Finally, scientists are making progress on long COVID

I’ve been thinking about the old-fashioned term “invalid.” In the 19th century, popular literature was awash with characters like Beth in Little Women, who patiently knitted away in her sickbed until she succumbed to long-term damage from scarlet fever. Characters like Beth were a prettied-up version of reality. Many children died or were disabled by diseases that we can now fend off with antibiotics and vaccines.

My mother could have been one of those grim true-life stories. As a child in the 1930s, she almost died from an infection of the mastoid bone, which is typically caused by ear infections. In the pre-antibiotics era, it was a leading cause of childhood death. Mom remembered long, lonely weeks lying in bed, staring out the window at children playing, and then many more months of being a weak, sickly child. She recovered and grew up to become a nurse specializing in pediatrics. I still have her copy of Little Women.

COVID-19 may seem a long way from Little Women, but in an odd way we’re also stuck in the part of the plot where people suffer and languish. Researchers around the world are trying to figure out how the SARS-CoV-2 virus causes lasting damage to the human body, and what treatments could restore health to those suffering from long COVID.

It’s a huge challenge, in part because there’s no test yet to determine if someone has long COVID. Instead, there’s an unruly bundle of symptoms that can include problems thinking, exhaustion, heart issues and joint aches. These ailments are common to many diseases. That makes it difficult to get a diagnosis, let alone treatment.

But recent advances in unraveling long COVID’s mysteries are exciting researchers, senior writer Meghan Rosen reports. Immunologist Akiko Iwasaki told Rosen that it’s as if there’s a “picture being revealed from the fog.”

That includes new findings on cognitive problems that are a persistent symptom of long COVID. In March, researchers reported that patients with what’s commonly called brain fog can have a leaky blood-brain barrier, which may allow viruses, cells and other intruders into brain tissue. The brains of patients without brain fog aren’t similarly affected.

Researchers are also searching more broadly, looking for clues to how the virus plays havoc with the immune systems of long COVID patients.

Rosen, an ace journalist with a Ph.D. in biochemistry and molecular biology, had her own reasons for wanting to find out the state of long COVID research. After catching the virus, she suffered for months with exhaustion and leg pain. Her doctor tested for all sorts of illnesses, including Lyme and thyroid disease, but the tests came back negative. So, probably long COVID, but who knows? Rosen kept trying to manage work and family, only to find herself wiped out if she pushed a bit too much.

Fortunately, Rosen’s now feeling much better, pretty much back to her usual energetic self. But many long COVID patients, she notes, are not so lucky. They’re waiting and hoping that science will help them move on from this wretched chapter in their lives.

Nancy Shute is editor in chief of Science News Media Group. Previously, she was an editor at NPR and US News & World Report, and a contributor to National Geographic and Scientific American. She is a past president of the National Association of Science Writers.