Long-haul COVID-19 on the rise in county

Healthcare providers in Crook County are seeing an increase in patients who appear to be suffering from long-haul symptoms of COVID-19, says Dr. Heith Waddell. But there may be hope on the horizon for people who are still suffering from coughs, aches and brain fog months after recovering from the virus.

While the evidence is still largely anecdotal, it may be that a COVID-19 vaccination can actually improve long-haul symptoms or, in some cases, cause them to disappear altogether.

According to an article published by NPR last week, the evidence so far includes 40% of the 577 long-haul patients contacted by support organization Survivor Corps reporting an improvement after their vaccination; a report from Dr. Daniel Griffin of Columbia University Medical Center that up to 40% of the patients in his long-term study are seeing an improvement; and a small UK study that found about 23% of long-haul patients saw an increase in symptom resolution.

Dr. Waddell cautions, however, that it’s too early to take this information as read, and not all the evidence yet supports the theory.

“I think you have to take that cautiously, because we’ve not actually had any studies come out to adequately demonstrate it,” he says.

The pandemic has made one thing very clear, he says: knowledge takes a while to solidify. Along the road to beating the virus, there have been numerous discarded theories and treatment ideas.

“When hydroxychloroquine came out, it was that everybody should be on hydroxychloroquine, but then we got some good studies that said no, it kills people, don’t do that,” Waddell gives as an example.

“I certainly think that it’s promising, but I think we need to wait until we have some better data and understand the long-term effects of this virus.”

Long-haul symptoms

The medical community has known for a while that not all patients who beat COVID-19 will feel better immediately. For some, symptoms can continue for weeks, or even months, after they have officially recovered, and this is something Crook County Medical Services District is seeing more and more.

“A lot of people have fatigue, some people have shortness of breath, a cough. I’ve had a few with headaches, some still have a sense of taste or smell that comes and goes,” Waddell says. “We’ve had some people who still have some memory issues, the ‘fog’ as they call it.”

Dr. Waddell saw a patient last week with long-haul symptoms a few months after officially recovering. These included fatigue, cough, shortness of breath and a general feeling of things not being quite right.

“She didn’t even have COVID-19 that was that bad. She didn’t require hospitalization or anything like that, but just feels like she’s never recovered,” Waddell says.

Not everyone realizes that COVID-19 has left their body damaged. Routine surveillance unrelated to COVID-19 required a CT scan for one patient, says Waddell.

“The radiologist actually called me and said, this person has terrible COVID-19 pneumonia,” he says.

The patient was not feeling sick and contracted COVID-19 a number of months ago. The scan, however, showed “very significant damage to their lungs” that was not causing problems at that moment, but may put them at higher risk of issues such as breathing problems and pneumonia at a later date.

“We may not even know that people have a problem until they come in in one year, two years or five years later with a bad pneumonia,” he says. “Again, that individual was not hospitalized or anything with COVID-19.”

Diagnosing Long-haulers

“The one thing to be really careful about when we’re thinking about long-haul is to make sure there’s not something else going on,” says Waddell of the challenge now facing medical providers.

“The person who is 70 years old and experiencing shortness of breath and who had COVID-19: is it really shortness of breath or is it a heart problem or is it long-haul COVID-19 symptoms?”

As cases increase, it will be important for the medical community to determine whether symptoms that appear to indicate long-haul COVID-19 are not disguising deeper issues.

“I think anybody who ends up going to their provider with what they might suspect is long-haul COVID-19 has to make sure that they’re not suffering from a heart condition, or have an autoimmune disorder that’s causing it, or something like that,” he says.

“Generally, in medicine, we just have to keep our eyes open for everything that could be there and test appropriately.”

On the other hand, he suspects that, “we’re probably going to diagnose a lot of long-haulers.”

“We have ordered some extra equipment to try to help in that, like a spirometer that helps us test your breathing,” he says.

Seeing the Doc

If you know you have been through a COVID-19 infection and you suspect you may be experiencing long-haul symptoms, Dr. Waddell recommends booking an appointment at the clinic.

“If you’re really not feeling normal, we do want to see you,” he says. “I do think we’re going to get an influx of people and I think, just as you normally would, if you got a cough or cold and gave it quite a bit of time and it doesn’t seem to be getting better, we should have a look at you.”

A diagnosis is always important, but there is no specific treatment or cure for long-haul symptoms at this time. It may be that long-haul symptoms are just something a person has to learn to live with, Waddell says – a low level of inflammation that could last anything from a couple of weeks to months.

“We’ve seen a new virus this last year and now we’re seeing that there are some new symptoms afterwards, and a lot of this is really new to us still too. Of course, we’re reading research that’s coming out about it, but it’s probably going to take us a little bit of time before we can have a good descriptor of what assessments we need to do to prove this,” Waddell says of the work being done to investigate long-haul COVID-19 and its symptoms.

“I think if we consider similar syndromes, like that people can have Lyme Disease that is chronic, it took a long time for us to identify it could be chronic and then we started getting some tests and treatments for it.”

The science might not yet be ready to support the idea of the vaccine getting rid of long-haul symptoms, but Dr. Waddell recommends getting your doses anyway. There’s no downside, he says: either it won’t affect the symptoms, or it will improve them.

“If you look at the people who are having this, there’s almost nobody who’s come through and said they’ve had long-haul COVID-19, got their vaccine and are now feeling worse. I haven’t had that at all,” he points out. “If there’s some chance that it would help people with these symptoms then yes, [people should have the shot].”