Long COVID (Post-COVID Syndrome) Is Pandemic’s Lingering Mystery

Therese Raphael wrote . . . . . . . . .

The downslope of the COVID-19 crisis is proving to be its own bumpy ride — and there’s no telling yet how long it will last. We’ve learned a tremendous amount about the disease itself, but in terms of grasping the impact of lingering post-COVID Syndrome, or Long COVID, as it’s often called, we’re just getting started.

As hospital admissions from COVID-19 decline, clinics dealing with post-COVID effects are being flooded with demand and questions around treatment are proliferating. Addressing the problem will require more resources at a time when health-care systems are tapped out. That’s hard in the U.K., where hospital executives say they will have to cut back services if the Treasury can’t find more funds than what Chancellor Rishi Sunak put in this month’s budget.

So far, research into Long COVID has suffered from various limitations, such as small sample sizes or truncated followup periods. Even so, the emerging picture is stark.

Britain’s Office for National Statistics estimates that 23.6 per cent of women with COVID-19 and 20.7 per cent of men continued to experience symptoms five weeks after they tested positive for the virus. Nearly 10 per cent had symptoms 12 weeks later.

More than 117 million people around the world have been infected with COVID-19. If at least one in 10 experience symptoms that persist for weeks or months after the virus has left their body, that’s a lot of disability, however temporary. The reported symptoms list is too long to publish here but includes fatigue, breathlessness, brain fog, muscle aches, stomach illness and heart palpitations. Long COVID doesn’t care if you’re young or super fit or just had a mild case of the virus.

At University College London Hospital, the clinic for post-COVID-19 treatment is a multidisciplinary team involving respiratory, cardiology and neurology specialists, as well as occupational therapists and psychologists. It is struggling to keep up with demand, says Melissa Heightman, a respiratory physician and clinical lead. Only about one-third of their non-hospitalized patients with post-COVID-19 illnesses have recovered fully, she says.

The problem isn’t only the number of patients struggling with Long COVID; it’s also that there is still much we don’t know about how to treat the condition that is complex and can affect different systems of the body.

Doctors treating post-COVID-19 patients find sharing experiences invaluable. Steroids, antihistamines and vitamin D have been shown to help reduce symptoms in some cases. Some patients are put on beta-blockers to control their elevated heart rate; a common treatment for gout has helped improve chest pain in some patients. Rest seems a universal protocol, whereas exercise can lead to a relapse. Researchers and patients (sometimes one and the same) exchange experiences, hope and exasperation on Facebook groups, Twitter and other social media.

Needless to say, there’s plenty of unscientific advice going around too. When Gwyneth Paltrow, founder of the lifestyle brand Goop, suffered “long-tail fatigue and brain fog” after her bout with COVID-19, she was recommended a program of “intuitive fasting,” which includes fasting until 11 a.m. every day and eating a keto and plant-based diet, by leading “functional medicine practitioner” Will Cole, who isn’t a medical doctor.

Paltrow was so happy with the results that she wrote about it in her blog, but the details (including regular use of an infrared sauna) set off alarm bells in the medical community. “We wish her well, but some of the solutions she’s recommending are really not the solutions we’d recommend in the NHS,” said Stephen Powis, medical director of the National Health Service in England.

The good news is that Long COVID sufferers are getting attention — there are some 70 Long COVID clinics around the U.K., and, according to NBC News, more than 80 post-COVID clinics in the U.S. This is a feat if you consider how relatively new COVID-19 is. It took more than 80 years to determine a diagnosis for what’s known as Chronic Fatigue Syndrome or ME/CFS. Today it affects an estimated 2.5 million Americans and shares symptoms with Long COVID.

For now,many suffering from Long COVID will have to continue to rely on support groups and their own reserves of patience. “Patients are expecting an awful lot from a health service that is pretty much defeated,” says Heightman. “We are so tired. And we don’t have enough of the right skill set in the right place. This is the moment to try to sort this out.”

Source: Winnipeg Free Press

Men Worldwide Have Shorter Life Spans Than Women

Why are men over 50 around the world 60% more likely than women to die early?

Two big reasons are higher rates of smoking and heart disease, according to a large new study.

The findings are based on an analysis of data from more than 179,000 people in 28 countries. Fifty-five percent were women.

Researchers examined how socioeconomic (education, wealth), lifestyle (smoking, alcohol consumption), health (heart disease, diabetes, high blood pressure and depression) and social (having a spouse, living alone) factors might contribute to the higher risk of premature death in men.

The findings were published in the Canadian Medical Association Journal.

Lead researcher Yu-Tzu Wu, of King’s College London, and co-authors said many studies have examined the impact of social, behavioral and biological factors on male-female differences in death rates, but few have investigated potential international variations.

“Different cultural traditions, historical contexts, and economic and societal development may influence gender experiences in different countries, and thus variably affect the health status of men and women,” Wu and colleagues said in a journal news release.

They said those differences can lead to different life experiences for men and women and variation in the death gap across countries.

Their findings are consistent with other research about life expectancy and death rates.

The diversity of sex differences in death rates across countries may indicate the “substantial impact” of gender — socially constructed roles of men, women and gender-diverse people — “in addition to biological sex, and the crucial contributions of smoking may also vary across different populations,” the authors wrote.

