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Long Covid Symptoms and Treatment: What We Know So Far – The New York Times

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There is no universal definition of the complex condition, but clues about causes and potential treatments are beginning to emerge.

Among the many confounding aspects of the coronavirus is the spectrum of possible symptoms, as well as their severity and duration. Some people develop mild illness and recover quickly, with no lasting effects. But studies estimate that 10 to 30 percent of people report persistent or new medical issues months after their initial coronavirus infections — a constellation of symptoms known as long Covid. People who experience mild or moderate illness, as well as those without any underlying medical conditions, can nonetheless experience some debilitating long-term symptoms, including fatigue, shortness of breath, an erratic heart rate, headaches, dizziness, depression and problems with memory and concentration.

Such lingering medical issues are so varied that one study by a patient-led research group evaluated 203 symptoms that may fluctuate or even appear out of the blue after people seem to have recovered.

As Dr. Ziyad Al-Aly, the chief of research and development at the VA St. Louis Healthcare System and a clinical epidemiologist at Washington University in St. Louis, said, “If you’ve seen one patient with long Covid, you’ve seen one patient with long Covid.”

There is little consensus on the exact definition of long Covid, also known by the medical term PASC, or post-acute sequelae of Covid-19. While the World Health Organization says long Covid starts three months after the original bout of illness or positive test result, the Centers for Disease Control and Prevention sets the timeline at just after one month.

Some researchers and health care providers use other time frames, making efforts to study and quantify the condition more difficult, said Dr. Al-Aly, who has conducted many studies on long-term post-Covid issues.

When patients experiencing persistent symptoms go to their doctors, tests like electrocardiograms, chest X-rays, CT scans and blood work don’t always identify physiological problems, Dr. Al-Aly said. Researchers are working to pinpoint certain biological factors, called biomarkers, that correlate with persistent Covid symptoms. These could include signs of inflammation or certain molecules produced by the immune system that might be measured by blood tests, for example.

For now, doctors must rely on their patients’ descriptions of symptoms and rule out alternative explanations or causes. Some post-Covid clinics have multidisciplinary teams of specialists evaluate patients to figure out the best treatment options.

It’s unclear what exactly drives long Covid, but research has begun to offer some clues. Some experts theorize that an immune response that goes into overdrive when you first get sick may lead to inflammation and damage throughout the body, eventually resulting in long Covid symptoms, said Dr. Michael Peluso, an infectious disease physician at the University of California, San Francisco.

“We know that during acute Covid-19, some people have a really revved-up immune response and some people have a reduced immune response, and that response can determine the trajectory of how well somebody does,” he said.

Another explanation, experts say, could be that your immune system never fully shuts down after the initial infection.

Research offers some hints about which patients might face a greater risk of long-term symptoms. In a study of 209 patients published in January, researchers found four factors that could be identified early in a person’s coronavirus infection that appeared to correlate with an increased risk of having ongoing symptoms two to three months later.

One factor was the level of coronavirus RNA in the blood early in the infection, an indicator of viral load. Another was the presence of autoantibodies — antibodies that mistakenly attack tissues in the body as they do in conditions like lupus and rheumatoid arthritis. A third factor was the reactivation of Epstein-Barr virus, which can cause mononucleosis and infects most people, often when they are young, and then usually becomes dormant.

The fourth factor was having Type 2 diabetes, although experts say that in studies involving larger numbers of patients, diabetes might be only one of several medical conditions that increase the risk of long Covid.

Studies from post-Covid clinics have also found other pre-existing medical conditions that may put people at risk for long Covid. In a report on the first 100 patients treated for neurological and cognitive symptoms at a post-Covid clinic at Northwestern Memorial Hospital in Chicago, 42 percent reported previously having depression or anxiety, though such patients might simply be more comfortable seeking neurological treatment, doctors said. Other pre-existing conditions included autoimmune diseases and headaches.

Studies also suggest that the risk of developing long Covid peaks in middle age, Dr. Peluso said. The average age of patients in the Northwestern study was 43. An analysis of 78,252 private health insurance claims across the United States found that people between the ages of 36 and 64 made up about two-thirds of the long Covid patients. (But that study did not include most Medicare recipients, so it involved relatively few older patients.)

Women may be disproportionately affected, with some studies finding that about 60 percent of patients are female. A similar pattern has emerged in other long-term conditions like ME/CFS (myalgic encephalomyelitis/chronic fatigue syndrome), which has several symptoms similar to those of long Covid.

Because the pandemic has had a significant impact on Black and Latino communities in the United States, and those groups have more limited access to medical care, they may have high numbers of long Covid cases as well, Dr. Peluso said.

The picture is still coming into focus, but several studies suggest that getting a Covid vaccine can reduce — but not eliminate — the risk of longer-term symptoms.

