Americas
5 years later, long Covid is still a medical mystery: What scientists have learned
When her school closed down in March 2020, Chimére Sweeney, an English teacher in Baltimore, thought she’d return to her students once the U.S. got a handle on the new SARS-CoV-2 virus. But “life had a different plan” when she got Covid shortly after — and then never recovered, she said.
At first, Sweeney developed only muscle aches. By the second week, she started having panic attacks, blurry vision, constipation and partial hearing loss. Half of her face would freeze “like concrete.” She forgot phone numbers and addresses and she developed a stutter. Within a month after getting infected, she lost 30 pounds.
“I was told that after two weeks I would be better,” Sweeney, now 42, said. “But my two weeks never came.”
Almost five years later, she’s still struggling with severe whole body pain, sleeplessness, depression, painful rashes and boils, uncontrollable urination, short-term memory loss, and irregular periods.
“I went from being a healthy 37-year-old woman who may have had to pop an allergy pill every now and again, to taking over 10 to 12 medications per day to control almost every system in my body,” Sweeney said.
Since the World Health Organization characterized Covid as a pandemic on March 11, 2020, scientists don’t fully understand why some people develop disabling chronic conditions after the initial viral infection. The U.S. may be coming through the first post-pandemic winter without a major surge in cases, but each infection carries a risk of developing long Covid. Some scientists are calling for new types of clinical trials to be designed for the most debilitated long Covid sufferers.
Long Covid is known to cause over 200 different symptoms in nearly a dozen organ systems, including those of the heart, lungs, kidneys, brain, eyes and skin, but there’s no approved test for it or recommended treatment. Research shows long Covid is more common in middle-aged people, particularly women and those with weakened immune systems, but anyone who catches the virus can get it.
The Centers for Disease Control and Prevention has estimated that 1 in 20 adults in the U.S., or about 14 million, are living with long Covid. Other data shows that up to 5.8 million children may be affected by the condition as well. However, experts say these numbers are likely underestimated because there’s no official surveillance system in place.
A $1 billion research initiative called RECOVER launched by the National Institutes of Health to find the causes of long Covid, as well as potential treatments, has fallen short on its promises, scientists and patient advocates say.
Meanwhile, experts fear that the Trump administration’s extreme cuts in federal spending may undermine long Covid research efforts, which could further delay the discovery of therapies. Just last month, President Donald Trump terminated the Health and Human Services Secretary’s Advisory Committee on Long COVID.
Dr. W. Michael Brode, medical director of UT Health Austin’s Post-COVID-19 Program in Texas, said, “We’re building the boat while we’re at sea, trying to figure it out together [with patients] … but we absolutely need to build on the progress we’ve already made.”
“We have not delivered the answers commensurate with the public health crisis we’re facing,” he said.
What causes long Covid
SARS-CoV-2, which causes Covid, isn’t the only virus that causes lingering symptoms. Another condition called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which shares many similarities with long Covid, is thought to be triggered by infections with the Epstein-Barr, influenza and varicella-zoster viruses, among others.
Covid is unique because it seems more likely to cause chronic illness than other pathogens, Brode said. Why it may lead to long-lasting symptoms is as yet undetermined. Experts have so far landed on several theories.
One idea is that remnants of the virus hide in different tissues after an infection subsides, Brode said. These viral particles continue to multiply or stimulate the immune system in ways that trigger long Covid symptoms.
Another potential cause involves the reactivation of other viruses, such as EBV and HIV, that have been sitting in a dormant state in people’s bodies.
It’s also possible that Covid tricks the immune system into producing antibodies that attack a person’s own healthy organs and tissues, said Dr. Igor Koralnik, co-director of Northwestern Medicine’s Comprehensive COVID-19 Center.
Some evidence shows that Covid affects the inner lining of the blood vessels, which can lead to the formation of tiny clots and help explain symptoms like irregular heartbeats and heart failure that some long Covid patients experience, Koralnik said.
It’s unclear whether one or a combination of these factors causes long Covid, experts say. But evidence suggests that they’re all associated with increased inflammation in the body, Koralnik said, which is why your risk of long Covid increases with each Covid infection.
“It’s like a river going over a dam,” Koralnik said. “The more episodes of Covid, the more the river level goes up to the point it overflows and there’s a flooding of long Covid symptoms.”
Diagnosing long Covid can be complicated.
Although we have diagnostic tools to confirm symptoms of long Covid, such as MRI scans for heart abnormalities, there’s no test that can diagnose the condition or distinguish it from similar illnesses, the CDC says.
