The British historian, the Italian archaeologist, and the US kindergarten teacher have never met in person, but they share a striking bond in the pandemic.

Three women suffering from eerily similar symptoms are credited with helping to explain, name and long-live COVID-19 in the public consciousness in early 2020. .

Liverpool’s Rachel Pope took to Twitter in late March 2020 to describe her troublesome symptoms after contracting coronavirus. Italy’s Elisa Perego used the term “long her COVID” for the first time in her May tweet of that year. Amy Watson of Portland, Oregon, took inspiration from the tracker cap she wore and the “Longhauler” she wore to name her Facebook support her group. She quickly became part of the pandemic dictionary.

Nearly three years after the pandemic, scientists are still trying to figure out why some people take COVID longer and why a small minority, including three women, have persistent symptoms. I’m trying to figure out what’s going on.

Millions of people around the world have had COVID for a long time, reporting a range of symptoms including fatigue, lung problems, brain fog and other neurological symptoms. Most evidence suggests that he will make a significant recovery within a year, but recent data show that he has killed more than 3,500 people in the United States.

Here’s some of the latest evidence:

Are women more at risk?

A number of studies and anecdotal evidence suggest that women are more likely to have COVID for longer than men.

There may be biological reasons.

Women’s immune systems generally respond more strongly to viruses, bacteria, parasites and other germs, said Sabra Klein, a professor of immunity research at Johns Hopkins University.

Women are also much more likely than men to get autoimmune diseases, causing the body to mistakenly attack its own healthy cells. We believe it may be due to an autoimmune reaction.

A new study also suggests that women’s bodies tend to have more adipose tissue, and the new coronavirus may hide in fat after infection. Scientists are also studying whether fluctuating hormone levels in women may increase risk.

Another possible factor: Women tend to seek health care more than men and are often more sensitive to changes in their bodies.

“I don’t think we should ignore it,” she said. Both biology and behavior are likely involved, Klein said.

So it may not be a coincidence that it was three women who helped shed some first light on the long COVID.

Pope, 46, began documenting what she experienced in March 2020. Following flu-like symptoms, her lungs, heart and joints were affected. A month later she started having a few days of her “OK” days, but her symptoms persisted.

Several of her similarly ill colleagues connected with Perego on Twitter. “We kind of started getting together because it was the only place we could do it,” the Pope said, apparently because it was going on, and I think he stopped joking. ”

Watson launched its virtual long-haul transportation group that April. Others soon learned of the nickname and accepted it.

monovirus

Several studies suggest that the ubiquitous Epstein-Barr virus may play a role in some cases of long-lasting COVID.

Dr. Timothy Henrich, a virus expert at the University of California, San Francisco, said the inflammation caused by coronavirus infection can activate the herpes virus, which remains in the body after causing an acute infection.

Epstein-Barr virus is one of the most common of these herpesviruses, infecting an estimated 90% of the US population. Viruses can cause symptoms that may be dismissed as mononucleosis or the common cold.

Henrich is one of the researchers who found immune markers in the blood of long-term COVID patients, especially those suffering from fatigue, that signal Epstein-Barr reactivation.

Not all long-term COVID patients have these markers. But while Epstein-Barr may be causing the symptoms, scientists say more research is needed.

Some scientists also believe Epstein-Barr causes chronic fatigue syndrome. This has many similarities to his long-term COVID, which is also unproven.

obesity

Obesity is a risk factor for severe COVID-19 infection, and scientists are trying to understand why.

Researchers at Stanford University are among those who have found evidence that the coronavirus can infect fat cells. I found signs of virus and inflammation.

Laboratory tests have shown that the virus can grow in adipose tissue. This raises the possibility that adipose tissue may act as a ‘reservoir’ and contribute to long-lasting COVID.

Can removing adipose tissue treat or prevent some cases of long-lasting COVID? It’s an intriguing question, but the research is preliminary, says an infectious disease professor at Stanford University. said Catherine Blish, Ph.D., senior author of the study.

Scientists at the University of Texas Southwestern Medical Center are studying leptin, a hormone produced by fat cells that can influence the body’s immune response and promote inflammation.

They plan to study whether injections of manufactured antibodies can lower leptin levels.

Dr. Philipp Scherer said:

interval

Based on early data from the pandemic, it is estimated that about 30% of people infected with coronavirus will develop long-term COVID.

Most people with prolonged, recurring, or new symptoms after infection recover after about three months. According to a recent study published in the Journal of the American Medical Association, about 15% of people who develop symptoms at 3 months will have symptoms for at least another 9 months.

Identifying who is at risk for years of symptoms is “a very complicated question,” says Dr. Lawrence Purpula, an infectious disease expert at Columbia University.

People with severe infections appear to be at higher risk of long-term COVID, although it can also affect people with mild infections. People whose infections cause severe lung damage, including scarring, may experience shortness of breath, coughing, or fatigue for a year or longer. , Neurological symptoms such as chronic fatigue and brain fog can last for a year or more, Purpura said.

“The majority of patients eventually recover. It’s important that people know that.”

It’s a small consolation for the three women who helped the world recognize the long COVID.

Perego, 44, developed heart, lung and nervous system problems and remains seriously ill.

She knows scientists have learned a lot in a short period of time, but says there is a “gap” between long-term COVID research and medical care.

“We need to translate scientific knowledge into better treatments and policies,” she said.

“I never recovered,” says Watson, who is approaching 50. In addition to severe migraines, she had digestive, nerve and leg problems.

She hopes the medical community will take a more systematic approach to treating long-term COVID. Doctors say that not knowing the underlying cause makes it difficult.

“I just want my life back,” said Watson.