Strategies for Minimizing Long-COVID Risk: Evidence-Based Insights
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Long-COVID is a term that encompasses various lingering symptoms, with fatigue and cognitive difficulties being among the most prevalent, following an infection with Covid-19. These symptoms are defined as unexplainable by other conditions and last for a duration of weeks or months, depending on the criteria used (American, British, or WHO).
The estimated prevalence of long-COVID varies significantly. Meta-analyses suggest a range of 30% to 80% among those who have recovered from Covid-19. However, prior to the pandemic, approximately 20% to 40% of the general population experienced similar symptoms like fatigue, indicating that the true prevalence of long-COVID might be less than 20%. Furthermore, if one considers only those whose symptoms interfere with daily life, the prevalence may drop to under 5%. Despite the relatively low likelihood of long-COVID severely impacting one’s life, it remains a chronic issue, with only 50% to 70% of patients recovering within 3 to 9 months.
To mitigate the risk of long-COVID, here are some evidence-based strategies:
0. Gender and Age Factors
Research indicates that females are three times more likely than males to develop long-COVID, influenced by various hormonal and immune system factors. Older age also increases risk due to a decline in immune function. While these factors are not modifiable, focusing on actionable strategies is essential.
1. Engage in Regular Physical Activity
Severe Covid-19 is a significant risk factor for developing long-COVID. Studies reveal that regular exercise can mitigate these risks. For instance, a 2022 South African study involving over 65,000 adults indicated that those who maintained high physical activity levels had significantly lower rates of hospitalization, ICU admissions, and mortality compared to those with low activity levels. Similar protective benefits were observed in studies from South Korea and the United States.
While physical fitness is linked to reduced long-COVID risk, caution is necessary when applying exercise as a treatment due to mixed evidence on its efficacy in long-COVID patients. Each patient may experience different biological mechanisms, necessitating personalized care plans.
2. Avoid Smoking, Obesity, and Comorbidities
A 2023 meta-analysis by Tsampasian et al. identified significant risk factors for long-COVID among 860,783 patients, including gender, age, obesity, smoking, and pre-existing medical conditions. While we cannot change gender or age, we can control obesity, smoking, and other health conditions, which contribute to chronic inflammation and oxidative stress, worsening overall health.
3. Maintain a Healthy Weight and Sleep Routine
Research from Harvard T.H. Chan School of Public Health highlights the importance of maintaining a healthy body mass index (BMI) and adequate sleep. Among women studied, those adhering to healthier lifestyles exhibited a decreased risk of long-COVID, with BMI and sleep being the strongest protective factors.
4. Get Vaccinated
The same meta-analysis noted that individuals vaccinated with at least two doses had a 43% lower risk of developing long-COVID compared to those unvaccinated. Multiple studies support these findings, showing that vaccination significantly lowers long-COVID incidence, regardless of whether it occurs before or after infection. Vaccines may help by preventing severe Covid-19, which is a strong predictor of long-COVID.
5. Prevent Covid-19 Infection; Consider Metformin if Infected
The most effective way to avoid long-COVID is to prevent Covid-19 infection altogether. If infected, discussing a metformin prescription with your healthcare provider may be beneficial. Research indicates that metformin can reduce the risk of long-COVID by addressing inflammation and viral load.
In summary, current research outlines several strategies to decrease long-COVID risk: (1) engage in regular exercise, (2) avoid smoking, obesity, and other health issues, (3) maintain a healthy weight and sleep routine, (4) get vaccinated, and (5) consider metformin post-infection. While no single measure guarantees complete protection, the combined approach can significantly lower risk.
For those seeking further information on managing long-COVID, I recommend this resource on treatment options and precautions to avoid exacerbating symptoms:
Long-COVID Treatment Suggestions and Precautions
A short guide for patients to get help with diagnosis and treatment (and importantly, what not to do). medium.com
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