Long-term side effects of COVID-19 have been reported even after people recovered from the virus: shortness of breath, hair loss, and cardiovascular problems to name a few. Another long-term effect is fatigue. For example, one study for patient recovery conducted in Italy and published in JAMA found that of 143 of those who participated in a follow-up assessment, more than half reported long-term feelings.
In recent months, doctors have warned of a “post-viral syndrome” following COVID-19. It is similar, they say, to chronic fatigue syndrome (CFS) as myalgic encephalomyelitis (ME), referred to by the CDC as ME / CFS, which is an often debilitating condition defined by extreme fatigue and a range of other symptoms (more on this letter). Here is what we know about the long-term symptoms that some patients experience that seem to be in balance with chronic fatigue syndrome.
What is chronic fatigue syndrome?
According to the CDC, people with ME / CFS have fatigue that is overwhelming, does not improve with rest, and may worsen after physical or mental exertion. It affects their ability to perform daily tasks, and includes other symptoms: muscle and pain, joint pain, headache, concentration problems that are often described as “concussion”, such as dizziness. Some people with ME / CFS may also have a headache, indigestion, chills and night sweats, shortness of breath, and an irregular heartbeat.
Certain viruses can potentially trigger the onset of ME / CFS, such as Epstein-Barr virus (a member of the herpes virus family and one of the most common human viruses, which can cause mono) or Ross River virus. (a virus spread by mosquitoes that can lead to joint pain and fatigue). Much about ME / CFS is difficult to find because researchers have not yet found out exactly what causes it, symptoms may look like other conditions, and there are no specific tests to diagnose it.
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Is chronic fatigue syndrome a side effect of COVID-19?
Doctors from foreign universities wrote a paper in June citing Severe Acute Respiratory Syndrome (SARS) as an example of another coronavirus that resulted in ME / CFS-type disease. “We suggest that once an acute COVID-19 infection is overcome, a subgroup of remitted patients is likely to experience long-term adverse effects similar to CFS / ME symptomatology such as persistent fatigue, diffuse myalgia [muscular pain and tenderness], depressive symptoms, and non-restorative sleep, “she wrote.
They pointed to the research of Harvey Moldofsky, MD, a former professor at the University of Toronto who studied SARS patients. He told Business Insider that through his research he saw people who had recovered from the acute SARS disease but had lingering symptoms, similar to what he classified as fibromyalgia syndrome (FMS) – a chronic condition that includes causes pain, stiffness, and tenderness to muscles, tendons, and joints – as well as chronic fatigue syndrome. The subjects he studied were mostly health care workers and they could not return to work after SARS for an average of up to 20 months. The hypothesis is that this may be the same for COVID-19 patients because of, most likely, an immune response that causes inflammation in the body.
Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases, said in an interview on July 17, and in interviews thereupon, “it’s amazing how many people have a post-viral syndrome that is very striking compared to myalgic encephalomyelitis / chronic fatigue syndrome. “
It may be chronic fatigue syndrome, but this doctor is not quick to define it
David Putrino, a physical therapist with a PhD in neuroscience, is the director of Innovation for Rehabilitation at the Mount Sinai Health System. He works closely with patients from the Center of Mount Sinai’s Center for Post-COVID Care, and he agrees with Drs. Fauci, however, told POPSUGAR that from his perspective the long-term effects his patients experience may be ME or CFS or dysautonomia. Symptoms of both diseases overlap, although he tends more towards something resembling dysautonomia. It is a disorder of the autonomic nervous system that can cause dizziness and curse, chest pain, cardiovascular and GI problems, fatigue, intolerance to exercise, sleep deprivation, memory and concentration problems, and more.
The patients who Dr. Putrino looks to be referred to as “COVID-19 cases” with long lungs with symptoms including unexplained high heart rate, cognitive fog, shortness of breath, and extreme fatigue after any kind of exertion, especially exercise. Some have a change in heart rate and blood pressure simply from transition from lying to sitting and from sitting to standing, which, said Drs. Putrino, can happen because of dysautonomia. Patients are also seen with GI symptoms that vary depending on the individual, but they include acid reflux, diarrhea and constipation.
Some people will often share with Dr. Putrino and his team that certain things trigger an “attack” of symptoms. “When they wear tight clothing, sort of around the chest, they feel very sluggish and in pain, and then their symptoms will come up,” he said. Others have reported that their symptoms may be triggered by change in temperature (which he sees with dysautonomia) or eating a large meal.
The interventions that Drs. Putrino and his team advise for these patients are highly individualized, but when the patient is ready and clears heart pathology, the Mount Sinai doctors try to challenge the autonomic nervous system gradually through exercise protocol with physical therapists so that the flareups of daily activities subside. The doctors have assigned breathing work to patients who are not well enough to start PT. Too much exercise too soon, explained Dr. Putrino, could actually make symptoms worse.
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What to do if you think you may have chronic fatigue after COVID-19
Dr Putrino said if you experience “anxiety symptoms”, such as heart palpitations in your chest or extreme fatigue where you leave your bed was never a challenge, but now it is, these are indications that you should call your doctor. “The things to look out for are the idea that all of a sudden you always feel like your heart is racing and you almost feel like you have no energy and that there is something physical that is getting you out of bed,” he explained. “The other really common symptom is the cognitive fog as concentrating difficulty.”
The median age of people who Dr. Putrino and his team treatment is 38, he said, and these lingering symptoms affect more women than men (note: as for ME / CFS, women are two to four times more likely than men to diagnose, according to the Office on Women’s Health). Dr. Putrino expects the recovery period to be three to six months, but, again, they may not be too sure; there is still a lot to learn. “An important piece for us is to just install them with the confidence that this is a long road, and sometimes you will have bad days because that is what chronic illness is,” he said.
“What has happened here is a virus has caused a very traumatic event for the body,” explained Dr. Putrino. “It’s causing physiological challenge, and the outcome is that our autonomic nervous system is a bit off kilter as a result of that extreme stress and trauma to our physiology.” Currently, he and his team call this lingering disease a ‘post-viral dysautonomia-like syndrome,’ although he says some doctors will argue that the disease is more targeted with ME / CFS. However, he and his team are not too busy giving it a name. Instead, they are focused on managing symptoms as they come “because that’s what our patients need at the moment.”
