We all lived through the Pandemic, but some people’s health continues to be at risk because of the ongoing effects of "Long COVID."
The CDC broadly defines "Long COVID" as the symptoms and conditions that continue to develop even after the body has defeated the initial COVID infection. Long COVID symptoms can be new or returning symptoms from a condition the patient had been previously diagnosed with and treated for. There is no test to determine whether the sudden appearance of these nonspecific symptoms is caused by the initial COVID infection or not, but doctors can determine whether their patient is being affected by Long COVID by analyzing the patient’s history and also but recognizing some of the common symptoms of Long COVID.
Common symptoms of Long COVID include fatigue, chest pain, shortness of breath, lightheadedness, changes in taste and smell, and rashes. Many symptoms of Long COVID are nonspecific. Hundreds of other symptoms are also attributed to Long COVID, and each diagnosis of Long COVID is typically specific and personalized to the affected patient.
There is currently not a lot of evidence to suggest who is most likely to be affected by Long COVID, but one study published by the journal Antimicrobial Stewardship & Healthcare Epidemiology shows that people vaccinated with one dose of the Moderna, Johnson & Johnson, AstraZeneca, or Pfizer before testing positive for COVID-19 had a 35% less chance of developing Long COVID compared with unvaccinated people. Studies by the CDC also suggest that people who are unvaccinated and were infected with COVID are more likely to develop Long COVID than those who were vaccinated, but risk factors are still being researched across the globe. Other risk factors for developing Long COVID include those who required intensive care when being treated for their initial COVID infection, people with underlying health conditions before contracting COVID, and those who experienced multisystem inflammatory syndrome (MIS) during or after contracting COVID. Currently, the only reported way to reduce your risk of developing Long COVID is to take preventative measures to avoid contracting the disease in the first place.
It is also important to note that with the rapid spread of the COVID-19 pandemic, the demand for scientific research about COVID and long covid has outpaced the actual process of peer-reviewed and official research, so often the information distributed by journalists, the CDC, and other health organizations is based on a small amount of official research or is based on preprints of these studies.
The data that is being produced by Long COVID studies is concerning. Women are more than 50% more likely to develop Long COVID than their male counterparts, even though men are more likely to contract COVID in the first place and typically present with more severe symptoms. People of Hispanic (28.9%) origin and mixed races (31.5%) also have higher percentages of diagnosed Long COVID, while people of Asian (19.5%) origin have the lowest reported percentage of a Long COVID diagnosis. Both white (26.8%) and black people (26.9%) have similar reported percentages of a recorded Long COVID diagnosis. These statistics reveal disparities among people that are diagnosed with Long COVID. Some variability with Long COVID diagnoses concerning race is attributed to inaccurate and rushed clinical trials for the COVID vaccine. Both Pfizer and Moderna tested primarily white people for clinical vaccine trials, with Pfizer having an 81.9% majority of trial participants being white, and Moderna having a 79.4% majority of trial participants being white. This means that these vaccines may not have been as effective for other racial groups but it is impossible to know for sure without increased clinical testing from these pharmaceutical companies.
The prevalence of Long COVID in women could be explained by historical medical negligence. Historically women are more likely to be diagnosed with vague conditions compared to their male counterparts for various reasons; lack of medical research focused on women, differences between symptoms between men and women, and general disregard from doctors. The biological differences between common symptom presentation in men and women make women more difficult to diagnose than men because medical schools typically focus on the typical male presentation for an illness. One such example of this is the differences between male and female symptoms for heart attacks. In men, heart attacks are as seen on television; tight chest pain, clutching the chest, and shortness of breath. In women these symptoms can be more nonspecific; some women will even get referred pain and report pain in their jaw when having a heart attack. Medical gender bias is real; in 2022 women waited 29% longer than men in hospital waiting rooms for potential heart attacks because healthcare providers wrote off their pain as being dramatic or less concerning. Because Long COVID is a nonspecific condition without a set symptoms list, some Long COVID diagnoses may be general explanations for a different underlying condition that a healthcare provider is writing off as Long COVID.
Research is the only way to reveal whether people with Long COVID actually have this illusive condition, or if their symptoms are the result of a totally different disease.
Females that contract Long COVID are also more likely to develop POTS (Postural Orthostatic Tachycardia Syndrome) than males, a condition women are already more likely to develop than men. POTS is a condition where an excessively lower volume of blood returns to the heart after standing up from a sitting or laying condition, causing lightheadedness, vision changes, and syncope episodes. There are currently very few POTS clinics within the United States and most health providers are unaware of how to treat or diagnose POTS. The surge of POTS cases due to Long COVID has placed stress on these clinics and made it increasingly difficult for people with POTS to seek care for their condition.
Unfortunately, much of the research being pushed out to the public on Long COVID is inconclusive or contradictory to other studies. Only continued research and reduced bias directed towards Long COVID will reveal how Long COVID will continue to affect people across the United States and the globe. //
Jackie Sullivan
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