If the symptoms persist: How does Long Covid develop – and what helps against it?

The corona infection has actually long since been overcome and the rapid test was negative again. But there are still symptoms. Headaches, exhaustion, difficulty concentrating. If symptoms typical of corona persist for more than four weeks after infection, worsen or recur, doctors speak of Long Covid.

At least 65 million people worldwide could now be suffering from Long Covid. This is suggested by a study that appeared last year in the journal “Nature Reviews Microbiology”. According to estimates by the World Health Organization (WHO), there could be at least 36 million people affected in Europe alone. But how do the long-term consequences of Corona come about? And what can those affected do if they have symptoms?

What you need to know about Long Covid

  • How does Long Covid happen?
  • Who is particularly affected?
  • Are children also affected?
  • What symptoms are typical for Long Covid?
  • How long do the symptoms last?
  • Where can those affected find help?
  • How is Long Covid treated?
  • Does vaccination protect against Long Covid?

How does Long Covid happen?

There is no exact cause for Long Covid – but there are several theories. There are now indications that “chronic inflammation and occlusions of the small vessels (microthrombi), virus persistence, activation of the Epstein-Barr virus, changes in the intestinal microbiome and autoimmune processes” can trigger the long-term consequences of Corona. This is what the Robert Koch Institute (RKI) writes on its website.

Numerous studies have now been published that examine possible causes of Long Covid. And new ones are still being added. complement Research published in the journal “Science” at the beginning of the year suggests that a specific part of the immune system plays a role in Long Covid: the system. A network of different proteins that becomes active as soon as pathogens invade the body and switches off again as soon as the intruders have been fought. In people with Long Covid, the complement system appears to be overactive and does not easily switch off. This probably leads to tiny clots in the blood, damages the blood vessels and destroys red blood cells – and so various organs are also damaged.

Irish researchers recently found an explanation for the brain fog, i.e. the clouding of consciousness that some Long Covid sufferers report. The infection with the coronavirus causes a disruption of the blood supply system in the brain, they write in their study. The blood vessels would become more permeable and would be less able to protect the brain from pathogens, toxins and other substances in the blood.

A study from Spain from the beginning of 2022 attributed some Long Covid symptoms to a disorder of the vagus nerve. The vagus nerve extends from the brain into the trunk and into the heart, lungs, and intestines, as well as into several muscles, including those used for swallowing. It controls the heart rate and is responsible for the gag reflex, the transport of food and sweating. Of a total of 348 study participants, 228 (66 percent) had at least one symptom that indicated a dysfunction of the vagus nerve, a press release said at the time.

“It is important to note that not all symptoms of Long Covid can be linked to the direct effects of vagal dysfunction and that there are many other manifestations that require further investigation,” had David Strain, chairman of British Medical Association, which comments on study results in an interview with the Science Media Center .

In 2022 , two research groups – one from the University of Innsbruck and one from Stanford University in California – looked into the cause of gastrointestinal symptoms such as diarrhea and vomiting in people affected by Long Covid. In their work, they were able to show that parts of the coronavirus sometimes remain in the intestine for months after an initial infection. However, the researchers were unable to prove a direct connection between Long Covid and the virus remnants. Further studies are necessary.

could also Autoantibodies be important in Long Covid. They are produced by the immune system and are directed against the body’s own healthy tissue. As a result, they can trigger a variety of different autoimmune diseases. At the end of January 2022, the journal “Cell” published a study suggesting that different autoantibodies could be responsible for different types of Long Covid.

How often long-term corona effects occur may also depend on which virus variant is responsible for the infection. A study from Great Britain showed that the risk of Long Covid with the Omicron variant, which is predominant in, is lower than with the previously dominant Delta variant. The results were published in the specialist magazine “The Lancet” in mid-June 2022.

Who is particularly affected?

Long Covid is not an age-specific disease. Anyone and everyone can be affected. However, as data from Great Britain recently showed, there are groups who complain particularly frequently about long-lasting symptoms: These are people between the ages of 35 and 69; Women; people living in socially disadvantaged areas; people who work in the social, teaching and educational sectors or in the healthcare sector; as well as those with previous illnesses, job seekers aged 16 and over and people with disabilities.

A risk factor for Long Covid could be the gene FOXP4, which is active in the lungs and in some immune cells. on Long Covid last year This was the result of the first genome sequence study, in which almost 6,500 people from 16 countries took part. In previous studies, the gene had already been associated with a higher risk of severe Covid-19 disease. Chronic and previous psychological illnesses as well as an immune deficiency could also be among the risk factors. Just like stress, as a study published in the journal “JAMA Psychiatry” suggests at the beginning of September 2022.

Basically, the more severe the course of Covid-19 disease, the more likely and more pronounced possible long-Covid symptoms can be. This means that someone who has to be treated in the hospital or even in the intensive care unit because of a corona infection has a higher risk of long-term effects than someone who cures mild cold symptoms at home. The reason for this is that if the course is severe, the body is more affected, more organ damage is possible and therefore long-lasting symptoms. But even mild courses of the disease can lead to long-term corona consequences, show international studies.

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