For the first time in over a decade, Yale's faculty is represented on Time Magazine's list of the 100 Most Influential People. They are Astronomy Department Chair Priyamvada Natarajan and Yale immunologist Akiko Iwasaki.
Iwasaki recently joined "All Things Considered" to discuss her landmark work in the study of what we have come to know as long COVID.
John Henry Smith: First, congratulations! How much does this mean to you?
Akiko Iwasaki: Oh, thank you so much, John. This means a lot to me because long COVID is affecting lives in a significant number of people. It's estimated to be around 70 million people in the world who are suffering from long COVID.
Long COVID has been much less studied than the acute COVID, and there are some people who deny the existence of long COVID. And, and even though some people do recognize that long COVID is out there, they don't realize how devastating it is to have long COVID. So the fact that I'm in this [Time100] list, it is a huge honor, but also a great opportunity to speak about this disease.
JHS: I hear there are around 200 symptoms that could indicate long COVID. Are some more prominent than others? How do you define the disease?
Iwasaki: There are indeed over 200 symptoms that have been reported, but the most common symptoms include things like severe fatigue, neuro-cognitive issues, as well as exercise intolerance. So these are some of the major symptoms that most people are suffering from, while others that are more, you know, unique include things like hair loss and skin rash and even sexual dysfunction.
JHS: The symptoms you describe sound like they can describe a myriad of ailments.
Iwasaki: Right. That's why it's very important to take very deep medical history of the patient, for instance, to rule out other causes. Doctors might order tests for other pathogens, like flu, for example. That's easy to test nowadays. And then of course, these set of symptoms, they might not appear immediately after COVID, but may appear within the first two months of having had COVID. So, knowing the timing and the COVID diagnosis, as well as the set of symptoms is very important. And, if you're not aware of this set of symptoms, you might miss it or misdiagnose it.
JHS: Is there a drug you can take? What is the conventional therapy?
Iwasaki: So, there isn't a known drug that can cure long COVID yet. We, and others, are doing multiple randomized clinical trials to try to get at this question But currently, the way in which the long COVID is treated is treatment of the symptoms themselves. For instance, if people have cardiovascular issues, they might go to the cardiologist and get treated for that symptom. If people have pulmonary issues, they would go to the pulmonologist and so on. So there isn't a single drug that can treat long COVID patients in general.
JHS: Are we getting as many new cases now that COVID-19 seems to be more under control?
Iwasaki: With the help of vaccines and antivirals, the rate has declined. For example, during the Omicron period, compared to the Delta period and prior. However, the fact that Omicron is so infectious and transmissible and millions of people are becoming infected with Omicron, you know-one in ten of those people are then going to develop long COVID. So this is an ongoing battle. It's certainly not over and people are, you know, getting long COVID today.
This interview has been edited and condensed.
