While working for a non-profit domestic violence organization in Arizona during the height of the Covid-19 summer wave in 2020, Timer wrote pandemic policies for his workplace, encouraging his colleagues to wear masks and, if exposed to coronavirus, or have had symptoms, get tested.
Timer herself did not realize she was exposed to or had any symptoms of Covid-19, such as cough or fever, but she began to experience some unusual moments when she felt tired or forgetful, along with several episodes of confusion.
“They didn’t actually put that on the list of symptoms to go for testing,” said Timer, now 64.
That August, “brain confusion was so unusual for me that I just thought, ‘I tell everyone to wear masks and follow these rules; I’d better go get tested, too, “Timer said. She decided to test for Covid-19 on the spot.
“I never expected to be positive,” she said, adding that she was “devastated” because she did not want to miss work.
Not only was it positive, it was just the beginning of a long battle.
New research shows that a small proportion of people who now live with long-term Covid may not have shown any symptoms of Covid-19 when they were originally infected – or their symptoms were mild or unusual, similar to those had a Timer.
“It was the most horrible moment of my life.”
Within about two weeks, Timer recovered from an acute infection with Covid-19. But when she returned to work, she still felt unusual, with problems such as overheating, confusion, loss of taste, sound hallucinations and shortness of breath.
“I realized that the more I tried to walk or get back to normal, my symptoms got worse and I would be in bed with pain and fatigue for weeks,” Timer said.
“It was the most horrible moment of my life,” she said.
Timer retired early – before her illness, she had not planned to retire – and moved to New Mexico in November 2020 to live with her sister while she sought treatment for her continuing symptoms. In February 2021, she moved to Michigan to live with her son.
Some people with long-term Covid said they have noticed that their symptoms are relieved after being vaccinated against Covid-19. Studies also show that vaccines not only reduce the risk of serious illness and hospitalization, but can reduce the chances of long-term symptoms of Covid-19.
Timmer was originally diagnosed with Covid-19 before the vaccines became available in the United States. Once authorized for her age group, she was vaccinated – and reinforced. She felt well after the first dose of the vaccine, but her long symptoms of Covid continued.
Timer still has “exhausting” symptoms from the long Covid and she is not alone.
A preprint published last year on the MedRxiv server includes an analysis of more than 1,400 medical records in California for people who tested positive for Covid-19. Approximately 32% of those who reported long-distance symptoms more than 60 days after diagnosis of Covid-19 were found to have no symptoms during their initial Covid-19 test.
“I have seen similar things in the clinic. Patients who come either without symptoms or with very mild symptoms such as sore throat, cough, maybe a little sneezing and a few weeks later a debilitating headache, inability to get up in the morning or just relentless fatigue and weakness. And before we realized that the long Covid was really a phenomenon, we didn’t know what to do, “said Dr. Ali Khan, who specializes in internal medicine at Oak Street Health in Chicago.
In some people, “we see how the coronavirus itself interacts with almost every part of the human body, which is so atypical of most diseases, especially most viruses. So we see this in some people – even people whose initial infections were silent – to act in the bloodstream to make you more likely to get a blood clot, “he said. “For other people, this coronavirus attacks nerves and causes nerve pain; causes headaches; causes long-standing sciatica, which many of my patients deal with.
“Even people who have not had symptoms of COVID-19 … may have conditions after COVID.”
The Centers for Disease Control and Prevention in the United States describes long-term Covid or “post-Covid” conditions as a wide range of new, recurring, or continuing health problems four or more weeks after acute Covid-19 infection.
“Even people who did not have symptoms of COVID-19 in the days or weeks after being infected may have post-COVID conditions,” according to the CDC. “These conditions can present as different types and combinations of health problems for different periods of time.”
The medical consensus is that Covid-19 is an “acute disease” and long-term Covid is a “subacute chronic disease,” said Dr. Adupa Rao, a pulmonologist at Keck Medicine at the University of Southern California who treats long-term patients with Covid in Keck Medicine COVID Recovery Clinic.
