关于COVID - 19，我们已经了解了很多，但仍有很多需要了解

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This much researchers agree upon: Long COVID is a serious and sometimes debilitating condition that can strike previously healthy people after even mild bouts of COVID-19. 在理解它方面正在取得快速进展.

但是在大流行的第三年, 关于长冠肺炎的很多信息——是什么导致了它, 如何治疗?, 甚至该怎么称呼它——仍在整理中.

“我们已经停止了对其真假的争论。. 伦纳德H. 花茎甘蓝, professor of medicine and head of clinical immunology at the Cleveland Clinic Lerner College of Medicine. “现在我们正在努力更好地定义它”，并学习如何解决它. “它被当作一种疾病来对待吗? 或者我们把它当作10种疾病? 或更多的?"

的 疾病控制和预防中心 says long COVID is an assortment of symptoms and conditions that continue four weeks or more after the initial phase of infection with SARS-CoV-2, 导致COVID-19的病毒. It is also referred to as post COVID-19 conditions or post-acute sequelae of SARS-CoV-2 infection.

“有很多不同的名字，有很多不同的定义。. 杰弗里·许, an assistant clinical professor of medicine at the David Geffen School of Medicine at the University of California, 洛杉矶. “我确实认为这是一个具有挑战性的研究领域."

不同的定义导致了对COVID的常见沙巴足球体育平台的一系列估计. “一些研究表明，这个数字似乎很低，”徐说. “其他研究表明，长COVID的人数似乎相当高."

白宫的 国家抗新冠肺炎研究行动计划, released last August, noted that risk estimates varied from 5% to 30% of COVID survivors. 一个大的 美国疾病控制与预防中心研究 estimated that 1 in 5 survivors ages 18 to 64 had at least one health condition related to prior COVID-19. 对于65岁及以上的人，这一比例为四分之一. 女性可能面临更高的风险.

"You can see patients that were completely healthy before having a COVID-19 infection and now are completely disabled,”医生说。. Cyndya一. Shibao, an associate professor of medicine at Vanderbilt University Medical Center in Nashville, 田纳西州.

医生的挑战:诊断长期COVID

超过200种症状与长期COVID有关. “名单很长,世宝说, 包括心血管, 肠胃和认知问题, 和更多的.

考虑到冠状病毒如何渗透我们的系统，这并不奇怪. "We know the virus can spread widely throughout our body,”许说。, and linger for months.

做出诊断的挑战, 花茎甘蓝说, is that doctors "don't really have crisp classification or diagnostic criteria that are universally accepted.“在某些情况下，与COVID-19的联系是显而易见的. 这些人“从一开始就有病”,他说, 永远不会回到COVID-19之前的状态. 其他时候，它更阴险.

他对此有切身体会.

在2021年7月出现轻度COVID-19病例后, 卡拉布雷斯的心率加快了, 然后开始出现认知问题. 他说:“我有无数个理由解释为什么可能是别的原因。. 他很忙，压力很大. 一旦事情弄清楚了, “我花了大半年的沙巴足球体育平台才恢复了那部分健康."

分组治疗

随着研究人员的理解不断进步, 他们已经开始根据主要症状对患者进行分组. 徐说，这将有助于他们找出导致每个星团的原因.

许说“脑雾”是一种群集. 另一个亚群有心脏问题——运动困难, 当他们站直时，心悸和症状会加重, 哪一种可能是体位性心动过速综合征的一部分, 或盆.

过度疲劳是另一个子类. "This is not just fatigue where you're tired and don't feel like getting out of bed in the morning,”许说。, 但是疲劳妨碍了正常的日常活动, 比如去杂货店.

Understanding the cause of each symptom cluster could drive better treatments, 他说.

For example, as a cardiologist at UCLA's long COVID clinic, 许 often sees patients with POTS. 他们的恢复可能需要适量的锻炼. But people with extreme fatigue need help learning how to pace themselves to manage their energy reserves, 他说, and pushing exercise – as some were advised early in the pandemic – can actually make things worse.

在卡拉布雷斯看来，新冠肺炎“显然不是一种疾病.“它遵循其他病毒感染的模式, 尽管还不清楚确切的机制是什么. 主要假设, 他说, include the idea of a lingering virus; microscopic clots in the bloodstream; and low-grade inflammation within the central nervous system.

每一种都有可能导致不同的问题，但这还不清楚. “这在很大程度上仍是一项正在进行的工作，”他说.

许, whose research is exploring whether long COVID might be caused by fragments of the virus in the body, 血管内壁的损伤是另一个可能的根本原因.

理解不同的可能性就是一种进步, 他说, but "it's still baffling" as to why long COVID affects some people who have few apparent risk factors but not others who would seem to have many.

Shibao, meanwhile, is studying possible causes and treatments for long COVID-related POTS. Shibao和许的研究项目就是其中之一 长期COVID研究 由美国心脏协会资助.

Shibao说 the number of publications about long COVID treatment has significantly increased in recent months.

她警告说，并非所有这些都有坚实的科学依据. 一些研究包括少量没有对照组的患者, but patients are so desperate that even if a treatment has not been rigorously tested, 他们在询问他们, Shibao说. “这非常令人沮丧."

如果怀疑长COVID该怎么办

寻求可靠的帮助, 认为自己长期感染COVID的人可以从他们的初级保健医生开始. But the demands and need for referrals might quickly overwhelm a single doctor, Shibao说. 病人“可能会出现呼吸短促的问题, 他们可能需要看肺病专家. At the same time, they can have gastrointestinal symptoms, or they can have chest pain."

这就是她推荐的原因, 在可能的情况下, 寻找一个长期的COVID诊所, 哪一个可以吸收来自不同背景的专家.

许同意. 他说了那句话, people should look for "a place where you feel like clearly they have your best interests in mind, 他们并不是想向你推销什么." A major research institution also can help connect patients with scientifically sound clinical trials.

现在还为时尚早

长期研究COVID的研究人员在大流行的三年里取得了很大进展, 徐说, 但是在评估还有多远的路要走的时候, 他用了一个棒球的比喻:我们刚打完第一局.

"It's really tough to identify an effective therapy for a disease that has just one type of presentation,他说. "But we're talking about this syndrome that has several different ways of presenting itself."

卡拉布雷斯认为我们正处于理解它的“开端”. 但他很乐观.

COVID将无限期地与我们同在. But "there is no disease in the history of medicine that has been more studied in such a short period of time than COVID-19,他说. "And I look forward to seeing highly productive research that will impact patients in the very near future."

编者注:由于围绕冠状病毒的沙巴体育平台点击进入迅速演变, 本文中提供的事实和建议自出版以来可能已经发生了变化. 访问 心.org 获取最新报道, and check with the 疾病控制和预防中心 and local health officials for the most recent guidance.

If you have questions or comments about this 美国心脏协会 沙巴足球体育平台 story, please email (电子邮件保护).