Is this COVID long or am I just getting older?

TECHNOLOGY
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You are middle-aged with new symptoms after COVID infection – fatigue, mental confusion, joint pain. Is it long COVID? Or are you just getting older?

If you wondered, you’re not alone🇧🇷

“It’s one thing,” said Dr. Alba Miranda Azola, co-director of the long-running COVID clinic at the Johns Hopkins University School of Medicine. Fortune🇧🇷

Given that the world has only seen 650 million officially registered cases of COVID — and that around 10% of the world’s population is aged 65 or older — aging and the long COVID are bound to intersect on a massive scale. This is especially true as the aging process, for many, becomes noticeable from early middle age onwards.

As patients age, “I think it gets a little cloudy,” Azola said.

There are currently no official diagnostic criteria for long-term COVID. Even the definition of the condition varies depending on who you talk to, although it’s usually considered new symptoms that start during a COVID infection or appear after one and persist for weeks or months.

To complicate matters, the symptoms and timing of aging can vary widely due to both genetic and environmental factors. So it’s not possible to definitively say whether your new symptoms are due to aging or the course of COVID, both or neither, Azola and other experts say.

“Can it be long COVID? The short answer is yes,” she said. “But it’s hard to figure out if it’s a long COVID or if other things are contributing.”

An ‘egg or chicken?’ dilemma

With more than 200 symptoms identified – from a persistent cough and fatigue to numbness in the ear and a “brain on fire” feeling – long-term COVID is arguably not one but several conditions, experts say.

True long COVID, many claim, is best defined as a chronic fatigue syndrome-like condition that develops after a COVID infection, similar to other post-viral syndromes that can occur after a herpes, Lyme disease, and Ebola infection. , among others.

Other post-COVID complications, such as organ damage, should not be defined as long-term COVID and better fit the broad category of PASC, experts say. Also known as post-acute sequelae of COVID-19, the term is used to encompass a wide variety of consequences of COVID, from symptoms similar to chronic fatigue and subsequent heart disease to lasting lung damage to strange new symptoms such as urinary incontinence, itching and skin lesions.

Signs of aging can overlap over COVID, or at least they seem to. They often include back and neck pain, osteoarthritis, chronic obstructive pulmonary disease and dementia, among others, according to the World Health Organization, in addition to fatigue.

Officially diagnosed or not, nearly 60% of the global population is estimated to have been infected with COVID, according to the Institute for Health Metrics and Evaluation at the University of Washington. Now that most global citizens have experienced the virus, it’s difficult to determine what new symptoms and conditions the virus has caused or contributed to, said Dr. Nir Goldstein, a pulmonologist at National Jewish Health in Denver, who runs the hospital’s long-running COVID clinic.🇧🇷

“It becomes challenging from a clinical perspective to temporally define causality,” he said. Fortune🇧🇷

Timing as a tip

The symptoms of aging tend to come on gradually, said Dr. Panagis Galiatsatos, an assistant professor in the Division of Pulmonary and Critical Care Medicine at Johns Hopkins, who has long-term care for COVID patients. Fortune. Not so with the long COVID.

“There really is a big difference between ‘Before I felt this way’ and ‘After I felt this way,’” he said of the long COVID symptoms following a COVID infection. “I don’t understand a lot of people mistaking their symptoms for aging.”

“Many patients will say that they feel like they have aged after COVID,” he added.

Azola has many elderly patients who have been less active in the past two years due to pandemic restrictions and now complain that exercise leaves them exhausted. Decreased activity during the pandemic — not the virus — could be to blame, at least for some of her symptoms, she said.

“The older population is experiencing a mix of decreased activity during the years of isolation and then deconditioning,” she said.

“Most respond well to more physical approaches to activity progression” or physical therapy, she said.

For now, it doesn’t matter what’s causing your symptoms, experts say, as no specific treatment for long-term COVID has been approved. Doctors treat the symptoms regardless of the cause.

Eventually, the cause of symptoms may matter if the exact mechanisms behind the long-running COVID are determined and treatments are developed, Goldstein said.

“But at this point, practically, no,” he said.

This story was originally featured on Fortune.com

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