The United Kingdom’s Health Security Agency conducted an analysis of eight studies that had looked at vaccines and long Covid before mid-January. Six found that vaccinated people who then became infected with the coronavirus were less likely than unvaccinated patients to develop symptoms of long Covid. The remaining two studies found that vaccination did not appear to conclusively reduce the chances of developing long Covid.

In that analysis, one study, which has not been peer-reviewed, of about 240,000 U.S. patients found that those who had received even one dose of a Covid vaccine before their infections were seven to 10 times less likely than unvaccinated patients to report symptoms of long Covid 12 to 20 weeks later. But another large study of electronic patient records at the U.S. Veterans Health Administration, also not yet peer reviewed, found that those who were vaccinated had only a 13 percent lower risk than unvaccinated patients of having symptoms six months later. Vaccinated patients mostly benefited by being less likely to develop lung problems and blood-clotting difficulties, said Dr. Al-Aly, one of the study’s authors.

“Reliance on vaccination as a sole mitigation strategy is wholly inadequate,” Dr. Al-Aly said. “It is like going to battle with a shield that only partially works.”

If you are concerned about any lingering symptoms after a confirmed or suspected coronavirus infection, don’t be afraid to ask for help. Checking in with your primary care provider is a good first step. More doctors are becoming aware of long Covid symptoms and can recommend tests that might at least rule out other causes of your symptoms.

“Even though we say that long Covid is when symptoms last for a month or three months after infection, you don’t have to wait that long to get help,” Dr. Al-Aly said. “People should really honor their symptoms.”

If you’re not getting help from a primary care doctor, you may want to seek out a post-Covid clinic, though Dr. Al-Aly acknowledged that “it’s easier said than done.” Access to post-Covid clinics can be difficult for those without adequate medical insurance. And, in some states, people may have to travel hundreds of miles to get to the nearest one. You can look up post-Covid clinics near you on the Survivor Corps database.

Bring your medical records if you’re visiting a new provider and make a list of all your symptoms, especially if you’re experiencing cognitive issues and are likely to forget some health concerns when your appointment comes around.

Some long Covid issues can be managed with existing medications or treatments for symptoms like headaches or gastrointestinal problems. Physical therapy and “cognitive rehab,” including approaches often used for patients who have experienced strokes or brain injuries, can also be helpful over time. Some people benefit from tailored physical and mental health rehabilitation services and breathing exercises, which can help them slowly build back strength and endurance for physical activities.

Other possible tools against long Covid, including antiviral treatments, are only beginning to be studied. The National Institutes of Health is devoting more than $1 billion to a major research effort called the Recover Initiative, but progress has been slow so far. Lawmakers are pushing for better funding for long Covid research and medical care.

Several groups, such as Body Politic, Long Covid Alliance and Survivor Corps, provide emotional support, as well as resources for seeking treatment, disability benefits and patient advocacy.

People with long Covid may also want to consider joining a research trial, Dr. Peluso said. You may be able to find continuing clinical studies at universities and academic centers near you, or sign up to be part of the Recover Initiative.

“Participating in research can be very empowering,” Dr. Peluso said.

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WHO calls for pressing action to contain monkeypox risk in Europe – Prensa Latina

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“The risk is considered high in the European region of the World Health Organization (WHO), due to reports about a geographically widespread outbreak involving a great number of newly affected nations,” Ms. Vujnovic said in an interview with Sputnik news agency.

Vujnovic explained the WHO highly recommended that all nations globally making teeming efforts to identify new monkeypox cases and trace contacts to control outbreaks and prevent further spread.

Likewise, the WHO representative stressed there is no need to vaccinate the Russian population massively against smallpox.

“Mass vaccination is not currently recommended, but itś being considered in certain situations to vaccinate those who were in contact or vulnerable people,” she stressed.

In this regard, Natalia Psheníchnaya, Deputy Director of Clinical and Analytical Work at the Russian Central Research Institute of Epidemiology, in previous days said Russia has no reported any monkeypox cases so far, however, she assured that health protocols have been set up to detect any case.

The WHO has to reported over 5,100 cases in 51 non-endemic nations from May 13 to July 1.

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Toronto Public Health hosting pop-up COVID-19 vaccination clinics throughout Canada Day weekend – Toronto.com

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Toronto Public Health continues to host summer pop-up vaccination clinics across the city in partnership with Toronto’s Canada Day festivals and special events. This is part of Team Toronto’s continued efforts to bring COVID-19 vaccination opportunities to places residents live, work and play.

“As people gather to celebrate Canada Day across the city, Team Toronto will be out helping residents get vaccinated against COVID-19 and keep their vaccinations up to date,” said Mayor John Tory. “We have made such progress thanks to our world-leading vaccination efforts, and that’s why we’re continuing to work throughout this holiday and into the summer to help deliver vaccine doses.”