As a result, people have to step away from work, school or other responsibilities to endure dozens of laboratory tests and scans that are not only expensive, but also stressful and time-consuming. It’s an extensive process of elimination that prevents people from getting the help they need, Brode said.
Clues in the eyes, gut and immune system
The challenge now is finding one or more biomarkers — genes, proteins or other substances associated with a specific condition — that can help diagnose long Covid.
A RECOVER study published last year found that routine lab tests, including 25 standard blood and urine exams, found few differences in biomarkers between people with and without prior Covid infection. The researchers concluded that these tests may not be useful in diagnosing long Covid.
Koralnik and his team recently discovered that people with long Covid have decreased blood flow in the small blood vessels in their retina, the light-sensitive layer behind the eye. This reduced flow is thought to decrease blood circulation in and around the brain, Koralnik said, which might “poison” tiny organelles called mitochondria that convert oxygen into energy.
This theory can explain why many people with long Covid experience cognitive issues, fatigue and exercise intolerance, Koralnik said. Overall, the findings, published in February in the Journal of Imaging, suggest the retina could be a long Covid biomarker.
Other research suggests promising biomarkers might exist in the gut and immune system, but Brode noted that these early findings are based on small groups of people and should be considered with a grain of salt.
As helpful as a diagnostic test would be for people with lingering symptoms, some experts say the lack of one shouldn’t slow scientists down in their search for long Covid treatments.
Julia Moore Vogel, senior program director with Scripps Research and contributor to the Patient-Led Research Collaborative for long Covid, said other conditions like migraine don’t have reliable biomarkers or tests to confirm diagnoses, yet several drugs are approved to treat it.
“I think we’ll get there,” said Vogel, who was a long-distance runner before developing long Covid in 2020 and now needs a wheelchair. “But I don’t personally feel like that should hold anything back.”
Disappointing progress in long Covid treatments
The Food and Drug Administration hasn’t approved any treatments specifically for long Covid. Experts aren’t sure we’ll get any soon.
“When I first got sick, I was like, OK, I just have to survive three to five years and I think there will be, at least, decent symptom management trial data so that we have options. But we’ve made almost no progress on treatments,” Vogel said. “There are now studies starting that are promising, but it’s nowhere near the volume it should be given the burden of disease.”
Most clinical trials are testing whether drugs used to treat other conditions prove helpful for long Covid. Researchers at the University of British Columbia, for example, are looking into low-dose naltrexone — a medication approved for opioid and alcohol use disorder. The drug is thought to have anti-inflammatory and pain-relieving properties, and is used off-label in people with fibromyalgia and ME/CFS, so it carries potential as a long Covid treatment, Brode said.
Other drugs like baricitinib, which is approved to treat rheumatoid arthritis and acute Covid, and temelimab, an experimental drug often given to people with multiple sclerosis, are also being investigated as potential long Covid treatments.
In lieu of specific treatments, people with long Covid must balance their rest and activity in a strategy called pacing, Brode said, and receive physical and cognitive behavioral therapy for further support. More often than not, many people end up relying on several drugs, including the antiviral Paxlovid, to treat symptoms.
Realistically, however, “we may not actually have a single, silver bullet treatment,” said Alison Cohen, an epidemiologist with the University of California, San Francisco who has had long Covid for three years. Long Covid manifests in such a wide variety of ways that it’s going to take a “multipronged approach” to find effective treatments, Cohen said.
What’s ahead for recovery?
As long as SARS-CoV-2 continues to spread, everyone is at risk of long Covid, Cohen said — and right now, evidence shows that recovery from the condition is rare. A study published last month found that only about 6% of people with long Covid recover after two years, according to Cohen. Covid vaccination was associated with better long-term recovery, especially among people who got the booster shots.
Those who do improve experience many “ups and downs,” Koralnik said. “You have to expect a lot of bumps in the road.”
“Living with long Covid is exhausting,” Cohen said. “So it’s important for everyone who is not living with it to think about what they can do to support folks who are.”
In the meantime, clinical trials must be designed to accommodate and include the patients they’re intended for, Vogel said. Many people are house- or bed-bound and can’t travel for multiple in-person visits and risk triggering a flare-up of symptoms, she added. “There’s just too much that you can’t know until you have them at the table,” she said.
There’s no telling when the long Covid community will finally get the answers and relief they need, but Vogel is keeping her head high.
“I know we can do it. I’m very confident that with enough trials that are well-designed, we can at least improve quality of life — if not cure the disease entirely,” Vogel said. “But I also can’t think any other way; I just can’t accept that this is it for my life.”
