May 18, 2022

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UNMC experts answer questions about long-haul COVID | Health & Fitness



Nebraska hit a new all-time high for COVID cases last week, but the pace of growth slowed. And hospitals across the state continued to see more coronavirus cases.







As we approach two years with COVID-19, medical understanding of the virus and disease continues to grow.

As doctors have learned more about the virus, guidance has changed even as misinformation has flourished. In an effort to provide solid information, The World-Herald, in partnership with the University of Nebraska Medical Center, is soliciting reader questions about COVID-19.

This week’s answers were provided by Dr. Mark Rupp, chief of the UNMC Division of Infectious Diseases and medical director of epidemiology and infection control at Nebraska Medicine; Dr. Andrew Vasey, assistant professor of internal medicine at UNMC and physician leader of the Primary Care Clinical Program; and Dr. Chad Vokoun, associate professor and chief of the Division of Hospital Medicine at UNMC.

What is COVID-19 long-haul syndrome?

COVID “long-haul syndrome” refers to the condition in which people continue to experience symptoms weeks or months after recovering from acute COVID-19. Some of the more common long-hauler symptoms are fatigue, malaise, headache, shortness of breath, neurocognitive problems known as “brain fog” and postural orthostatic tachycardia — rapid heartbeat and other symptoms upon standing. However, nearly all organ systems and various symptoms have been involved with the syndrome.

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How often does COVID-19 long-haul syndrome occur?

Some studies show that as many as 25% to 33% of people have one or more symptoms four or more weeks after recovering from acute COVID-19. Although persistent symptoms are more common in those with more severe illness, the long-haul syndrome can occur in those with even mild disease and in all age groups. We are continuing to gain experience with COVID-19, and we now have seen patients with long-haul symptoms persisting for greater than a year. In some people, we fear these conditions may be very long lasting or permanent.

What can one do to prevent long-haul syndrome from occurring with omicron?

We have not had enough experience with the omicron variant to know whether the incidence of long-haul syndrome will be different from previous variants. However, based on our experience with COVID-19 to date, some people infected with omicron will have lingering symptoms. The good news is that the COVID-19 vaccine not only decreases the risk of severe infection, hospitalization and death, but may also decrease the risk of long-haul syndrome. According to the Nebraska Department of Health and Human Services, in December 2021, Nebraskans who were vaccinated and boosted were 46 times less likely to be hospitalized for COVID-19 than Nebraskans who were not fully vaccinated. A recently peer-reviewed study from the U.K. showed that people who had received two doses of COVID vaccine were about half as likely to report lingering symptoms.

If I experience COVID-19 long-haul syndrome from the omicron variant, should I get vaccinated?

With the other variants, there are case reports of people’s post-COVID long-haul symptoms going away after getting vaccinated. So, if a person does get long-haul symptoms after omicron and hasn’t been vaccinated, getting vaccinated after acute illness recovery may give additional benefits.

What are the best practices to reduce the time being sick?

Not much can help reduce time being sick. Most treatments are symptomatic and are the same things used for other viral upper respiratory tract infections — staying hydrated, getting rest, taking acetaminophen (Tylenol) or ibuprofen (Motrin) for fever and pain. For people at higher risk (those with weakened immune systems, pregnant women, underlying cardiorespiratory disease, etc.), other therapies, although in short supply, can potentially reduce symptoms/prevent hospitalizations (sotrovimab, outpatient remdesivir, nirmatrelvir/ritonavir, molnupiravir). Certain other monoclonal therapies used for other variants in the past are not effective against the omicron strain.

In addition, it is smart to keep your body as healthy as possible so if you do contract COVID-19, you’ll be better prepared to fight it. Eat a well-balanced diet and consider a multivitamin/mineral supplement, get plenty of rest, try to avoid stress, exercise moderately, stop smoking. Particularly during the winter, when we are not exposed to as much sunlight, think about taking a vitamin D pill. Also, try to prevent other illnesses — get your flu shot.

Responses from UNMC medical and public health professionals are general, and are not intended as individual medical advice. Individual medical questions, particularly in cases of current illness or symptoms, should be addressed by an individual’s medical professional.

Send your questions to Executive Editor Randy Essex — [email protected] — and we’ll forward the best ones to UNMC experts.