TPH will host the following vaccination clinics in early July:

• High Park Canada Day Festival at High Park, 1873 Bloor St. W., Friday, July 1, 10 a.m. to 2 p.m.

• East York Canada Day Festival at Stan Wadlow Park. 373 Cedarvale Ave., Friday, July 1, 11 a.m. to 5 p.m.

• Canada Day event at Mel Lastman Square, 5100 Yonge St. Friday, July 1, 2 to 7 p.m.

• CIMA Mayor’s Cricket Trophy event at Sunnybrook Park, 1132 Leslie St. Saturday, July 2, 9 a.m. to 4 p.m.

• Lakeshore Ribfest at 1 Colonel Samuel Smith Park Dr. Saturday July 2 and Sunday, July 3, 11 a.m. to 6 p.m.

• Afrofest at Woodbine Park, 1695 Queen St. E. Saturday, July 9 and Sunday, July 10, 1 to 7:30 p.m.

• Dragon Boat Challenge (GWN Sport Regatta) at Marilyn Bell Park, 1095 Lakeshore Blvd. W. Saturday July 9, 8:30 a.m. to 3:30 p.m.

These family-friendly and youth-friendly clinics will provide first, second, third, fourth and children’s COVID-19 doses to eligible residents age five and up on a walk-in basis, with no appointment or health card required. Pfizer and Moderna vaccines will be offered by TPH nurses, who will also answer COVID-19 and vaccine-related questions.

Residents can continue to get vaccinated at city-run immunization clinics, primary care offices and more than 525 pharmacies. A full list of clinic locations and hours is available on the City’s COVID-19: Where to Get Vaccinated webpage.

As of Monday, July 4, the city-run immunization clinic at Metro Hall will operate Monday to Friday noon to 6 p.m. and Saturday and Sunday 10 a.m. to 4 p.m. Residents can find a pharmacy offering COVID-19 vaccination by using the Government of Ontario’s COVID-19 pharmacy vaccine locations webpage.

All eligible residents are encouraged to get their third and fourth dose as soon as possible. As with vaccines for other diseases, people are protected best when they stay up to date. COVID-19 vaccines have been scientifically proven to lower the risk of illness, hospitalization and death while protecting oneself, loved ones and the community, and residents with three doses had the lowest rates of hospitalization, ICU and death over any other level of vaccination.

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Style File: Smart sunscreens – Montreal Gazette

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Postmedia may earn an affiliate commission from purchases made through our links on this page.

Article content

Sunscreen is always a good idea.

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Skin cancers are the most common forms of cancer in Canada, according to Statistics Canada. And severe sunburns are noted as “an important risk factor for melanoma and non-melanoma skin cancers,” according to the agency.

With this in mind, it’s important to slather, smooth, spray — or whatever your chosen format of sun protection may be — this summer.

Here are four smart sunscreen options to consider adding to your daily sun-protection plan:

Tint time

From the French brand La Roche-Posay, this “ultralight” sunscreen formula features a universal tint to match most skin tones. See you later, face makeup. The Anthelios Mineral Tinted Ultra Fluid boasts a sun protection factor (that’s the SPF) of 50, thanks to 100 per cent mineral filters. Suitable for sensitive skin, the broad-spectrum sunscreen — it blocks both UVA and UVB rays, is sweat resistant and water resistant for up to 40 minutes.

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$35.95 | Shoppers Drug Mart, Laroche-posay.ca

Double duty

This advanced sunscreen formula from Shiseido acts as a moisturizer, sunscreen and face primer all-in-one formula. The Urban Environment Oil-Free Sunscreen has an SPF of 42 and features skin-loving ingredients such as spirulina and hyaluronic acid to hydrate and smooth skin while broad-spectrum UV filters protect against ultraviolet rays.

$45 | Sephora, Shiseido.com

Smooth operator

Perfect for those who struggle with acne, this Clear as Day SPF 46 from the brand Starface is vegan and cruelty-free, while also being oil-free and non-comedogenic. The fragrance-free formula features a unique gel texture and is completely clear so there’s no fear of a white cast on skin. Water resistant for up to 80 minutes, so you can spend a little extra time splish-splashing about.

$32 | Starfaceworld.ca

All-over option

Sun protection doesn’t stop at the face, neck and décolletage. Introduce head-to-toe coverage to your summer routine with the Garnier Ombrelle Sensitive Expert Body Lotion SPF 60. The hypoallergenic sunscreen formula features broad-spectrum coverage, is fragrance-free, dermatologist-tested, non-comedogenic and water resistant for up to 80 minutes. Plus, the lotion formula is easy to apply, and absorbs quickly.

$24.99 | London Drugs, Londondrugs.com

Aharris@postmedia.com

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