“In the medical world, acute diseases usually mean one to two weeks of illness. Subacute means two to four weeks, and chronic means something between four and six weeks, which is long,” Rao said. “So, chronic long-term symptoms of Covid are usually people who do not return to or close to baseline after the initial infection – and the ability to diagnose Covid for a long time is quite difficult.”
Estimates of the long-term incidence of Covid range from about 30% to more than half of people who have recovered from an acute Covid-19 infection. Women and older people seem to be more likely to have it than men and younger adults. Although the risk of prolonged Covid-19 appears to increase with the severity of acute Covid-19 infection, nearly one-third of people who had mild symptoms when they were first diagnosed may have symptoms months later, according to some. estimates. “We know that even a mild or relatively asymptomatic acute infection with Covid can eventually cause long-term Covid,” said Dr. Gerald Harmon, a family medicine specialist and president of the American Medical Association.
“Between 10% and 30% of patients may experience symptoms of Covid after apparently recovering, even if they were not ill in the first place,” he said. “And it’s a wide range of new, recurring or continuing health problems that we’ve usually divided into three different categories.”
The first category, Harmon said, includes people who have direct cell damage caused by the coronavirus during the initial infection and it takes a long time to recover. Examples include acute kidney damage, acute lung damage, a major pneumonia infection, or a blood clot in the brain.
The second category describes people hospitalized with Covid-19 who may have long-term complications from bed attachment for weeks, such as neurological damage, lung damage, or muscle weakness.
Experts are “probably more concerned” about the third category, Harmon said. Includes anyone who has recovered from an initial Covid-19 infection that was not severe but then had symptoms.
“And they think, ‘My God, is this a re-emergence of Covid’s infection?’ Is it slow? This new thing disguised as Covid? Or is Covid disguised as something more common, such as pneumonia? ”Said Harmon.
One review paper analyzed 11 studies published between December 2019 and September 2021 on people with asymptomatic or mild forms of Covid-19. The analysis suggests that long-term Covid develops on average in about 30% to 60% of patients, with the most common symptoms being fatigue, shortness of breath, cough or loss of taste and smell.
Many long-term Covid studies tend to bring together people who initially had asymptomatic or mild infections, wrote Dr. Linda Gang, co-director of the COVID-19 Post-Acute Syndrome Clinic at Stanford Health Care, in an email.
For example, one of the findings of this review is that the presence of anosmia or loss of odor during an asymptomatic or mild course of the disease may be “predictors” for the development of prolonged Covid. If there is anosmia, then someone is not completely asymptomatic, writes Gang.
In other studies, “some of the patients who were labeled as ‘asymptomatic’ may have had symptoms that were not treated or captured” in their electronic health records, Gang wrote.
“Some patients didn’t think they had COVID until they were tested and instead thought it was just an allergy or something. All of this can be difficult to draw clear conclusions from studies due to certain limitations and complexity. We need additional learning in this area, “she said.” However, it is clear that you do NOT need to have severe acute COVID to develop Long COVID. “
“She didn’t want to live in a wheelchair”
Los Angeles-based director Nick Gute says his wife, screenwriter Heidi Ferrer, was among those who did not initially have a severe infection with Covid-19, but still developed debilitating long-term symptoms of Covid.
In April 2020, Ferrer showed signs of Covid’s toes – which included discoloration and swelling – “and that bothered her because she read about Covid and had some very mild gastrointestinal symptoms that were a mild upset stomach for a day. or two. That made her think she needed to be tested, “Gute said. “So she didn’t have the serious lung problems that some people have who really have trouble breathing.
Gute and Ferrer visited a Covid-19 test site at the University of California, Los Angeles. Both cheeks were washed with a swab and the test was negative.
But within six weeks, Ferrer Covid’s toes had deteriorated, making it difficult to walk. The woman, who walked 90 minutes a day, could barely walk 100 feet without a sharp pain in her legs, like diabetic neuropathy.
On May 28, 2020, “I remember her birthday at my mother’s house very clearly, because she had to sit on a pillow with her feet and could no longer wear sneakers. They were too painful. She only had to wear them to walk on the sidewalk and then take them off when she came in …
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