{"id":787,"date":"2023-12-08T09:53:26","date_gmt":"2023-12-08T09:53:26","guid":{"rendered":"https:\/\/annualreports.healthsciences.arizona.edu\/?post_type=story&p=787"},"modified":"2023-12-18T23:06:04","modified_gmt":"2023-12-18T23:06:04","slug":"fighting-the-second-pandemic-long-covid","status":"publish","type":"story","link":"https:\/\/annualreports.healthsciences.arizona.edu\/2023\/story\/fighting-the-second-pandemic-long-covid\/","title":{"rendered":"Fighting the second pandemic: long COVID"},"content":{"rendered":"

More than 10% of people who had COVID-19 might have long COVID, according to research conducted at the University of Arizona Health Sciences. As researchers quickly work to understand the new disease, people with myriad symptoms face a number of possible frustrations when seeking care.<\/p>\n

\u201cThere is a striking void in care for people with SARS-CoV-2 postviral syndrome, especially when compared to the national action to combat acute COVID in the beginning of the pandemic,\u201d said Janko Nikolich, MD, PhD<\/strong>, director of the Aegis Consortium<\/a> and head of the College of Medicine \u2013 Tucson<\/a>\u2019s Department of Immunobiology<\/a>. \u201cThere are a wide range of symptoms associated with long COVID, so patients are often referred to different specialists, such as cardiologists, pulmonologists and neurologists. It can be time consuming, stressful and expensive. Even worse, some patients are still told that this is all ‘in their heads’ because most doctors do not know how to diagnose or treat long COVID.\u201d<\/p>\n

\"Janko
Janko Nikolich, MD, PhD, is leading the Arizona Post-SARS-CoV-2 Cohort Consortium (AZP3C), a six-institution partnership supported by the RECOVER Clinical Science Core at New York University Langone Health. He is the director of the Aegis Consortium which unites a diverse coalition of experts across multiple disciplines to find solutions for a pandemic-free future.<\/figcaption><\/figure>\n

On top of the immediate issue of people needing effective treatment for long COVID, there are many unanswered questions surrounding its symptoms and the potential for unforeseen consequences years in the future.<\/p>\n

\u201cOne of several theories about long COVID is that an acute infection leads to an activation of dormant viruses, such as the Epstein-Barr virus,\u201d said Kristen Pogreba-Brown, PhD, MPH<\/strong>, associate professor and epidemiologist in the Mel and Enid Zuckerman College of Public Health<\/a>. \u201cThis is concerning because a driving hypothesis for the underlying driver of multiple sclerosis is history of EBV infection. Does that mean in 10 to 20 years we will see an increase in MS patients? We simply don\u2019t know, and more research needs to be done.\u201d<\/p>\n

What is long COVID?<\/h3>\n

According to the Centers for Disease Control and Prevention, each time a person is infected or reinfected with SARS-CoV-2, the virus that causes COVID-19, they are at risk of developing long COVID. Commonly reported symptoms include but are not limited to fatigue, difficulty breathing, cough, chest pain, change in smell or taste, brain fog, joint pain, and gastrointestinal issues.<\/p>\n

Researchers are trying to better understand the reasons behind the unusually diverse and vague combination of symptoms. They say the pervasive nature of the virus is a likely culprit.<\/p>\n

\u201cThis virus enters the endothelial cell, which lines the inside of blood vessels. Endothelial cells are everywhere in the body. Every organ in the body needs blood to function,\u201d said Sairam Parthasarathy, MD<\/strong>, professor of medicine and chief of the Division of Pulmonary, Allergy, Critical Care and Sleep Medicine<\/a> in the College of Medicine \u2013 Tucson\u2019s Department of Medicine, director of the UArizona Health Sciences Center for Sleep Circadian and Neurosciences<\/a>, and one of four principal investigators on the Arizona RECOVER study. \u201cSo, this virus affects every nook and cranny of the body \u2013 the ovaries, the testicles, the skin, the brain, you name it. Even our nerves have blood vessels in them.\u201d<\/p>\n

\"Sairam
Sairam Parthasarathy, MD, has a broad background in clinical-translational research with emphasis on intervention-based approaches in sleep, COVID-19 and health disparities. He is the director of the University of Arizona Health Sciences Center for Sleep, Circadian and Neuroscience Research.<\/figcaption><\/figure>\n

