Among the uncertainties and worries that living with COVID-19 presents, long COVID-lingering effects of the disease that persist longer than four weeks after an initial infection clears-is a big one. Patients with long COVID, sometimes dubbed "COVID long-haulers," report symptoms ranging from headaches, to chronic fatigue, to shortness of breath; the long-term impacts of the condition are largely unknown.
To answer the many puzzling questions about long COVID, researchers at Boston University's School of Medicine and Boston Medical Center (BMC) are beginning to investigate "post-acute sequelae of SARS-CoV-2 (PASC)," the medical term used for the array of long COVID symptoms. The newly launched project, called the RECOVER (Research COVID to Enhance Recovery) study, is part of a national effort-funded by the National Institutes of Health-that aims to better understand who is at risk, how recovery varies in different people, and what can be done to prevent the condition and treat patients.
Being able to fully understand long COVID starts with being able to properly define it, says Jai Marathe, a coprincipal investigator on the RECOVER study. She says that's been difficult since symptoms are so varied.
"Patients with long COVID may present with a variety of different symptoms and no two patients are the same," says Marathe, a BU School of Medicine assistant professor who specializes in infectious diseases. "The important thing to note is that we are learning about long COVID along with our patients-and we are constantly evaluating our treatment recommendations to address the patients' needs. For some, [symptoms] are mild, but can be debilitating for others."
Marathe is also the founding director of the ReCOVer Long COVID Clinic at BMC, a multidisciplinary clinic with specialties that include neurology and behavioral health, and that currently has about 85 patients under its care. The RECOVER study will recruit from the clinic, and also have a control group of people who are not displaying signs of long COVID.
"The tough part to date has been that studies have used different definitions of long COVID. A well controlled cohort like this one, with a large number of patients, can help clarify the biological and clinical features that are hallmarks of PASC," says Nahid Bhadelia, an infectious diseases expert and physician at BMC, BU School of Medicine associate professor, and founding director of BU's Center for Emerging Infectious Diseases Policy & Research. Bhadelia is a coprincipal investigator on the RECOVER study-which will take place over the next three years-and is helping BMC collaborate with five other Boston-area hospitals that are also a part of the national project.
To learn more about the study and the effects of long COVID, The Brink spoke with Anna Cervantes-Arslanian, a coinvestigator on the project and a neurologist at BMC-the primary teaching hospital of BU School of Medicine-who works with patients in the long COVID clinic. She's also a neuro-ICU specialist and BU School of Medicine associate professor of neurology, neurosurgery, and medicine. Cervantes-Arslanian recently led a study for the Society for Critical Care Medicine involving over 16,000 patients hospitalized with COVID-19 to look at associated risk factors and serious neurologic outcomes, like encephalopathy, stroke, and seizure.
This conversation was edited for length and clarity.