Americas
Nationwide protests planned after arrest of former Columbia University activist by immigration authorities
Nationwide protests are planned this weekend after Mahmoud Khalil, a former Columbia University student activist, was arrested by immigration authorities, fueling tensions between the Trump administration and student movements over immigration policy.
Khalil, 30, was taken into custody by Immigration and Customs Enforcement agents in the middle of the night last weekend, prompting outrage in recent days. Khalil, an Algerian citizen of Palestinian descent, helped lead pro-Palestinian demonstrations at Columbia University last spring.
Protests calling for his release will be held in cities including New York City, Boston, Phoenix, Charlotte, Oklahoma City, Miami and Indianapolis on Saturday and Sunday.
Several dozen protestors gathered in Times Square on Saturday afternoon, wearing traditional Palestinian scarfs, known as kuffiyehs, and waving Palestinian flags.
“Release Mahmoud right now!” the protestors shouted.
Grant Miner, the former president of a union representing thousands of Columbia student workers who were fired and expelled this week, addressed the crowd. He described Mahmoud’s detention as “a campaign of fear.”
“We must stand up together to tell Trump and his billionaire buddies that we’re not going to stand for this intimidation and the backsliding of civil rights in this country,” he said.
To justify Khalil’s arrest, the Trump administration cited an obscure foreign-policy clause that allows the federal government to deport foreign nationals whom it deems national security threats. The Department of Homeland Security alleges that Khalil “led activities aligned to Hamas, a designated terrorist organization.”
On Monday, a federal judge temporarily blocked the Trump administration from expelling Khalil, a legal permanent resident, from the country as he challenges his deportation.
Khalil filed an amended petition and complaint in federal district court in Manhattan on Thursday, stating he was the target of “retaliatory detention and attempted removal of a student protestor because of his constitutionally protected speech.” Khalil finished his classes at Columbia in December 2024 and was expected to graduate in the spring, according to the filing.
Immigration authorities are holding the 30-year-old in Louisiana and his lawyers have petitioned for him to be returned to New York City. His wife, an American, is eight months pregnant.
“I urge you to see Mahmoud through my eyes as a loving husband and the future father to our baby,” she said in a statement through Khalil’s defense counsel on Monday. “I need your help to bring Mahmoud home, so he is here beside me, holding my hand in the delivery room as we welcome our first child into this world.”
Trump administration targets campus protesters
Khalil’s arrest marks the first attempt to fulfill President Donald Trump’s campaign pledge to deport international students who protested in support of Palestinians on campuses across the country last spring.
On Tuesday, a doctoral student from India whom DHS accused of supporting Hamas self-deported to Canada. And on Friday, another Palestinian student who took part in Columbia’s protests last year, identified by DHS as Leqaa Kordia, was arrested for allegedly overstaying her student visa.
“It is a privilege to be granted a visa to live and study in the United States of America,” DHS Secretary Kristi Noem said in a statement on Friday. “When you advocate for violence and terrorism that privilege should be revoked, and you should not be in this country.”
DHS agents also raided two Columbia dormitories on Thursday evening, but made no arrests, according to a statement by the university. Commenting on the raids on Friday, Deputy Attorney General Todd Blanche said the Justice Department was “looking at whether Columbia’s handling of earlier incidents violated civil rights laws and included terrorism crimes.”
Civil rights groups and protesters have denounced the federal government’s actions at Columbia as an infringement on free speech. Protesters staged demonstrations this week at both the university and inside Trump Tower, located in Manhattan.
Columbia’s international students have expressed fear, with several telling NBC News on Friday that they are increasingly hesitant to criticize the Trump administration due to fears of repercussions.
The university’s journalism school said its staff and students are “witnessing and experiencing an alarming chill.”
“One does not have to agree with the political opinions of any particular individual to understand that these threats cut to the core of what it means to live in a pluralistic democracy,” the journalism school said in a statement issued Friday. “The use of deportation to suppress foreign critics runs parallel to an aggressive campaign to use libel laws in novel — even outlandish ways — to silence or intimidate the independent press.”
Columbia University in the glaring spotlight
The arrests are part of the Trump administration’s broader effort to “root out” what it calls “anti-Semitic harassment in schools and on college campuses.” And perhaps no other college campus in the country drew more attention for its pro-Palestinian demonstrations last year than Columbia.
For weeks last spring, student activists staged daily protests, occupied a university building and established an encampment of several dozen tents on university lawns, inspiring similar setups on college campuses across the country. Fueled by outrage over Israel’s war in Gaza, students pushed for their universities to divest from companies linked to the Israeli government. The activism sparked intense debates on campuses, with some students expressing concerns over antisemitism.