All three researchers say a clinical definition is crucial to the treatment of long COVID. They are all part of the NIH RECOVER initiative, a nationwide study to develop a definition of post-acute sequelae of SARS-CoV-2 infection, or PASC, the scientifically accurate name for long COVID. RECOVER seeks to understand, treat and prevent PASC.<\/p>\n

\u201cOur goals are to define the clinical spectrum and pathophysiology of long COVID, to determine its natural history and prevalence, and to characterize the way in which SARS-CoV-2 causes post-acute sequelae,\u201d said Nikolich, who is the contact principal investigator for the Arizona Post-SARS-CoV-2 Cohort Consortium, a six-institution statewide partnership and one of more than 30 research teams across the country participating in the NIH\u2019s RECOVER initiative.<\/p>\n

In the recently published paper in the Journal of the American Medical Association<\/a>, co-authored by Parthasarathy, Pogreba-Brown and Nikolich, investigators of the RECOVER study analyzed nearly 10,000 study participants who self-reported their symptoms. Researchers identified 37 symptoms present more often in SARS-CoV-2\u2013infected participants at 6 months or more after infection compared with uninfected participants. The 12 symptoms that emerged most prominently included post-exertional malaise, fatigue, brain fog, dizziness, gastrointestinal symptoms, palpitations, change in sexual desire or capacity, loss of or change in smell or taste, chronic cough, thirst, chest pain, and abnormal movements.<\/p>\n

Catching all the data<\/h3>\n

Pogreba-Brown is a co-investigator on the RECOVER initiative and also leads AZ CoVHORT, an online research study of COVID-19 and post-COVID conditions. More than 8,800 Arizonans are enrolled in the study.<\/p>\n

\u201cCoVHORT is a very traditional, longitudinal epidemiologic study. We try to be as hands-off as possible, because we are trying to see what the progression of things are over time. This information will help us understand what treatments work best in the fight against long COVID,\u201d Pogreba-Brown said. \u201cWe send people surveys every three months if they are not having symptoms or every six weeks if they are having symptoms.\u201d<\/p>\n

\"Kristen
Kristen Pogreba-Brown, PhD, MPH, (left) says Arizona is first in the nation when it comes to COVID-19 deaths per capita. She says the CoVHORT study will be critical to addressing the rural and cultural populations that are unique to the state, looking at biomedical and social risk factors, and translating the data into practice and treatments. Pictured here with Melanie Bell, PhD, professor emeritus at the Mel and Enid Zuckerman College of Public Health.<\/figcaption><\/figure>\n

CoVHORT aims to catch all of the data to track how a COVID-19 infection might progress into long COVID for some and not others.<\/p>\n

\u201cWe want to know if you get sick, how quickly are you recovering? If you are having long-term symptoms, what are those symptoms?\u201d she said. \u201cWe ask people questions about what their health was like before the pandemic, such as other chronic conditions they might have including diabetes or heart disease.\u201d<\/p>\n

Questions related to stress, anxiety and depression are also included. The study also asks about food security, multigenerational housing, health insurance and work environment. This will help elucidate social determinants that play a role in outcomes.<\/p>\n

According to the World Health Organization, more than 658 million people worldwide have been infected with SARS-CoV-2. In the U.S., the CDC states most Americans have had COVID-19. Even if the prevalence of long COVID is only a small fraction of the total number of infections, the world\u2019s health care systems are facing another enormous challenge.<\/p>\n","protected":false},"featured_media":782,"parent":0,"template":"","college":[],"uahs_theme":[16],"class_list":["post-787","story","type-story","status-publish","has-post-thumbnail","hentry","uahs_theme-new-frontiers-for-better-health"],"acf":[],"yoast_head":"\nFighting the second pandemic: long COVID - University of Arizona Health Sciences Annual Impact Report 2024<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/annualreports.healthsciences.arizona.edu\/2023\/story\/fighting-the-second-pandemic-long-covid\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Fighting the second pandemic: long COVID - University of Arizona Health Sciences Annual Impact Report 2024\" \/>\n<meta property=\"og:description\" content=\"More than 10% of people who had COVID-19 might have long COVID, according to research conducted at the University of Arizona Health Sciences. 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