COVID-19 is not the common cold. Here’s an effort to keep you up-to-date on long COVID developments. Not “in the clear” after first infection What we knew: Long COVID after first infection was clearly a risk. The risk of long COVID-19 after re-infection
Forgive me the short political rant, but ONLY IN AMERICA ... do we have to rely on GoFundMe and Patreon to get through medical crises.... (rant over).
As to an earlier comment about masking - to me, it is such a non-hassle, that if I am going to be indoors and among people whose health status I don't know (ranging from the local supermarket to airports), I put on my N95. At least for me, there is no "cost" (other than the mask itself) and a ton of potential benefit.
I’d like to emphasize how hard it is getting to get an accurate test. I just received a bill from my primary care provider for a PCR test ( after a direct exposure): $360 per test, after Medicare and insurance kicked in their shares. This means most people will use rapid antigen tests,
and many will not know they are positive until it is too late to take Metformin. So you are right, metformin is unlikely to work in the USA, except for rich people. Medicare for All, now, could at least help get tests and drugs to everyone.
I am a one trick pony when it comes to long Covid having lived with it for almost 3 years now. I think an example or two is worth mentioning here. I was diagnosed in early April 2020. Yesterday morning, I had heart issues (accidental VPB for the cardiologists out there) in the afternoon. I take 4 flecainides daily. No one in two generations in my family have had heart issues and I never had them until 2020. This morning I had difficulty adding 523 to 1,500 in my head and I'm pretty good with mathematics! So brain fog isn't a myth. There's more, but long Covid is by turns stubborn and protean and an almost daily companion for some of us. I think in 3 years most of my own symptoms have disappeared or lessened, but the ones remaining are doozies. Avoid it at all costs.
Katelyn - thank you for doing a post on Long Covid, even a quick one is so appreciated. There is so much we still do not know. My son, 17, developed Long Covid in March 2022. His symptoms have continually worsened to the point where he can no longer attend school in person. We live in Boston, he is seen at the Long Covid/PASCC Clinic at Boston Children's Hospital. It is a world class hospital and every specialist we have seen has taken the time to really dive deep in to his symptoms, history and try things to improve his health. As amazing as they are there is no "cure" and due to the overwhelming number of children being seen at BCH we can wait months for appointments.
Everyone has a different risk calculus but if you or a loved one develop Long Covid the cost is steep, physically, emotionally and financially.
Thank you so much for this, Dr Jetelina! This is the clearest information I’ve seen in a long time. I don’t understand why the government isn’t discussing this topic in a way designed to help people make decisions, even if we must operate from imperfect data. The silence on the issue is communicating a message they probably don’t intend — that those currently with long Covid are being left behind, and anyone who gets it moving forward can expect the same. If you have influence on the people working on messaging, could you let them know it’s not landing well?
You are right! It is hard to know which patients are vulnerable. We'll still be masking around EVERY patient on my floor because we're an oncology/autoimmune infusion center. We are very protective of our patients. Also, all staff throughout the entire health system are required to wear masks around any patient that requests it.
Re getting metformin in any sort of timely manner, it doesn't help those who don't already have a relationship with a provider, but for those who do, I'll point to what Daniel Griffin has been saying in clinical updates - "Pre-exposure period : Make a Plan.". He's generally referring to planning ahead for whether or not ones conditions and drugs play nicely with paxlovid and if not how to modify or what the next choice is (Remdesivir is infused), but it sounds like a discussion re metformin should now be included.
Metformin is cheap enough I wonder whether keeping 2 weeks on hand could become a thing.
In addition to/aside from Paxlovid and metformin, though, what I am most curious about is how preventive vaccines (particularly the bivalent) are for long covid. What's tricky about the time frame re: metformin is that it sounds like many covid infections don't appear on rapid tests until several days after symptoms begin, at which point it could be too late to get benefit from metformin.
I realize there's not likely much data on this for the bivalent booster because it's only been around since September, but I am wondering whether there's information about whether the likelihood of long covid is reduced for people who've been vaccinated with the bivalent booster.