In the week before the arrests, the Trump administration singled out Columbia, announcing that it would cancel approximately $400 million in federal grants to the university. The administration cited “the school’s continued inaction in the face of persistent harassment of Jewish students.”
The move marked an unprecedented intervention by the federal government into the affairs of a private university.
Columbia responded by pledging to work with the federal government to restore its funding.
“We take Columbia’s legal obligations seriously and understand how serious this announcement is and are committed to combatting antisemitism and ensuring the safety and wellbeing of our students, faculty, and staff,” a university spokesperson told NBC News last week.
On Thursday, the university said it suspended or expelled some of the students who participated and temporarily revoked the diplomas of some graduates.
“I’m not surprised that the university is choosing to throw its students and workers under the bus for grant money,” Miner told NBC News. “We know exactly how much now it costs, to buy Columbia’s morals.”
Jackie and Shadow, the Big Bear bald eagle couple whose parenting journey has been livestreamed to the world, appear to be missing one of the three eaglets that hatched this season.
Video of the nest posted to social media Thursday afternoon showed three baby birds in the nest being fed by their parents.
But as of Friday, only two eaglets appeared to be in Jackie and Shadow’s nest, according to the Big Bear Bald Eagle Live Nest Cam.
It’s not clear what happened to the third eaglet, but Friends of Big Bear Valley said late on Friday that it was possible the remains of the missing chick may have been observed in the nest bowl.
“We are waiting for more clear visuals to confirm,” read the statement,” adding that the view into the nest bowl is partially obstructed by snow.
“We know that both the possibility and the uncertainty are hard to hear,” the organization said in an update. “We share these feelings with all of you.”
At daybreak on Saturday, an eagle could be seen feeding just two eaglets a dead frog.
Jackie laid three eggs at the end of January, according to Big Bear, and all three hatched last week.
The first hatched March 3, the second on March 4, and the third a few days later.
It is unclear which of the three birds is missing.
At least three people have died as a powerful system of storms sweeps across the a wide swathe of the central and southern of the United States, with another three killed in vehicle crashes as blinding winds whipped through Texas and Oklahoma.
From the southern Plains to the Midwest an estimated 138 million people are at risk of severe weather, with tornado warnings issued in parts of Illinois, Missouri, Arkansas, Mississippi, Indiana, Kentucky, Louisiana and Tennessee.
The storm system has left buildings in ruins, wrecked power supplies, and intensified more than 100 wildfires.
The Missouri State Highway Patrol said on X that a tornado had caused two deaths in the Bakersfield area in Ozark County, with reports of multiple injuries. It posted pictures of wrecked and ruined buildings, and a smashed up car on the roadside.
Another person died in Butler County, on Missouri’s border with Arkansas, after a mobile home was hit by extreme weather on Friday night, the county’s rescue services told NBC News.
Butler County Emergency Management said the number of fatalities there may rise, with the search and rescue operations at the site ongoing.
In the Texas Panhandle, three people were killed by car crashes caused by a a dust storm on Friday, according to Texas Department of Public Safety Sgt. Cindy Barkley. She said that the crashes were in the Amarillo area, and blamed high winds and low visibility.
Millions remain at risk as the storm carves a path through the region.
More than 300,000 customers are without power across the Midwest and South, according to PowerOutage.us, an organization that aggregates live power outage data.
Nearly half a dozen tornadoes were reported in Missouri alone.
Tornadoes were reported to have ripped down trees and power lines in the state, according to the National Weather Service, and NBC affiliate KSDK of St. Louis reported that businesses were damaged and tractor-trailers were overturned.
Tornadoes were also reported in Arkansas and Mississippi. The reports are unconfirmed; storm survey teams typically determine later whether tornadoes actually occurred. The weather service for Jackson, Mississippi, shared a photo on X of what was said to be a large wedge tornado north of Cruger.
Footage circulating on social media and verified by NBC News showed the mangled remains of a fuel station outside a 10Box store in Poplar Bluff, Missouri.
Other photos posted by the Missouri Highway Patrol showed storm damage in Rolla, Missouri, around 95 miles southwest of St. Louis, and to a bus barn in Dixon.
Strong nighttime tornadoes at EF2 on the tornado strength scale, defined by sustained winds of 113 to 157 mph, are possible from southern Iowa to Jackson, Mississippi.
The worst of the system is also threatening damaging winds and hail into Saturday. Hail the size of baseballs was reported in Christian County, Missouri, on Friday night, the weather service said.
