Is this long COVID or am I just getting older?

You are middle-aged with new symptoms after your COVID infection: fatigue, brain fog, joint pain. Is COVID long? Or are you just getting older?

If you’ve found yourself wondering, you’re not alone.

“It’s one thing,” said Dr. Alba Miranda Azola, co-director of the long-running COVID clinic at Johns Hopkins University School of Medicine. Fortune.

Since the world has seen almost 650 million officially registered cases of COVID-cast about 10% of the world’s population You are 65 or older: Aging and the long duration of COVID will largely intersect. This is especially true given that the aging process, for many, becomes noticeable after early middle ages.

As patients get older, “I think it gets a little cloudy,” Azola said.

Currently, there are no official diagnostic criteria for prolonged COVID. Even the definition of the condition varies depending on who you talk to, although it is generally considered to be new symptoms that start during or after a COVID infection and persist for weeks or months.

To complicate matters, the symptoms and timing of aging can vary widely due to genetic and environmental factors. So it’s not possible to say definitively whether your new symptoms are due to aging or prolonged COVID, both, or neither, say Azola and other experts.

“Could it be COVID long? The short answer is yes,” she said. “But it’s hard to tell if it’s long-term COVID or if other things are contributing.”

A ‘chicken or egg?’ dilemma

With more than 200 symptoms identified—from persistent cough and fatigue to ear numbness and a “brain on fire” feeling—long-term COVID is surely not one but multiple conditions, experts say.

Many argue that true long-term COVID is best defined as a chronic fatigue syndrome-like condition that develops after a COVID infection, similar to other postviral syndromes that can occur after herpes infection, Lyme disease, and Ebola, among others.

Other post-COVID complications, such as organ damage, should not be defined as long-term COVID and better fit into the broader general category of PASC, experts say. Also know as post-acute sequelae of COVID-19the term is used to encompass a wide variety of consequences of COVID, from chronic fatigue-like symptoms and beyond heart disease to lasting lung damage to strange new symptoms such as urinary incontinence, itching and skin lesions.

The signs of aging can overlap with those of long-term COVID, or at least feel like they do. They often include back and neck pain, osteoarthritis, chronic obstructive pulmonary disease, and dementia, among others. according to the World Health Organizationin addition to fatigue.

Whether officially diagnosed or not, it is estimated that almost 60% of the world’s population has been infected with COVID, according to the Institute for Health Metrics and Evaluation at the University of Washington. Now that most of the world’s citizens have experienced the virus, it’s hard to determine what new symptoms and conditions the virus caused or contributed to, said Dr. Nir Goldstein, a pulmonologist at National Jewish Health in Denver who runs the long-running clinic. hospital COVID..

“It becomes challenging from a clinical perspective to temporally define causality,” he said. Fortune.

time as an indicator

The symptoms of aging tend to come on gradually, said Dr. Panagis Galiatsatos, an assistant professor in the Johns Hopkins division of pulmonary medicine and critical care who cares for long-term COVID patients. Fortune. Not so with the long COVID.

“There really is a big difference between ‘I felt like this before’ and ‘After I felt like this,’” he said regarding prolonged COVID symptoms after a COVID infection. “I don’t understand many people who confuse their symptoms with aging.”

“Many patients will tell you that they feel like they have aged after COVID,” he added.

Azola has many elderly patients who have been less active for the past two years due to pandemic restrictions and now complain that exercise is exhausting them. Decreased activity during the pandemic, not the virus, could be to blame for at least some of her symptoms, she said.

“The older population is experiencing a combination of decreased activity during the years of isolation and then deconditioning,” he said.

“Most respond well to more physical approaches to activity progression” or physical therapy, he said.

For now, it doesn’t matter what the cause of the symptoms is, experts say, as no specific treatments for long-term COVID have been approved. Doctors treat the symptoms, regardless of the cause.

Eventually, the cause of the symptoms could be important if the exact mechanisms behind prolonged COVID are determined and treatments are developed, Goldstein said.

“But at this point, pretty much, it doesn’t,” he said.

This story originally appeared on

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