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Here's what we know about long COVID and its treatment


On March 13, 2020, then-President Donald Trump declared the coronavirus pandemic a national emergency. Three years later, as the end of that national emergency approaches, the CDC has released a guidance saying, quote, "the virus that causes COVID-19 can have lasting effects on nearly every organ and organ system of the body weeks, months and potentially years after the infection." Have we even begun to dent the surface of what we know about so-called long COVID and its effects? Dr. Leora Horwitz is a physician at NYU Langone Health. She works with patients who still have COVID symptoms months, sometimes even years, after the initial infections. Dr. Horwitz, thanks so much for being with us.

LEORA HORWITZ: It's my pleasure.

SIMON: Some of the language that the CDC used is - let me put it this way - unforgettable. They say that complications could include cardiovascular, pulmonary, neurological, renal, endocrine, hematological and gastrointestinal complications as well as death. Help us understand this in the most practical terms.

HORWITZ: Well, that's absolutely true. And it's what makes the study and the treatment of long COVID so difficult. What we are seeing is that the virus can affect any part of the body. We see that in the acute infection when people first have COVID, but we see it especially in this long COVID. So people are describing all kinds of symptoms whether they are general, like fatigue or exhaustion, to more specific, with certain organs. People are having confusion or difficulty concentrating. People are having inflammation of the heart. People are having trouble breathing. People are having dizziness when they stand. And it's possible that all of that is related to the same sort of underlying problem, or it's possible that there are different kinds of causes that are leading to different kinds of symptoms in different people. We just don't know enough yet.

SIMON: How many patients have you seen who you would put into these categories?

HORWITZ: Oh, well, I see plenty as they come through the hospital or elsewhere. I have the most experience because I'm helping to lead the National Institute of Health's study of long COVID across the country. We don't know an exact number yet in part because we don't have an exact definition yet. But it's clearly a meaningful proportion of people who originally get COVID who go on to still have symptoms months later.

SIMON: Have we gotten better at treating it?

HORWITZ: We don't know very much yet about treating it. Right now, people are mostly treating the symptoms, trying to help people who have dizziness to not have dizziness, trying to help people who have trouble breathing with rehabilitation. We are starting to see a lot of trials, however, beginning with specific treatments for the virus itself or for the consequences. And I have confidence that we will get much better at treatment in the next couple years as we learn more about the underlying cause.

SIMON: As I certainly don't have to tell you, COVID restrictions are - and precautions are dropping all over the country. You know, and there have been profound economic, social and educational losses from prolonged COVID lockdowns. Now, the White House has announced an end to the national and public health emergencies to come in May. What's your reaction?

HORWITZ: Well, I think it is important that we learn how to live with a virus that's never going to go away. But I think what that means is trying to minimize our risk. That means keeping up to date with vaccinations as they come out. I think that in terms of the long COVID, people should extend grace. I think in many places, even in many doctor's offices, people don't recognize yet that this is a real disease. And because we don't have a blood test or an official diagnosis yet, it's easy sometimes for people to feel that it's all in their head or they're just being difficult, and that's just not the case.

SIMON: Did I hear you say there are doctors that don't recognize long COVID?

HORWITZ: Yeah, I think there are still some. And we have seen this for a long time with post-viral conditions of other kinds, too. So it takes a while to get knowledge into the medical community especially as we are - all of us are learning still. But the basic concept that there is a post-viral-condition long COVID that can happen after SARS-CoV-2 infection is not in dispute.

SIMON: Dr. Leora Horwitz is a physician at NYU Langone Health in New York City. Thanks so much for being with us.

HORWITZ: Thank you for having me. Transcript provided by NPR, Copyright NPR.

Scott Simon is one of America's most admired writers and broadcasters. He is the host of Weekend Edition Saturday and is one of the hosts of NPR's morning news podcast Up First. He has reported from all fifty states, five continents, and ten wars, from El Salvador to Sarajevo to Afghanistan and Iraq. His books have chronicled character and characters, in war and peace, sports and art, tragedy and comedy.