Long COVID Prevention and Treatment
This week’s article will conclude the four-article series on the long-term consequences of being infected with SARS-CoV-2.
Information presented is intended to provide a medical perspective - the articles are not intended as a political statement for or against any public policy. Statements in these articles should be considered coming from myself, not from any organization I represent or my employer.
The last three articles in this series have touched on several different aspects of the long-term consequences of being infected with SARS-CoV-2. Many of the short-term symptoms of COVID-19 involve the lungs and upper airways. Some people will have damage to the lungs and we can see this on lung scans and there may be measurable deficits in lung function on testing long after the original infection - resulting in long term pulmonary symptoms.
COVID-19 however is not just a disease of the lungs. In the proceeding articles in this series, I briefly introduced a sampling of the objective findings and subjective experiences of people with long-term consequences of their infection. There are wide ranging effects on multiple body systems including the heart, brain, and nervous system.
We are just beginning to understand the full impacts that these long-term consequences have for us all. Studies on an individual level have shown significant long-term effects on everything from cognition in students, productivity of workers to athletic performance of professional soccer players. It is reasonable to expect that the long-term effects of COVID-19 on individuals will have a negative impact on our overall economy and society. The more people infected with COVID-19 - the greater the impact. Treating and preventing the long-term consequences of being infected with this virus is not just a medical concern for individuals but a societal concern.
Developing effective treatments for the long-term problems of COVID-19 is an area of active research. Scientists and medical researchers around the globe are studying this problem.
The role of vaccines in the prevention and treatment of “Long COVID” is one area of active research. A group of researchers from the UK Health Security Agency conducted a literature search and provided an analysis of studies on this subject from around the world including the US. This analysis made public in February looked at evidence relating to the effectiveness of vaccination against long COVID, both for vaccinations given before infection and for vaccinations given after infection with COVID-19 and development of long COVID symptoms. I will briefly mention a sampling of their findings below, for those interested in more information search “The effectiveness of vaccination against long COVID A rapid evidence briefing” and look for a downloadable pdf file.
The group looked at three studies of people with long COVID who were unvaccinated when they were initially infected, compared people who were subsequently vaccinated and people who remained unvaccinated. The authors of the analysis noted the following: “All these studies suggested that people with long-COVID were less likely to report long COVID symptoms shortly after vaccination, and over longer periods, than people with long COVID who were not subsequently vaccinated.”
Six of 8 studies assessing the effectiveness of vaccination before COVID-19 infection suggested that people who were vaccinated were less likely to develop symptoms of
long COVID following infection. This protection against long COVID symptoms was noted in the short term (4 weeks after infection), medium term (12 to 20 weeks after infection) and long term (6 months after infection). It is worth taking a closer look at the two studies that did not show a benefit from vaccination. One study was conducted in India with COVAXIN. This vaccine uses an inactivated virus which is a different vaccine technology than the vaccines that most people in the US have been vaccinated (using mRNA). It is very unlikely this vaccine will be used in the US - on March 4th the FDA rejected an application for authorization of this vaccine. The other study that failed to show benefit for vaccination was conducted in Indonesia. The vaccine used in the study was also an inactivated virus vaccine.
It should not be overlooked that our vaccines prevent people from getting COVID-19 in the first place (and thus keep you from getting long COVID). People who are up to date on their vaccinations are not just much less likely to end up in the hospital with COVID-19, they are less likely to get symptomatic infection.
A study published on March 2nd in The New England Journal of Medicine looked at the effectiveness of our vaccines against the Omicron variant. Waning of immunity has been noted several months after vaccination however after a booster protection against symptomatic disease significantly increased. The study looked at different combinations of primary vaccines and booster vaccines and reported the data for each combination - there was some variability based on the specific vaccines being used. For those who had both a primary and booster mRNA vaccination, the data showed protection against symptomatic disease ranged from 45% to 64% when assessed at least 5 weeks after getting the booster. It should be pointed out that other studies have shown that people who have had a booster shot of an mRNA vaccine have excellent protection against being hospitalized (in the 90% range).
To find a place to get a primary or booster COVID-19 vaccination go to vaccines.gov . Vaccination is the best way we know of to prevent yourself from having long lasting symptoms of COVID-19.
If you are suffering from long COVID symptoms I encourage you to make an appointment with your primary care provider. We can first evaluate you for other conditions that might be causing your symptoms. People who have had COVID-19 are more likely to develop other conditions such as diabetes. There may also be treatments that can help alleviate symptoms of long COVID.
Russ Coash, PA-C
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