizes persistent COVID or long COVID, and defines it as those individuals with a history of probable or confirmed SARS-CoV-2 infection, usually about three months after the onset of COVID-19, with symptoms whose duration extends for at least two months and which cannot be explained by an alternative diagnosis.

It is a symptom-producing pathology (dyspnea, asthenia, generalized weakness, tachycardia, difficulty in concentration, mental fog…) and is very disabling for the patients who suffer from it.

In which persons is persistent VIDOC likely to occur?

The prevalence of persistent COVID is estimated to be about 10% of patients who have had an acute infection, in most cases in a mild form. It is more common in middle-aged women.

What causes it? What causes one person to pass COVID and another to develop long COVID?

There are several theories about the cause of persistent COVID that are under investigation. The most relevant are:

1. Viral persistence. The virus remains active in the organism producing the symptomatology.
2. Hyperstimulation of the vagus nerve. The virus produces an immune response that alters the functioning of the vagus nerve.
3. Hyperinflammatory syndrome and altered immune response. The virus generates a hyperactivation of the immune system with alteration of the cytokine response that produces a generalized involvement of the endothelium (endothelitis) as well as microvascular involvement with involvement of different devices and organs …

What are the symptoms of persistent COVID and how long does it last?

Up to more than 200 symptoms or signs have been described in patients with persistent COVID, and the most frequent and characteristic are the following:

• Dyspnea. Shortness of breath with fatigue on increasing exertion.
• Asthenia or tiredness. The patient presents generalized weakness and excessive fatigue for the usual activities of daily living.
• Generalized joint and muscle pain.
• Paresthesias and dysesthesias. Cushing sensation and altered sensation in the context of small fiber neuropathy.
• Dysautonomia. Occurrence of orthostatic postural tachycardia syndrome (POTS). Affectation of the vegetative cortex (nausea, diarrhea, sweating…).
• Mental fog or brain frog. Difficulty in attention and concentration, with a feeling of daze and dullness. ….

As for the duration, it is currently considered to be a fluctuating pathology with a variable duration of symptomatology and with a tendency to chronicity in a considerable percentage of cases?

How is persistent COVID treated?

Currently, apart from symptomatic treatment, there are three lines of work or research with curative intent, although all of them are in the trial phase or as experimental treatment with promising preliminary results, but without sufficient scientific evidence.

1. Use of antiretroviral drugs in the face of the possibility of viral persistence or acting to stop the hyperinflammatory syndrome.
2. Use of monoclonal antibodies.
3. Plasmapheresis.

For more information, consult a specialist in Internal Medicine.