Is there a “chronic” form of COVID-19?

There have been reports from credible sources that some patients have a “chronic” or prolonged version of corona virus infection. These reports describe symptoms that range from recurrent fevers and myalgias, often associated with weakness and tiredness. Some of these patients have been diagnosed with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). As many may know, this disorder has no known etiology, but can be very debilitating for many of its sufferers. 

Chronic patients need to be accurately diagnosed as having COVID-19.

While it is very possible that there is a post viral syndrome associated with COVID-19, I feel that some caution is important in this regard. Many of the patients with these symptoms have not been shown to have been infected with COVID-19, either by PCR swab tests or by looking for COVID antibody in the blood. In addition, there are also a number of other infections reportedly present in the population that had been associated with chronic fatigue or post viral syndromes. This may make it difficult to differentiate a recurrent syndrome from COVID-19 to those from another source. 

I think it’s very important for any physician or patient considering a diagnosis of chronic post viral syndrome from COVID-19 to first document that the patient has actually been infected with COVID-19. Since many of these patients are weeks out from their initial clinical symptoms, it would be best to accomplish this with screening for COVID antibodies in the blood. FDA approved assays are now robust and reliable, and can identify almost all patients who have been infected.

It would also be important to determine if the patient has recurrent viral shedding by PCR swab test to make sure that they are safe to associate with uninfected individuals. Recent data from Korea have suggested that chronic shedding with this virus does not occur even in patients with chronic symptoms. Given this, it is likely that even with symptoms these patients are safe.

In summary, a chronic, post viral syndrome following COVID-19 infection may exist, but the patient first needs to be diagnosed as having COVID-19 before any assumption as to the nature of their symptoms. 

Published by jbakerjrblog

Immunologist, former Army MD, former head of allergy and clinical immunology at University of Michigan, vaccine developer and opinionated guy.

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