Background:
The current concern for “long COVID” underscores an increasing recognition of chronic illnesses that appear to arise from infectious diseases. This overlooked, growing public health problem often includes a patient history of infection by viral or bacterial pathogens followed by long-lasting and often debilitating symptoms including severe fatigue, cognitive impairment, and multi-organ dysfunction. Examples of infection-associated chronic illnesses include:
- Long COVID or post-acute sequelae of COVID-19: Between 10 to 30% of patients infected with SARS-CoV-2 develop chronic symptoms that lead to a diagnosis of long COVID. This estimation translates to a disease burden of between 7.7 million and 23 million patients who will be living with long COVID by February 2022.
- Myalgic encephalomyelitis/chronic fatigue disease (ME/CFS): ME/CFS onset is often associated with a prior, unidentified infectious episode. Approximately 1.7 to 3.3 million patients in the U.S. are diagnosed with ME/CFS and experience chronic, multi-organ symptoms.
- Persistent or post-treatment Lyme disease: Between 10-20% of Lyme disease patients develop persistent and debilitating symptoms after standard antibiotic treatment There are approximately 2 million patients in the U.S. living with persistent or post-treatment Lyme disease syndrome.
- Multiple sclerosis: A strong association of multiple sclerosis with Epstein-Barr virus infection was recently reported. In the US, more than 700,000 patients are living with multiple sclerosis.
In addition to the debilitating physical impact on patients, chronic illnesses present broader societal impacts. For example, between 31-70% of COVID patients remain absent from work after the acute phase of the disease and long COVID may be responsible for 1.6 million fewer full-time workers in the U.S. labor market. In the United Kingdom, an estimated economic loss of 32.2 billion pounds over 10 years will be attributable to permanent injury from COVID-19 in adults, 92% of which may be due to long COVID.
Given the commonality in chronic symptoms among long COVID, persistent Lyme disease syndrome, ME/CFS, multiple sclerosis and other conditions, it is not surprising to find similarities in the leading hypotheses for the explanation of these illnesses; e.g., pathogen or antigen persistence, immune response dysregulation, altered neurologic function, and altered microbiome composition and activity. Researchers studying different infection-associated chronic illnesses face common challenges in identifying disease biomarkers and developing diagnostics and therapeutic options.
In addition to this workshop, other National Academies activities are addressing the significance of infection-associated chronic illnesses. The following activities are focused on the impacts of the COVID-19 pandemic:
About:
Participants can attend the workshop both in person and virtually. On June 29 and 30, the Workshop will take place in Keck 100. For those who attend the Workshop in person, breakfast and lunch will be provided.
Planning Committee:
Timothy Coetzee, co-Chair
National Multiple Sclerosis Society
Timothy Endy, co-Chair
CEPI; State University of New York, Upstate Medical University
Amy Proal
PolyBio Research Foundation
Avindra Nath
National Institute of Neurological Disorders and Stroke, NIH
Brian Fallon
Columbia University Irving Medical Center, New York State Psychiatric Institute
Lorraine Johnson
LymeDisease.org, MyLymeData
Melissa Nolan
University of South Carolina
Rafael Obregon
UNICEF
Peter Rowe
Johns Hopkins University School of Medicine, Children's Center