Long COVID-19: NIH launches large-scale studies on extended illness

The National Institutes of Health announced on Wednesday it has awarded nearly $470 million to build large-scale national population studies in order to better understand the long-term effects of COVID-19. 

The award was given by the NIH’s REsearching COVID to Enhance Recovery (RECOVER) Initiative to New York University’s (NYU) Langone Health academic medical centers, which will help facilitate the infrastructure needed for more than 100 researchers and 30 institutions to successfully implement the upcoming study on long-haul COVID-19. 

RELATED: CDC calls long-term COVID-19 ‘emerging public health concern’

NIH’s RECOVER Initiative was launched with the aim to understand why COVID-19 exacerbates long-term, developing or returning symptoms following the initial infection of SARS-CoV-2, the virus that causes COVID-19. 

The NIH says the most common long-haul COVID-19 symptoms they have observed so far include pain, headaches, fatigue, brain fog, shortness of breath, anxiety, depression, fever, chronic cough and sleep problems.

"We know some people have had their lives completely upended by the major long-term effects of COVID-19," said NIH Director Dr. Francis Collins. "These studies will aim to determine the cause and find much-needed answers to prevent this often-debilitating condition and help those who suffer move toward recovery."

The upcoming studies will include adult, pregnant and pediatric populations. Patients will be enrolled in the studies during the onset of infection and after to study the progression of long-term effects. 

The NIH aims to provide insight into the extended illness in the coming months in hopes of better understanding why COVID-19 is unlike other respiratory illnesses previously identified. 

The news of the upcoming studies comes days after the U.S. Centers for Disease Control and Prevention called long-haul COVID-19 "an emerging public health concern that is not well understood."

In a report released by the agency on Sept. 10, the CDC determined that while there may be a dearth of data on long-term symptoms associated with COVID-19, lingering illness is becoming more common among those who contract the novel coronavirus.

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During the onset of the pandemic, many doctors were baffled by some of the deleterious effects caused by COVID-19 — originally thought to be just a respiratory illness.

But cases detailed in the most recent CDC report as well as anecdotally by thousands of others illustrate that the effects of the novel coronavirus can be much more complex.

Earlier this year, radiological images published at Northwestern University detailed the various types of long-term effects of COVID-19 including rheumatoid arthritis flares, autoimmune myositis or "COVID toes," among other conditions.

In a study published on Feb. 17 in the journal "Skeletal Radiology," the collections of images included ultrasounds, X-rays, MRIs, and CT scans which confirmed and illustrated the causes of various COVID-19 symptoms.

"We’ve realized that the COVID virus can trigger the body to attack itself in different ways, which may lead to rheumatological issues that require lifelong management," said corresponding author Dr. Swati Deshmukh.

Currently, several symptoms of COVID-19 identified in the study are not recognized by the CDC. Symptoms like "COVID toes" and "rheumatoid arthritis" aren’t listed on the CDC’s website detailing long-term effects of the coronavirus.

According to the CDC, the most commonly reported long-term symptoms include:

  • Fatigue
  • Shortness of breath
  • Cough
  • Joint pain
  • Chest pain

Other reported long-term symptoms include:

  • Difficulty with thinking and concentration (sometimes referred to as "brain fog")
  • Depression
  • Muscle pain
  • Headache
  • Intermittent fever
  • Fast-beating or pounding heart (also known as heart palpitations)

More serious long-term complications appear to be less common but have been reported. These have been noted to affect different organ systems in the body. These include:

  • Cardiovascular: inflammation of the heart muscle
  • Respiratory: lung function abnormalities
  • Renal: acute kidney injury
  • Dermatologic: rash, hair loss
  • Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems
  • Psychiatric: depression, anxiety, changes in mood

The CDC said, "While most persons with COVID-19 recover and return to normal health, some patients can have symptoms that can last for weeks or even months after recovery from acute illness."

"Given the range of symptoms that have been reported, intensive research using all available tools is necessary to understand what happens to stall recovery from this terrible virus. Importantly, the tissue pathology studies in RECOVER will enable in depth studies of the virus’s effects on all body systems" said Dr. Walter J. Koroshetz, director of NIH’s National Institute of Neurological Disorders and Stroke and one of the RECOVER co-chairs in the NIH press release published Wednesday. 

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