When could long COVID start to improve? New study offers possible timeline

As COVID-19 continues to linger in the population, serious cases are decreasing, but some milder symptoms are hanging on.

It’s called long COVID, and it can impact anyone who contracts the coronavirus.

Some experiencing long COVID have called it debilitating and raised calls to action for research and support for patients.

New research, however, suggests there is light at the end of the tunnel for those with symptoms sometimes years after an infection.

Researchers in Australia found that some of the immune abnormalities in long COVID patients resolved after about two years, “providing optimism that long COVID can resolve over time,” according to an April 17 news release from the University of New South Wales.

Here’s what you need to know.

Long COVID identified early

The study, published April 17 in the journal Nature, followed people in Australia who contracted COVID-19 during the country’s first wave in the middle of 2020.

All of the participants tested positive for the virus, but only a few still had at least one of the major symptoms (fatigue, trouble breathing and chest pain) four months after infection, according to the study.

These participants were classified as long COVID patients, and the researchers followed their progress for the next two years.

The researchers note that when the first wave hit Australia, none of the infected participants were vaccinated since vaccines weren’t available, but 85% were vaccinated during the course of the study.

When a person is infected with a virus, their immune system has a series of symptoms called biomarkers that can be used to determine how prevalent the virus is in the body.

In the study, the researchers took blood work, chemistry and immune system biomarkers from the participants at each visit to track their experience with long COVID, according to the study.

Along with the medical testing, the study participants shared self-reported health information about the symptoms they were experiencing and their overall quality of life, the study said.

Reason for hope

In 2022, the team published its findings from the eight-month mark, which showed the biomarkers of COVID-19 were present in patients with long COVID, in connection with their lingering symptoms.

The team was the first in the world to provide “a clear biological basis for the syndrome of long COVID,” the university said.

This was generally bad news as health experts continue to work to understand the possible longevity of long COVID symptoms.

But when the team tested the patients again at 12 months, then at 24 months, they were surprised to find the biomarkers were going away, and the symptoms were improving.

“Almost one and a half years later, we are pleased to see that among this same group, significant improvements were found in blood markers,” Chansavath Phetouphanh, first author on the study and a senior lecturer at the Kirby Institute in Australia, said in the release. “For the majority of samples we analyzed in the laboratory, the biomarkers previously indicating abnormal immune function have resolved.”

The authors say it is hard to quantify immune function, since it varies from person to person, but at the two-year mark, there was no significant difference between those in the study and a control group of similar people who hadn’t contracted COVID-19.

The finding isn’t universal, and as many as one third of the patients still have an ongoing impact on their overall quality of life, the researchers said. But that could be driven by other underlying factors that weren’t included in the study.

“What we know is that for most people with long COVID, both their symptoms and their biomarkers improve significantly over time, and this is a cause for optimism,” Kirby Institute director Anthony Kelleher said in the release. “Importantly, we will continue to undertake research to understand more about why some people don’t improve, and what can be done for those people.”

What to know about long COVID

There is no one universally accepted definition of long COVID, but the study authors defined the condition for their work as “generally encompass(ing) various physical and neuropsychiatric symptoms lasting longer than 12 weeks” following a COVID-19 infection.

For some, this might be a cough that won’t go away, but for others, the condition is life-changing.

Kate Whitley, a 43-year-old with long COVID, told McClatchy News the condition made her feel like she “deteriorated.”

Chuck Whestphal, a 53-year-old firefighter from Florida, died after contracting the COVID-19 virus on the job and fighting long COVID symptoms for more than two years, McClatchy News reported.

Changes to the Centers for Disease Control and Prevention COVID-19 guidelines were met with outrage from those in the long COVID community, including Joshua Pribanic, founder of the Long COVID Action Project and long COVID patient.

Pribanic told McClatchy News in March that the symptoms can have waves of improvement before worsening again, and decreasing isolation time following a COVID-19 infection could allow the virus to linger in the population and subject more people to long COVID.

The Long COVID Action Project crashed a Senate hearing in January demanding attention and funding for long COVID patients, McClatchy News reported.

Data from KFF, published April 9, estimates 17 million adults currently have long COVID. Nearly 80% of long COVID patients reported the condition limiting their activities, 25% of whom said long COVID limits their activities “a lot,” KFF found.

The CDC says people experiencing long COVID should “seek care from a healthcare provider to come up with a personal medical management plan that can help improve their symptoms and quality of life,” but no clear guidelines on treatment have been offered by the agency.

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