Dr. Samuel Detwiler, a primary care physician with BHS Primary Care in Chicora, said long COVID continues in the county.

In the three years since a mysterious and deadly virus called SARS-CoV-2 landed in Pennsylvania and began spreading, doctors and disease experts have learned many and varied factors about the virus that caused a global pandemic.

One of the more interesting abilities of the virus, which causes COVID-19, is its symptoms hanging on or reappearing in those who contract it.

That unfortunate circumstance is largely known as “long COVID.”

“The World Health Organization has developed a definition for post-COVID-19 (the WHO’s term for long COVID) as coronavirus symptoms that persist or return three months after a person becomes ill from infection with SARS CoV-2, the coronavirus that causes COVID-19,” said Dr. Samuel Detwiler of BHS Primary Care in Chicora.

He said symptoms can come and go, but have an impact on the sufferer’s everyday functioning and cannot be explained by another health problem.

Detwiler said a recent study of medical records from 122 U.S. health systems aimed to hone in on long COVID symptoms.

Included in the study were the electronic medical records of more than 17,000 patients who had COVID before April 14, 2022, as well as the records of 17,000 people diagnosed with another respiratory virus between March 1, 2020 and April 1, 2021, plus almost 16,700 people who went to a health care setting between 2020 and 2021 but were not diagnosed with a virus, Detwiler said.

“The results indicated that certain common long COVID symptoms are not actually more common after COVID than after other respiratory viruses,” Detwiler said.

He said the study found long COVID had a stronger association with heart palpitations, hair loss, fatigue, chest pain, difficulty breathing and joint pain.

Detwiler said as of Jan. 16, 15% of all adults in the U.S. reported having long COVID symptoms at some point.

Of those who had long COVID, more than half no longer are reporting symptoms, Detwiler said.

“Looking ahead, although a smaller percentage of people with COVID are reporting long COVID, 5% of the adult population is struggling with activity limitations from long COVID,” he said.

Regarding which COVID patients are more likely to contract long COVID, Detwiler said recent research has identified four factors that correlate with greater risk of long COVID.

Those factors are Type 2 diabetes, prior infection with Epstein-Barr virus, level of SARS-CoV-2 RNA detected in the blood, and the presence of autoantibodies.

Detwiler said long COVID lasts about two weeks for most people, while others experience lingering symptoms even after symptoms disappear and they test negative.

“For the majority of long COVID patients, the good news is that many have profound recovery by three to six months after their symptoms,” Detwiler said. “Probably less than 10% have symptoms for longer than a year, and an even smaller percentage are still having symptoms that are considered moderate or severe for more than a year and a half.”

While most patients experience shortness of breath on exertion, decreased exercise capacity, feeling more tired, lingering cough or brain fog, another type of long COVID involves the heart and lungs.

Those patients likely had severe illness that affected those organs during acute infection, Detwiler said.

Doctors also learned that COVID can lead to nerve damage that alters the sense of smell and taste, and some people will have nonspecific neurological disturbances such as tingling or discomfort.

Ringing in the ears, numbness and tingling in the hands and feet, problems with concentration and memory, and chronic fatigue are other neurological hangers-on after COVID, Detwiler said.

Increased heart rate and lightheadedness when changing body position are other symptoms doctors have heard from those who had COVID, he said.

When doctors in the BHS system diagnose a patient with long COVID, which is done based on their previous COVID status and a thorough examination and full evaluation, the first approach to treatment is lifestyle modification.

“We start by making recommendations that people can implement immediately,” Detwiler said.

He suggests patients think about their symptoms as a potentially longer-term issue instead of a cold that clears up within a week or two.

Because long COVID patients have diverse symptoms, patients should start at the primary care physicians, who may recommend follow-up treatment with a specialist in neurology, cardiology, pulmonology or other areas if necessary, Detwiler said.

He said the Butler/Excela Health System can help long COVID patients with all their needs.

“Your primary care doctor should manage your care and support your recovery every step of the way,” Detwiler said.