Public health policies should account for sex- and gender-based differences and how social and cultural factors affect health, the researchers suggested.

Source: HealthDay

New Pies from Pie Specialty Store “Pie Face (パイフェイス)” in Japan

Bacon and Grilled Vegetable Genovese

Sweet Matcha Fromage

The pies will be available for limited time at 390 and 320 yen (plus tax) each respectively.

Primary Care Doctors Can Help Preserve Brain Health

Primary care doctors can play an important role in helping to preserve brain health by encouraging healthy behaviors and addressing risk factors associated with cognitive decline, according to a new scientific report.

The American Heart Association statement published Monday in the journal Stroke outlines seven lifestyle targets and six risk factors for brain health that primary care doctors should address in adults of all ages. The statement also has been endorsed by the American Academy of Neurology as an educational tool for neurologists.

As the nation ages, preserving brain health has become a growing concern. Mild cognitive impairment affects an estimated 1 in 5 Americans age 65 and older; 1 in 7 has dementia – a number expected to triple by 2050.

“Primary care is the right home for practice-based efforts to prevent or postpone cognitive decline,” Ronald Lazar, chair of the scientific statement writing group, said in a news release. Lazar directs the Evelyn F. McKnight Brain Institute at the University of Alabama at Birmingham.

“Prevention doesn’t start in older age; it exists along the health care continuum from pediatrics to adulthood,” he said. “The evidence in this statement demonstrates that early attention to these factors improves later life outcomes.”

The statement asks primary care doctors to integrate brain health into their treatment of adults guided by the AHA’s Life’s Simple 7, a collection of lifestyle targets shown to help achieve ideal heart and brain health. These include managing blood pressure, cholesterol and blood sugar levels; increasing physical activity; eating a healthy diet; losing weight; and not smoking.

The statement also asks them to assess their patients’ risk factors for cognitive health, including depression, social isolation, excessive alcohol use, sleep disorders, lower education levels and hearing loss.

“Scientists are learning more about how to prevent cognitive decline before changes to the brain have begun,” Lazar, a professor of neurology and neurobiology, said. “We have compiled the latest research and found Life’s Simple 7 plus other factors like sleep, mental health and education are a more comprehensive lifestyle strategy that optimizes brain health in addition to cardiovascular health.”

Dr. Deborah Levine, one of the statement’s co-authors, said it is never too soon to target risk factors for ideal heart and brain health. It’s also never too late.

“For example, lower blood pressure levels reduce the risk of cognitive impairment and dementia in older adults,” she said. “In adults of all ages, the metrics in Life’s Simple 7 prevent stroke, and stroke increases the risk of dementia by more than twofold.”

Additional risk factors can help physicians identify which patients may need special attention, said Levine, an associate professor of medicine at the University of Michigan Medical School in Ann Arbor.

For example, “Primary care doctors can help their patients reduce dementia risk by identifying and aggressively treating vascular risk factors like high blood pressure. Black and Hispanic individuals, women and individuals with lower educational levels appear at higher risk for dementia, so these high-risk groups are a top priority,” Levine said.

According to the statement, recent research shows high blood pressure, diabetes and smoking in adulthood and midlife increase the odds of cognitive decline in middle age. And they accelerate cognitive decline in older age.

“Many people think of high blood pressure, Type 2 diabetes and other risk factors as affecting only heart health, yet these very same risk factors affect our brain health,” Lazar said. “Patients might be more likely to pay attention to the importance of addressing modifiable risk factors if they understood the links.”

The statement defines brain health using the term cognition, which includes memory, thinking, reasoning, communication and problem-solving.

Together, these functions enable people to navigate the everyday world, according to the report. The ability to think, solve problems, remember, perceive and communicate are crucial to successful living; their loss can lead to helplessness and dependency.

“Studies have shown that these domains are impacted by factors that are within our control to change,” Lazar said. “Prevention and mitigation are important, because once people have impaired cognition, the current treatment options are very limited.”

Source: American Heart Association

Grilled Fish with Artichoke Caponata

Ingredients

1/4 cup extra-virgin olive oil, plus more for rubbing
4 tender celery ribs, diced (1 cup)
1 onion, finely chopped
3 garlic cloves, thinly sliced
1/2 cup prepared tomato sauce
1/2 cup dry white wine
1/4 cup white wine vinegar
8 ounces marinated artichoke hearts, drained and chopped
1/2 cup pitted green olives, chopped
1/4 cup pine nuts
3 tablespoons sugar
2 tablespoons small capers, drained
Kosher salt and freshly ground pepper
3 tablespoons shredded basil
6 (7 ounce) skinless mahi-mahi fillets

Method

  1. In a large, deep skillet, heat the 1/4 cup of olive oil until shimmering. Add the celery, onion and garlic and cook over moderate heat until just softened, 4 minutes.
  2. Add the tomato sauce, wine, vinegar, artichokes, olives, pine nuts, sugar and capers and season with salt and pepper. Simmer until the vegetables are tender and the liquid is reduced, 8 minutes.
  3. Stir in the basil and let cool.
  4. Light a grill or preheat a grill pan.
  5. Rub the fish with olive oil and season with salt and pepper. Grill over moderately high heat, turning once, until cooked through, about 9 minutes.
  6. Transfer the fish to plates, top with the artichoke caponata and serve.

Makes 6 servings.

Source: Chef Michael White


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