Catch up quick: Long COVID

Katelyn Jetelina MPH-PhD

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 was not known.

New info: In the U.K., risk of long COVID dropped after second infections compared to first infection (4% → 2.4%). This is good and bad news: Risk drops, but risk is clearly not zero.

Why it matters: There is still reason to avoid COVID-19, even if you’ve had it already.

Metformin may work
What we knew: ~300 clinical trials are testing treatments for long COVID-19, including Metformin. Results are trickling in.

New info: Metformin reduced long COVID in a large randomized control trial.

Metformin had a 42% reduced risk in long COVID cases compared to the placebo; 63% reduced risk if taken within 4 days of symptoms.

For every 100 people who took the drug, 4 fewer cases of long COVID 9-months after infection occurred.

Ivermectin and fluvoxamine had no impact.

Why it matters: People should consider Metformin, especially women who are at higher risk for long COVID. It’s best taken within 4 days of infection. This is a challenging timeframe in the U.S. medical care system, though.

Cumulative incidence curve of long COVID diagnoses over 10 months after randomization. Source: Lancet preprint.
Paxlovid may help… a little?
What we knew: Paxlovid helps reduce severe disease by 50-90%. We didn’t know if it helped with long COVID, though.

New info: Paxlovid reduced risk of long COVID by 26%, regardless of vaccination status and history of prior infection. We need more studies, particularly among young people, as Paxlovid’s effect will likely increase among younger people.

Why it matters: There may be small, proxy benefits from taking Paxlovid, including among younger populations that aren’t “eligible.”

Long COVID is annoyingly stubborn
What we didn’t know: We didn’t know the longevity of severe symptoms.

New info: Among those with long COVID, the rate in which symptoms affected daily life decreased from 45% → 25% over 7 months.

Why it matters: If you get severe long COVID, there is a chance that symptoms will get better after 7 months. Then again, there’s a chance that they won’t.

Still not convinced?
What we know: People living with long COVID report profound stigmatization because people disbelieve that long COVID is a “thing.”

New info: A YLE community member, Dianna Cowarn (also known as Physics Girl on YouTube), was diagnosed with long COVID last summer. Her crew made a 4-min video. Check it out here if you’re still not convinced. It’s painstaking.

Bottom line
COVID-19 infection is not the common cold for some. Our knowledge is inching closer to treatments. But with so much unknown, we still need to emphasize prevention—keeping COVID-19 cases low and ensuring vaccination.

Love, YLE

“Your Local Epidemiologist (YLE)” is written by Dr. Katelyn Jetelina, MPH PhD—an epidemiologist, data scientist, wife, and mom of two little girls. During the day she works at a nonpartisan health policy think tank and is a senior scientific consultant to a number of organizations, including the CDC. At night she writes this newsletter. Her main goal is to “translate” the ever-evolving public health science so that people will be well equipped to make evidence-based decisions. This newsletter is free thanks to the generous support of fellow YLE community members.