The Lamen

Why is Coronavirus still keeping people sick?

A bar graph for the breast cancer rates among women of different ethnicities.

A large chunk of the long COVID puzzle still remains unexplained, as millions experience the after-effects of the infections even months or years later. 

Photo: Cottonbro Studios/Pexels

Published on Jul 28, 2023

At least 20 percent of the people who were infected by the coronavirus never showed any symptoms. Then there’s the other end of the spectrum, the so-called “long haulers” of COVID-19. These individuals continued to experience “long COVID,” defined as “signs, symptoms, and conditions that continue or develop after initial COVID-19 infection.”

People with long COVID experience extreme fatigue, pain, or “brain fog,” described as feeling fuzzy, under the weather, or a lack of concentration — lasting up to months or years after the initial infection in some cases.

Even if the virus no longer has the world in alarm, we are still in the early stages of understanding why it continues to keep some sick. The condition has been associated with over 200 symptoms, and scientists are now looking into the genes to find answers for these post-acute sequelae of SARS-CoV-2 infection (PASC).

Details: A recent study published in Nature collected data from 6,500 long COVID patients to determine whether specific genes could lead to more severe infection and a greater risk of long-term complications.

  • The researchers found that a particular segment of the DNA was associated with a 1.6 times higher risk of developing long COVID. Found near the FOXP4 gene, this segment of the DNA has previously been linked with lung cancer.
  • The report adds that the variation alone could not explain the risk of serious infection. “This variant has a much stronger impact on long COVID than its impact on severity,” said Hugo Zeberg, a geneticist and a lead author of the report.

The most common disabling symptoms of long COVID have been recognized as brain-related, and while SARS-CoV-2 may be a relatively new virus, post-acute infection syndromes (PAISs) are not. The fact that even if a patient’s health is meant to improve over time, the symptoms may never go away completely poses becomes a literal brain teaser.

What COVID means in the long haul.

Nearing four years since the COVID-19 outbreak, we have yet to know the full scope of the damage it dealt — and the deaths that are almost certainly a gross undercount that show much of the world lacks the resources to deal with the condition.

While we are yet to know the scale of the pandemic, one fact has been made abundantly clear: a COVID infection can mean long-term implications for a large chunk of the population.

Some viruses can persist for a long time inside our bodies, and researchers suggest that SARS-CoV-2 is one of this breed. Such viral persistence often occurs in the so-called “sanctuary tissues” — certain body parts that immune cells aren’t surveilling as actively as the rest of the body.

  • The virus doesn’t just disappear from your body. Instead, it may leave behind its genetic material in a process called “persistent viral RNA shedding,” detectable even months after the initial infection.
  • These persistent but non-latent viruses are not actively getting you sick, instead causing long-term damage by several different means — such as triggering inflammation or reactivating latent pathogens.
  • A study suggests that the lingering of these “bits of virus” in the body for more than 14 days has been associated with diabetes, chronic kidney disease, and a greater risk of dying from COVID-19.
  • Some evidence suggests that vaccination may help reduce such symptoms, but it has been met with an equal amount of scrutiny and follow-up studies are yet to confirm such claims.

With at least 65 million people (likely growing) worldwide estimated to have long COVID, characterization of the condition and understanding risk factors take precedence.

Affecting multiple organ systems, the most serious sequelae symptoms include:

  • myocardial inflammation
  • diabetes
  • autoimmune issues
  • neuroinflammation
  • kidney, spleen, or liver injury
  • stroke

But the most common symptoms that have emerged as a result of long COVID seem to be of the neurological kind, with the term “brain fog” becoming the quiet sensation making people question whether they’re one of the victims.

Long COVID and a “brain fog” fix.

Grasping the reasons behind neurological manifestations is hard to understand when your knowledge of both the condition and the resulting symptoms themselves remains fleeting.

Brain fog isn’t a term easy to define. Is it the inability to think with a clear head, feeling sluggish like you’ve just had pasta as your afternoon meal, feeling overwhelmed with work, or simply can’t remember the minutiae of the day.

  • Brain fog is exactly what it sounds like: feeling as if your ability to think has been shrouded by a thick fog. This isn’t exactly a medical condition, but a term coined by patients to describe symptoms that result in cognitive dysfunction.
  • According to a study from the University of California, San Diego (UCSD), the signs of brain fog, such as memory impairment and decreased concentration, were reported in over 68 percent of the group.

Brain fog isn’t expected to get worse over time, and may even go away by itself in a few weeks. Keeping track of your symptoms and noting any changes can help you better understand your position, and whether you require medical expertise.

The approach to healing brain fog is a largely unexplored area, with many of the fixes described as holistic or spiritual. We are, however, moving in a pharmacological direction where people experiencing debilitating symptoms can choose a pill as the fix.