Las Vegas Sun

March 28, 2024

For many Las Vegans, it’s a long haul to full recovery from COVID-19

Emory Nihipali

Steve Marcus

Emory Nihipali got sick with COVID-19 in April 2020 and continues to feel the effects of the virus that caused it.

Krystal Benson’s daughter spared no expense for her mother’s birthday cake, having it mailed to Las Vegas from Milk Bar in New York.

The cake was everything Benson could have dreamed of, with icing that was thick and saccharine, and the batter peppered with multicolored sprinkles.

There was only one problem: When Benson took a bite of the cake, she couldn’t taste anything. Turns out, she was positive for COVID-19, and loss of taste is a common symptom.

That was in July.

Benson still has not regained her taste or sense of smell, and her meals, even ones heavy on fresh vegetables, taste metallic, like pennies, she said.

“Anything I would put in my mouth — my toothpaste, things like that — it was like, you can’t taste it, but it was almost like this aroma that filled through your whole head,” she said. “I can’t smell perfume, but I know when someone has (it on) because you can feel it in your head.”

Benson has post-acute sequelae SARS-CoV-2 infection (PASC), colloquially known as “long COVID.” So-called “long-haulers” like her experience symptoms for weeks or months after getting sick with COVID-19.

The Mayo Clinic states that approximately 10% of people between 18 to 49 who have COVID-19 get long COVID. For those 70 and older, it is about 22%.

Long COVID symptoms can be either new or ongoing from first infection, and they tend to align with other COVID-19 symptoms: difficulty breathing or shortness of breath, fatigue, cough, heart palpitations, joint or muscle pain, fever, and changes in taste or smell, among other effects.

As of July 2021, long COVID can be considered a disability under the American Disabilities Act.

“You don’t know if you’re making things up, like, “Am I just anxious, and that’s why I feel this way?” Benson said. “But every day I would be sitting there, honestly not even thinking about it, just working, and I would just get hit with something else, whether it was an ache, or some kind of a pain or a coughing fit or whatever it was.”

Experts do not know what causes long-haul COVID symptoms, and research has not yet indicated what treatment and prevention for long COVID looks like, whether it can exacerbate heart and brain problems, or how vaccines factor into it. Benson was not vaccinated when she first tested positive, she said.

Now, she lives with her kids, 18 and 14, who act as her caretakers when she is too sick to function, she said. Both have been home-schooled since before the pandemic, allowing them to be near Benson when she needed them. Besides her lack of taste and smell, Benson said she is frequently fatigued and experiences shortness of breath.

“My daughter is a crutch for me for that stuff,” Benson said. “And I don’t like that.”

Brian Labus, an infectious disease epidemiologist and assistant professor at the UNLV School of Public Health, said there is not a case definition for how long a person must be sick before being considered a long-hauler, though experts are working to establish one.

He said long COVID cases first appeared in spring 2020, when the disease was first rapidly spreading across the United States.

“Is it one condition? Is it a set of conditions? And that’s really the challenge,” Labus said. “We had to understand what type of symptoms people were having, how long they lasted, basically describing what the experience was of all these people who were reporting long-term symptoms from COVID.”

Emory Nihipali is familiar with the long-haul symptoms.

After being hospitalized for a week in April 2021, he was prescribed supplemental oxygen to breathe. The Las Vegan said his digestive system is also in disarray, and exercising for longer than 15 minutes can be strenuous.

Nihipali still requires the oxygen, he said, though his doctors said he is progressing slowly and for the better.

“They can’t pinpoint when we’re going to recover fully, but it is in the right direction,” Nihipali said. “It’s like having asthma.”

It doesn’t help that Nihipali works in a smoke-filled environment at Palomino Club, where the longtime maintenance man often retires to the smoke-free back office for respite and oxygen.

Marc Kahn, dean of the Kirk Kerkorian School of Medicine at UNLV, said experts do not have data to prescribe treatments for long COVID because they do not know what causes the extended symptoms and therefore cannot offer remedies to halt it.

“There’s no specific drug; there’s no specific intervention,” he said. “Right now, it’s basically supportive care.”

Respiratory therapy can be effective in managing patients’ long COVID symptoms, said Sarah Sarich, a respiratory therapist at Physician’s Choice Vegas. Many of her clients in pulmonary rehab, which treats individuals with chronic breathing problems, have pulmonary hypertension, and some, like Nihipali, require oxygen to breathe.

Several had no history of respiratory issues before being infected with COVID-19, and they sought respiratory therapy to strengthen their endurance and combat inflammation, she said.

Improvement time varies per patient, and the approach therapists take in treating a patient also depends on their preexisting conditions, she said. A patient who has shortness of breath resulting from COVID-19 but no comorbidities will have a treatment plan dissimilar to a long-hauler who also has, for example, diabetes.

“That’s the tricky part of being a respiratory therapist and treating these long-hauler patients, is that they don’t present the same,” she said. “They’re all very different.”

Kahn also said data do not indicate whether vaccines prevent long-term symptoms or whether vaccinated or unvaccinated people comprise a larger percentage of long-haulers. Back in spring 2020, when the first long COVID cases appeared, the COVID-19 vaccine had not yet been approved.

What is slightly clearer, however, is the link between those with pre-existing conditions and long COVID.

“There is some suggestion that people who have conditions such as obesity and diabetes, perhaps, are more likely to get (long COVID), although the data is still evolving even on that question,” Kahn said.