Widespread tornado, severe weather risk
Missouri Gov. Mike Kehoe declared a state of emergency on Friday as the state prepared for the front’s unstable air overnight. The declaration will allow state resources to reach local governments quicker, his office said.
“I urge all Missourians to stay alert, monitor weather forecasts, and follow official warnings,” he said.
Florissant, Missouri, Mayor Timothy Lowery told KSDK that “we’ve got a lot of damage” in the city, including to many houses. A tree also fell on landmark restaurant Hendel’s, the station reported.
“So, tonight’s been, I’ll say a very horrible night here in the city of Florissant,” Lowery said.
Police in St. Louis warned late Friday that there were reports of vehicles getting trapped in high water, and urged people to “Turn around don’t drown!”
Tornado watches were issued for parts of Indiana, Kentucky, Louisiana, Mississippi, Missouri and Tennessee until at least 3 a.m. CT, with some watches extended until 5 a.m.
A tornado outbreak across the central Gulf Coast states into the Tennessee Valley was also likely late Saturday. Significant tornadoes were possible in eastern Louisiana, in Mississippi, and in Alabama.
Strong winds and fires in Texas, Oklahoma
In Texas, blowing dust blinded drivers with deadly consequences, officials said.
Texas Department of Public Safety Sgt. Cindy Barkley said Friday that there were three fatal crashes in the Amarillo area due to high winds and low visibility. The number of deaths was not immediately clear.
One person died and two others were injured in a crash between three semis and four other vehicles in Palmer County, said Cesar Marquez, city manager and fire chief in Bovina. It was not clear if the crash was included in the three in the Amarillo area.
There was “so much blowing dirt we were getting shocked every time we got near something,” Marquez said.
Parts of northern Texas saw gusts as strong as 62 mph, according to National Weather Service data.
Potter County Fire-Rescue reported four roads were restricted or closed after separate incidents in which big-rigs had “flipped.” The county in the Texas Panhandle includes the northern half of Amarillo.
“Visibility is poor at best and zero in places,” the agency said on social media. “If you don’t have to be out, please stay where you are.”
The dust was not the only concern. The same system whipped up wildfires in Texas and Oklahoma on Friday as the low pressure system moved east.
The largest of the state’s six active wildfires, the Windmill Fire in Roberts County, grew from 500 to 18,000 acres in less than a day, according to Texas A&M Forest Service. The blaze was 50% contained Friday night.
The Rest Area Fire in Gray County marched across 4,500 acres on Friday, but its expansion stopped by early evening, Texas A&M Forest Service said. Firefighters had achieved 30% containment by the end of the day, it said.
Texas A&M Forest Service said on Thursday conditions may be right for a Southern Great Plains Wildfire Outbreak, a dangerous weather formula based in part on low humidity and gusty wind, though such an outbreak was not officially declared by Friday afternoon.
Multiple fires were burning in Oklahoma on Friday night.
Gov. Kevin Stitt urged residents covered by mandatory evacuations in Mannford, a city in the northeastern portion of the state were wildfire raged Friday night, to “leave now.”
Mandatory evacuations were also in effect for parts of Norman, where multiple wildfires were burning, according to the Norman Police Department.
Mandatory evacuations in the city of Stillwater were expanding late Friday, with locations including a Walmart and multiple hotels, and cover “several square miles.”
The winds have apparently also helped fuel multiple structure fires in the city, and firefighting reinforcements are en route, it said in a statement.
The National Weather Service office in Norman said earlier that “a dangerous wildfire outbreak” was underway, later identifying blazes near Chickasha, Chandler, Camargo and Leedey; and near Lake Carl Blackwell, where residents were urged to evacuate. There was also one in Lincoln County, where evacuations were ordered north of the town of Meridian.
Weather system to shift east
The low pressure system is affecting the southern and northern reaches of the nation’s midsection as it pushes eastward, promising upheaval into the eastern U.S. through the end of the weekend.
As it moves into the Eastern Seaboard on Sunday, the tornado threat will shift to Virginia and Carolinas.
On the northern side of the front, including the upper Midwest and the northern Plains, blizzard conditions were forecast for the weekend, with 8 inches of snow possible in some regions.
The new week was expected to bring even more winter storm action when at least two more low pressure systems march eastward, the National Weather Service Weather Prediction Center said.
The first of the two would likely form a solid, counterclockwise winter storm, a process the weather service calls cyclogenesis, it said. It will likely bring snow to the interior, including the Midwest and Great Lakes, with a second storm likely to bring a fresh wave of snow, rain and thunderstorms to a stretch of the nation from the Rocky Mountains to the Upper Midwest mid- to late-week ahead of the first day of astronomical spring on Thursday.
