16% of all North Carolinians have long COVID. Here’s an updated guide to the condition.

About 16% of North Carolinians — one of the highest rates in the country — have experienced long COVID, according to a recent CDC survey.

Despite the pervasiveness of this condition, much is still unknown about how to treat it and why the lingering symptoms appear in the first place.

Researchers like Dr. John Baratta, co-director of the UNC COVID Recovery Clinic, are starting to uncover some answers about the mysterious condition.

Here’s what we know right now:

What are my odds of getting long COVID?

People with long COVID can experience dramatically different symptoms and severity. Baratta’s patients most commonly report fatigue and brain fog as their most severe symptoms.

The good news is that an infection from the omicron subvariants, which are overwhelmingly dominant right now, appears to be less likely to cause long COVID. Research on this is still in its infancy, but Baratta said omicron is about 50% less likely to cause long COVID than the delta strain.

Baratta said COVID vaccines and prior infections can also reduce the risk of developing long-term symptoms.

Other factors, like gender and whether you were healthy before the infection, can also play a role in your risk level. At the UNC COVID Recovery Clinic, three-quarters of patients are women, which mirrors national trends. It’s not clear why more women appear to develop the condition than men, though Baratta said some researchers hypothesized it has to do with differing inflammatory processes that have historically caused higher rates of autoimmune conditions in women.

“There is still not a clear understanding of the exact risk factors that would cause someone to have long COVID,” he said. “The types of patients that we see do cluster into various groups.”

What are the treatment options?

Researchers still don’t know exactly how or why COVID causes long-term problems in some people. So rather than treating the underlying cause of the condition, treatments are focused on lessening symptoms.

At UNC’s clinic, patients are typically paired with occupational therapists to strategize ways to deal with their most debilitating symptoms. Patients struggling with fatigue might be taught how to strategically allot their energy and prioritize their most important daily tasks.

The clinic also coaches patients on how to improve diet, exercise schedules, hydration levels and sleep habits, which can help relieve symptoms, he said.

There are also a host of medications that can be prescribed to improve alertness, like Wellbutrin and low doses of naltrexone.

Can you fully recover from long COVID?

It’s too soon to tell how people are recovering from long COVID, Baratta said.

Early research shows that most people see their symptoms improve in a year.

A recent study found that patients who saw improvement 90 days after being discharged from the hospital for a COVID infection were more likely to recover over the course of a year. In other words, those who don’t feel like they’re improving in the first 90 days are more likely to have persisting symptoms.

“In our experience many people do have improvements, although it is slow,” he said.

What is next in long COVID research?

Barrata’s center is working on a number of studies that could help shed light on a condition that is not fully understood by the scientific community. The upcoming projects include:

• A study in which long COVID patients are given a smell stimulus, like a scratch-and-sniff sticker, and then asked to select what they are smelling from a multiple choice list. The study will evaluate the number of patients who have reduced or altered smell.

• A clinical trial that tests how effective a sodium citrate sinus rinse is at restoring smell. The sinus rinse will also be paired with smell retraining therapy.

• A 12-month longitudinal study that tracks long COVID symptoms and how they affect lifestyle, like whether people are able to work and shop for groceries.

These studies will enroll participants who have already been seen by physicians at the UNC clinic. The current wait time for a new patient visit is four to six months, he said.

Barrata said he hopes his research on COVID will help inform the treatment of other chronic illnesses that are poorly understood, like chronic fatigue syndrome.

“I think there is reason to be optimistic for better understanding in the coming months and years,” he said.

Teddy Rosenbluth covers science and health care for The News & Observer in a position funded by Duke Health and the Burroughs Wellcome Fund. The N&O maintains full editorial control of the work.