Q&A: How 'Long COVID' Is Impacting San Diegans

Speaker 1: 00:00 Just like the pandemic itself, the COVID-19 virus can have long-term consequences and estimated 10% of people who've been sickened by the virus have developed what's being called long COVID and array of symptoms that linger sometimes months after their initial illness, a new clinic has been established by UC San Diego to treat these COVID long haulers and research how the virus can cause these long-term effects journey is Dr. Lucy Horton, founder of UC San Diego Health's post-acute COVID-19 telemedicine clinic and Dr. Horton, welcome to the program. Thank you so much for having me here. I said about 10% of COVID patients develop lingering symptoms. Is that right? I've heard the percentage could be higher. Speaker 2: 00:47 Great question. So there's not a lot of great data on it. Reports have estimated between 10 to 30%, but I suspect that we're really only seeing the tip of the iceberg here. There's probably a lot more patients that are suffering from long COVID, who just haven't presented to care yet, or aren't aware that their symptoms are those of long COVID. Speaker 1: 01:10 And what are the most common complaints and complications that you're seeing in people who have recovered from COVID, but have these long-term complications? Well, the symptoms Speaker 2: 01:21 Vary greatly among patients and they really reached the whole spectrum in terms of different organ systems involved. Some of the most common symptoms we see are persistent fatigue, reduced exercise tolerance, uh, post exertional, malaise feeling really exhausted and crummy after minimal activity. Um, there are neurologic components like brain fog, headaches, difficulty with memory, um, or concentrating. Uh, we see some cardiovascular effects. So, uh, issues with rapid heart rate, um, difficulty controlling the blood pressure. There are some lingering respiratory symptoms in some patients, for example, chronic cough development of asthma, difficulty breathing. Some patients may have chronic nausea, diarrhea, you know, there's really quite a range of symptoms. I think the ones that really, um, are the most prominent that the majority of patients experience is some form of fatigue and muscle ache and, um, the sensation of brain fog. Speaker 1: 02:31 Yeah. Can you describe that brain fog that lingers for some people? How does it affect people's lives? Speaker 2: 02:39 Yeah, it's a really concerning symptom because it really does affect people's ability to return to their, um, pre COVID lives. Uh, the brain fog is often described to me by patients as feeling like, um, they're just not as sharp as they used to be. Um, their, their reactions are delayed. Um, I'll give you an example. I had a patient who, um, told me that she had set up a zoom meeting with colleagues and when she logged on to the zoom meeting, she just couldn't remember why she had even set up the meeting and she had to ask them, why are we meeting? And that caused a lot of distress. You know, she's worried about I'm losing her job because she's not performing well. And her colleagues are worried about her. You know, people describe, um, getting in their car to go drive somewhere and not really remembering where they're going to drive, um, difficulty concentrating on, um, tasks. Like I've had a couple of patients who are lawyers who say, when they sit down to read some of the legal documents, they it's very exhausting and fatiguing, um, because they're trying to concentrate and they just feel like they're not as sharp as they used to be. Speaker 1: 03:45 Dr. Horton are the people who suffer from long. COVID the same high risk individuals for a serious COVID illness. And I'm talking about people over 65 with underlying conditions. So there Speaker 2: 03:57 Are some of those patients, those high risk patients who may have been hospitalized, who might've even been in the intensive care unit who have persistent symptoms. Um, but the majority of the patients that we're seeing with more of the classic long COVID actually had mild to moderate disease. So most of them, um, were never hospitalized, never needed to go to the emergency room. Um, a lot of them come from younger age groups. So people in their twenties to fifties who didn't really have a lot of underlying conditions, um, we definitely do not see as many who have those kinds of high-risk conditions like diabetes, obesity, immunocompromise. Um, I will note that some of those patients who had the more severe disease who are high risk, they may continue to have symptoms, um, more related to the severity of their initial illness and the fact that they were in the ICU. Um, and so there is a little bit of an overlap in the two, um, conditions at times, Speaker 1: 04:57 Does getting a COVID vaccine help resolve long COVID symptoms. Speaker 2: 05:02 We've seen anecdotal reports from across the country of patients who report improvement or even complete resolution of their symptoms after getting a vaccine. Um, we just don't have a lot of experience here since very few of our long COVID patients have been vaccinated yet. Um, but if it does in fact provide some therapeutic benefit to them, I think that would be wonderful. And you know, just another great reason to get vaccinated. Speaker 1: 05:29 Now you've told us that many of the people suffering from long COVID don't fit the profile of high-risk individuals, they tend to be younger. And that kind of flies in the face of the idea that COVID is not really risky for younger people. Doesn't it? Speaker 2: 05:45 It certainly does. And if there's one message I can give to younger people who, you know, don't think that COVID is going to affect them and may not be that concerned about catching COVID. Um, I would, you know, educate them about the potential of, you know, progressing to becoming a long hauler, um, in getting these symptoms. I think it's really quite concerning how many younger, healthier people have developed long COVID. And we really don't have a good understanding at this point, why that is and what are the underlying risk factors for developing one COVID. So really everyone is at risk and everyone should continue to protect themselves as best as possible. Speaker 1: 06:27 And do we know how long, long COVID actually is? Speaker 2: 06:31 We don't so know we've only known this virus for about 15 months now, so I can tell you that some people have symptoms past a year, but we really don't know if it's going to last a lot longer it's suspect based on what we know about other chronic conditions or chronic sequella of, uh, viral infections, that there is going to be a small subset that may have symptoms their entire life. Um, there'll also be a good number who hopefully would recover. Um, you know, within one to three years, Speaker 1: 07:04 I've been speaking with Dr. Lucy Horton. She is founder of UC San Diego. Health's post acute COVID 19 telemedicine clinic. Dr. Horton. Thank you very much. Speaker 2: 07:15 Thank you so much. Have a wonderful day.