How Long COVID Will Change Healthcare

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If we can understand the disease patterns of Long COVID, and if those patterns become predictable, then that means they are potentially preventable and treatable, said Katelyn Jetelina, MPH, PhD at the Institute of Functional Medicine Annual International Conference in Orlando, Florida.

The problem is, long COVID is a complex disease to study, explained Jetelina, an epidemiologist, data scientist, and scientific communicator. She said long COVID has become an umbrella term for a constellation of symptoms, making it difficult for scientists to reach a consensus on its general definition. In addition, while countless people, young and old, have reported symptoms of long COVID, the condition's prevalence is still unclear.

“It’s estimated that there are around six to seven million Americans suffering from long COVID today,” said Jetelina. "But it's imperative that I say up front that we don't really know the incidence or how many people get it per infection. That's been difficult to grasp over the past couple of years.”

However, according to Jetelina, just because it’s difficult to study does not mean long COVID isn’t a real issue. While there’s little empirical evidence on long COVID, the condition is undoubtedly biologically plausible, Jetelina explained. Experiencing lasting symptoms following a viral infection is not a new phenomenon. In addition, research has found that variables like a high viral load and more severe variants are linked to long COVID.

“There's a very strong relationship between SARS-CoV-2 viral load and long COVID,” said Jetelina. “A recent study found the level of RNA in blood positively predicts long COVID three months after infection.”

Jetelina explained that there’s also a scientific explanation for the extensive range of symptoms in both acute COVID-19 and long COVID. “The virus can enter almost every organ and create damage, creating this wide variety of symptoms around patients.”

To Jetelina, long COVID is a very real problem with significant consequences. In her presentation, she argued the condition will have profound impacts on patients, doctors, and the healthcare system as a whole.

“The health footprint of SARS-CoV-2 is going to extend decades beyond immediate impact,” Jetelina said. She explained that healthcare systems will increasingly face COVID-19 post-ICU recovery, resource restrictions due to non-urgent COVID-19 conditions, and interruptions of care for chronic conditions.

Most importantly, long COVID severely affects the health and well-being of many patients, said Jelelina. While some cases are relatively mild, in others, long COVID triggers additional health problems and becomes completely debilitating. And while some treatments have shown promise, such as metformin four days within symptom onset, the cure for long COVID remains a mystery.  

“We must convince institutions and funders to invest in long COVID clinical research infrastructure because the problem is not going away,” Jetelina urged. “Patients are going to continue to suffer unless we all really take a multidisciplinary approach to long COVID.”

Editor's note: This article is part of our live coverage of the 2023 Institute for Functional Medicine Annual International Conference. Click here for a list of full coverage.