Here & Now

Managing Long-Term Effects of COVID-19

Frederica Freyberg:

Even as there could be signs the pandemic is slowing, some people who have been infected are now coping with Post-COVID Syndrome, or Long COVID. What is it? Who’s at risk? And what can be done about it? For answers to these questions and more, we turn to Dr. Greg Vanichkachorn, with the Mayo Clinic Health System and the medical director of their COVID-19 Activity Rehabilitation Program. He has worked with many patients diagnosed with Long COVID Syndrome. He joins us now from Rochester, Minnesota, and, doctor, thank you very much for joining us.

Greg Vanichkachorn:

Thank you very much for having me. I appreciate it.

Frederica Freyberg:

So how common is it for people to get this Long COVID?

Greg Vanichkachorn:

You know, it is fairly common. I wish I could say that this is a rare thing, but according to our research, anywhere between 10% and 30% of individuals with COVID can expect to come down with Post-COVID Syndrome. And that’s a conservative measurement, unfortunately.

Frederica Freyberg:

Wow. That is a really big number, bigger than I definitely understood. Can a person develop it even if they didn’t initially have symptoms, like say a child?

Greg Vanichkachorn:

Absolutely. Unfortunately, we don’t see a relationship necessarily between long haul COVID symptoms and how severe the acute infection was. In fact, some of our patients haven’t had really any symptoms and just found out after the fact through things like contact tracing. And, yes, we have seen this also occur in the pediatric population as well.

Frederica Freyberg:

So what are the symptoms of this syndrome?

Greg Vanichkachorn:

It can be quite nebulous, but the two things that most people think about are fatigue that is quite profound. So, for example, patients will say they have to take a three to four-hour nap after doing something as simple as taking out the trash or doing some simple household chores. The other thing we hear a lot about is ongoing shortness of breath and it’s not just when people are doing activities, but even at rest. On top of that, we see a lot of other symptoms, including neurological symptoms like headaches and brain fog, which is often manifest with things like troubles with short-term memory and troubles multi-tasking.

Frederica Freyberg:

Can it be hard to diagnose or is it pretty clear to people like you, but what about across the board with primary care physicians or something?

Greg Vanichkachorn:

Yes. This remains a challenge unfortunately for a lot of providers around the country. There just still isn’t a lot known about this condition. There’s also no specific diagnostic test can be done to readily identify this condition. And so many providers out there are at a loss to accurately diagnose this.

Frederica Freyberg:

Can a person develop Post-COVID Syndrome after a breakthrough case, even after a vaccine?

Greg Vanichkachorn:

Yes, unfortunately, we have seen that happen. I’ve had a few cases now where patients have had breakthrough infections and then have gone on to have Long COVID symptoms. But fortunately that’s rare from what we have seen so far in our experience here. And I will say that the patients that do have a more prolonged course after a breakthrough infection, they seem to be getting better than the patients we saw before the vaccine. Now it’s too early to say whether or not the vaccine is truly what’s preventing people from having long-haul COVID. We are now seeing individuals with Long COVID symptoms earlier than we did last year. The average time last year was about three months after the infection when someone would come for care. But now people are showing up two to three weeks out after their infection to kind of get ahead of the problem.

Frederica Freyberg:

Does it ever go away?

Greg Vanichkachorn:

Some it does. I absolutely want to give people hope. We do see a group of patients that seem to get better around four to six months and they’re able to bounce back right to their normal lives, their normal work and pastimes. But at the same time, we do have some patients now who are a year or more out from their infection and they’re still experiencing symptoms. They are better than when they first started with treatment, but it really does look like this Long COVID issue can be a chronic problem.

Frederica Freyberg:

What is the treatment for Long COVID?

Greg Vanichkachorn:

Well, the first thing that we do for treatment here is to make sure that nothing else is going on that could explain a patient’s symptoms. There can be some very serious complications, like a blood clot in the first few weeks after a COVID-19 infection. So we like to make sure everything is okay. After that it’s more about reconditioning the body appropriately and helping manage the symptoms associated with this so that patients can participate in that rehabilitation. So taking care of headaches, for example, treating poor sleep, treating pains in the bodies, all of those things we help to minimize so patients can appropriately recover in a proper fashion. We’ll typically involve our physical therapists and occupational therapy groups to help with that.

Frederica Freyberg:

This has got to be very difficult for the patients. What is your message to people who might be suffering these kinds of symptoms?

Greg Vanichkachorn:

Absolutely. I would say the most important thing is that if patients are suffering this condition, don’t be afraid to self-advocate for yourself. As I mentioned earlier, there are a lot of barriers to individuals getting care for this. Don’t settle for taking no for an answer or there’s nothing we can do for you. There are centers out there like Mayo Clinic but also other clinics out there that are ready to help patients who are in need.

Frederica Freyberg:

All right. Well, thank you very much. Thanks for this information. Very important, doctor. Thank you.

Greg Vanichkachorn:

Thank you for having me again. I appreciate it.