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What Causes Long COVID?

Doctorpedia Editorial Team Doctorpedia Editorial Team November 18, 2021
Medically reviewed by Susan Kerrigan, MD and Marianne Madsen

Having COVID is bad enough. The symptoms, including difficulty breathing, fatigue, mental and/or emotional issues, muscle and joint aches and pains, and loss of smell and/or taste, can be debilitating. Even worse? Those symptoms may not just go away. According to a recent study of people who have had COVID, more than half of those who have suffered through a case of COVID will have lingering symptoms for at least six months after they “recover.”

 

What is causing this phenomenon? It’s not a new thing–many people suffer long-term symptoms after experiencing an infection. In fact, there are many syndromes, such as myalgic encephalomyelitis (chronic fatigue syndrome) and PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections) that are linked to specific infections. While it’s not known specifically why these infections cause long-lasting effects, a potential culprit has been identified for long COVID–blood clotting.

 

COVID and Blood Clotting Markers

 

A recent study followed a group of 50 patients who had long COVID symptoms, including fatigue, breathlessness, and an inability to return to former fitness levels. These patients had been “recovered” from COVID for at least six weeks. In addition to a regular clinical workup, they walked for six minutes, then had blood drawn for analysis.

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COVID-19 Long Hauler – Overview

COVID-19 Long Hauler – Overview

The researchers discovered that clotting markers were significantly elevated in the long COVID patients when compared to healthy controls. The clotting markers were highest in those patients who had been hospitalized due to COVID, but even those patients who had managed their COVID symptoms at home had higher clotting markers. “Because clotting markers were elevated while inflammation markers had returned to normal, our results suggest that the clotting system may be involved in the root cause of Long COVID syndrome,” said Dr. Helen Fogarty, the study’s lead author, ICAT Fellow and PhD student at the Irish Centre for Vascular Biology in the RCSI School of Pharmacy and Biomolecular Sciences.

 

Why Does COVID cause blood clotting?

 

Researchers think that the abnormal blood clotting caused by a COVID infection may be from the high levels of inflammation that COVID causes throughout the body. These levels of inflammation can affect all types of body systems and organs. They are also thought to be the cause of MIS-C (multisystem inflammatory syndrome in children), and these levels of inflammation are particularly hard on the heart.

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COVID-19 Long Hauler – Symptoms

COVID-19 Long Hauler – Symptoms

However, the finding of this study–that the inflammatory markers in the blood had returned to normal, likely signifying that inflammation had subsided, but the blood clotting markers were still significantly elevated–is puzzling and requires further research as to why.

 

What Does it Mean?

 

If you’ve had COVID, especially if you had a related hospital stay, you may have long-term symptoms that just don’t go away. It’s possible that these symptoms are related to the problems caused by the blood clotting associated with COVID. Work with your healthcare provider to come up with a plan to help you deal with your lingering symptoms. Researchers are working on these issues to help those with long COVID get to a full recovery.

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