What is ‘long tail’ form of coronavirus? Experts baffled why some are sick for months

Several months and over 4 million reported cases into the global coronavirus pandemic, COVID-19 is still finding new ways to mystify researchers.

The latest puzzle: Why are some coronavirus patients suffering symptoms of the disease months after diagnosis?

Most mild cases are beaten within a two-week period, the Centers for Disease Control and Prevention suggest. But some patients, even young ones, are taking much longer to recover, outlets report, and experts aren’t sure why.

‘Like it will never end’

“For almost seven weeks I have been through a roller coaster of ill health,” Paul Garner, a professor of infectious diseases at the Liverpool School of Tropical Medicine, wrote in an essay for the British Medical Journal. “Although not hospitalised, it has been frightening and long. The illness ebbs and flows, but never goes away.”

Others have shared similar stories.

Kelsey Meeks, a 36-year-old attorney, told Business Insider that 32 days after testing positive, her most intense symptoms have subsided, but she can’t shake persistent body aches, headaches and nasal congestion.

Meeks was by all accounts in good physical health, and even ran a four-day, 48.6-mile challenge at Disney World back in January.

“I haven’t had a day where I woke up and I thought, ‘Oh, I’m over this,’” she told Business Insider. “I can have a better day and then the next day I can’t walk and talk at the same time.”

Massachusetts resident Kate Porter described an ebbing and flowing “wave” of symptoms, CNBC reported. Porter would feel as if she was improving one day, only to be knocked down the next with low-grade fevers, coughing, chest-tightness, and stomach ailments.

“I woke up drenched in sweat this morning,” she said a month after her diagnosis, CNBC reported. “It literally feels like it will never end.”

‘Long tail’

Tim Spector, a King’s College London professor, suggests a large number of people are dealing with a “long tail” form of COVID-19 that lingers weeks longer than the average case, he told The Guardian.

“I’ve studied 100 diseases. Covid is the strangest one I have seen in my medical career,” he said.

Spector played a key role in developing the Covid Symptom Tracker app, which was rolled out to help health officials measure the virus’ spread and impact. Any user who suspects they have the virus can input a daily log of what they are feeling, and what is happening to them, and 3 million to 4 million people did so.

Of those, 200,000 reported having symptoms for at least six weeks.

“These people may be going back to work and not performing at the top of their game,” Spector told the outlet. “There is a whole other side to the virus which has not had attention because of the idea that ‘if you are not dead you are fine.’”

What’s the cause?

There is debate among medical experts as to what’s behind these long symptomatic periods.

Is the coronavirus still clinging to these patients after so much time? Or is it somehow reactivating?

Reactivation isn’t likely, and earlier reports of such cases in South Korea were discovered to be dead virus fragments triggering false positives, according to the Korea Herald.

Or is the body knocked so out of alignment from battling the virus that it struggles to fully recuperate?

It’s possible, Dr. Eric Strong, a clinical associate professor at Stanford University’s School of Medicine, told CNBC.

“It doesn’t mean that patients can’t remain symptomatic for prolonged periods of time as a consequence of their SARS-CoV-2 infection,” Strong said. “But it would suggest that some are not still infected, which would be akin to post-Lyme disease syndrome” -- meaning, the disease itself is gone though symptoms remain, for up to six months in the case of PLSD.

Garner believes the explanation for his seven-week “roller coaster of ill health” is simple -- it’s the “long tail.”

Still, much of the public seems to doubt the “long tail,” he said.

There’s an expectation of when someone should recover. Anything longer than two weeks and people start to wonder, he said, unless hospitalization is needed. Friends and family might suggest it’s psychological; employers might say it’s time to get back to work.

“Health professionals, employers, partners, and people with the disease need to know that this illness can last for weeks, and the long tail is not some ‘post-viral fatigue syndrome’ — it is the disease,” Garner said. “People who have a more protracted illness need help to understand and cope with the constantly shifting, bizarre symptoms, and their unpredictable course.”