Is the UK study saying that 4% of all adults with a Covid infection reported some type of long Covid symptom? Other estimates seem to be much higher, up to 20% or 30%. It is hard to evaluate risk when the numbers are so different. (Ex, this often cited stat that 1 in 5 US adults experienced long Covid https://www.cdc.gov/mmwr/volumes/71/wr/mm7121e1.htm)
I am an 86 year old female in relatively good health. I have not had covid and I am very cautious because long covid scares me. I don't want to spend my remaining years in a brain fog or chronic pain. If I get covid, should I take metformin rather than paxlovid? I value your opinion but of course I will also check with my doctor. I am so glad I found you! Your information is always helpful and valuable. I hope you will respond. Thank you.
What if anything is known the effects of metformin on people who are already taking metformin for diabetes before getting covid? Covid less severe? Less Long-covid? Any info? So many of us with diabetes controlled with oral agents these days, some of us must be in some data set or other!
These are important concerns. Masking on our floor includes hallways, bathrooms, and any area where patients go. Our building is only a year old, but I don't know specifics about air exchange rates and those types of things. But I do know they matter. Michael Osterholm uses cigarette smoke to help people understand how easily airborne viruses can spread. And most people, especially those over 40, can relate to that analogy.
This is very interesting news. I have been on Metformin for a few years for type 2 diabetes. Here's what's really interesting: my husband and I both had Covid in Dec, 2020. In the spring of 2021 we both got the Pfizer shots. In the fall of 2021, we got boosters with Moderna, then in May 2022 we both got another booster of Moderna. In late June 2022 we were both exposed to Covid while traveling in Europe, both tested positive. He had very mild cold/sore throat symptoms with a fever. I had no symptoms at all. I wonder if the Metformin had anything to do with my milder case!
For those who have not seen Dianna Cowern/Physics Girl's excellent videos, her You Tube channel is excellent, as is the whacky inventions (NOT its name) You Tube channel of Simone Giertz who created the video in this column. (Using Physics Babe is unlikely to find Physics Girl for those who want to see her work and witness how extremely healthy she was prior to getting Long COVID.)
Thank you for the good news that a study is now seeing a reduction in cases of Long COVID after previous illness. Is this a true change from what some previous studies had suggested, or are different timings involved, different definitions of Long COVID involved, or differences with different variants of COVID possible?
Forgive me the short political rant, but ONLY IN AMERICA ... do we have to rely on GoFundMe and Patreon to get through medical crises.... (rant over).
As to an earlier comment about masking - to me, it is such a non-hassle, that if I am going to be indoors and among people whose health status I don't know (ranging from the local supermarket to airports), I put on my N95. At least for me, there is no "cost" (other than the mask itself) and a ton of potential benefit.
I’d like to emphasize how hard it is getting to get an accurate test. I just received a bill from my primary care provider for a PCR test ( after a direct exposure): $360 per test, after Medicare and insurance kicked in their shares. This means most people will use rapid antigen tests,
and many will not know they are positive until it is too late to take Metformin. So you are right, metformin is unlikely to work in the USA, except for rich people. Medicare for All, now, could at least help get tests and drugs to everyone.
I am a one trick pony when it comes to long Covid having lived with it for almost 3 years now. I think an example or two is worth mentioning here. I was diagnosed in early April 2020. Yesterday morning, I had heart issues (accidental VPB for the cardiologists out there) in the afternoon. I take 4 flecainides daily. No one in two generations in my family have had heart issues and I never had them until 2020. This morning I had difficulty adding 523 to 1,500 in my head and I'm pretty good with mathematics! So brain fog isn't a myth. There's more, but long Covid is by turns stubborn and protean and an almost daily companion for some of us. I think in 3 years most of my own symptoms have disappeared or lessened, but the ones remaining are doozies. Avoid it at all costs.
Katelyn - thank you for doing a post on Long Covid, even a quick one is so appreciated. There is so much we still do not know. My son, 17, developed Long Covid in March 2022. His symptoms have continually worsened to the point where he can no longer attend school in person. We live in Boston, he is seen at the Long Covid/PASCC Clinic at Boston Children's Hospital. It is a world class hospital and every specialist we have seen has taken the time to really dive deep in to his symptoms, history and try things to improve his health. As amazing as they are there is no "cure" and due to the overwhelming number of children being seen at BCH we can wait months for appointments.
Everyone has a different risk calculus but if you or a loved one develop Long Covid the cost is steep, physically, emotionally and financially.
Thank you so much for this, Dr Jetelina! This is the clearest information I’ve seen in a long time. I don’t understand why the government isn’t discussing this topic in a way designed to help people make decisions, even if we must operate from imperfect data. The silence on the issue is communicating a message they probably don’t intend — that those currently with long Covid are being left behind, and anyone who gets it moving forward can expect the same. If you have influence on the people working on messaging, could you let them know it’s not landing well?
FYI - Diana’s youtube account name is Physics Girl (and has many really interesting videos!). Her struggle with long covid is awful.
You are right! It is hard to know which patients are vulnerable. We'll still be masking around EVERY patient on my floor because we're an oncology/autoimmune infusion center. We are very protective of our patients. Also, all staff throughout the entire health system are required to wear masks around any patient that requests it.
Re getting metformin in any sort of timely manner, it doesn't help those who don't already have a relationship with a provider, but for those who do, I'll point to what Daniel Griffin has been saying in clinical updates - "Pre-exposure period : Make a Plan.". He's generally referring to planning ahead for whether or not ones conditions and drugs play nicely with paxlovid and if not how to modify or what the next choice is (Remdesivir is infused), but it sounds like a discussion re metformin should now be included.
Metformin is cheap enough I wonder whether keeping 2 weeks on hand could become a thing.
This is good information and I appreciate it.
In addition to/aside from Paxlovid and metformin, though, what I am most curious about is how preventive vaccines (particularly the bivalent) are for long covid. What's tricky about the time frame re: metformin is that it sounds like many covid infections don't appear on rapid tests until several days after symptoms begin, at which point it could be too late to get benefit from metformin.
I realize there's not likely much data on this for the bivalent booster because it's only been around since September, but I am wondering whether there's information about whether the likelihood of long covid is reduced for people who've been vaccinated with the bivalent booster.
Thank you!
Is the UK study saying that 4% of all adults with a Covid infection reported some type of long Covid symptom? Other estimates seem to be much higher, up to 20% or 30%. It is hard to evaluate risk when the numbers are so different. (Ex, this often cited stat that 1 in 5 US adults experienced long Covid https://www.cdc.gov/mmwr/volumes/71/wr/mm7121e1.htm)
Wishing Dianna a full recovery.
I am an 86 year old female in relatively good health. I have not had covid and I am very cautious because long covid scares me. I don't want to spend my remaining years in a brain fog or chronic pain. If I get covid, should I take metformin rather than paxlovid? I value your opinion but of course I will also check with my doctor. I am so glad I found you! Your information is always helpful and valuable. I hope you will respond. Thank you.
What if anything is known the effects of metformin on people who are already taking metformin for diabetes before getting covid? Covid less severe? Less Long-covid? Any info? So many of us with diabetes controlled with oral agents these days, some of us must be in some data set or other!
lucy candib
These are important concerns. Masking on our floor includes hallways, bathrooms, and any area where patients go. Our building is only a year old, but I don't know specifics about air exchange rates and those types of things. But I do know they matter. Michael Osterholm uses cigarette smoke to help people understand how easily airborne viruses can spread. And most people, especially those over 40, can relate to that analogy.
This is very interesting news. I have been on Metformin for a few years for type 2 diabetes. Here's what's really interesting: my husband and I both had Covid in Dec, 2020. In the spring of 2021 we both got the Pfizer shots. In the fall of 2021, we got boosters with Moderna, then in May 2022 we both got another booster of Moderna. In late June 2022 we were both exposed to Covid while traveling in Europe, both tested positive. He had very mild cold/sore throat symptoms with a fever. I had no symptoms at all. I wonder if the Metformin had anything to do with my milder case!
For those who have not seen Dianna Cowern/Physics Girl's excellent videos, her You Tube channel is excellent, as is the whacky inventions (NOT its name) You Tube channel of Simone Giertz who created the video in this column. (Using Physics Babe is unlikely to find Physics Girl for those who want to see her work and witness how extremely healthy she was prior to getting Long COVID.)
Thank you for the good news that a study is now seeing a reduction in cases of Long COVID after previous illness. Is this a true change from what some previous studies had suggested, or are different timings involved, different definitions of Long COVID involved, or differences with different variants of COVID possible?