Is this a long covid or just getting old?

You’re middle-aged with new symptoms after a COVID infection—fatigue, brain fog, joint pain. Is debt COVID? Or are you just getting old?

If you’ve wondered, you’re not alone.

“That’s the thing,” said Dr. Alba Miranda Azola, co-director of the long-standing COVID-19 clinic at the Johns Hopkins University School of Medicine. Wealth.

Given that the world has officially seen barely 650 million of recorded cases of COVID– and that about 10% of the world’s population is 65 or older—aging and long-term COVID will inevitably intersect. This is especially true considering that the aging process for many becomes visible at the beginning early middle ages.

As patients get older, “I think it gets a little cloudy,” Azola said.

There are currently no official diagnostic criteria for long-term COVID. Even the definition of the condition varies depending on who you talk to, though it’s generally considered new symptoms that start during or appear after a COVID infection and last for weeks or months.

More complicated, the symptoms and timing of aging can vary greatly due to genetic and environmental factors. So it’s not possible to say definitively whether your new symptoms are due to aging or long-term COVID, both or neither, Azola and other experts say.

“Could the debt be COVID? The short answer is yes,” she said. “But it’s hard to tease out whether it’s long-term COVID or whether other things are contributing.”

‘The chicken or the egg?’ dilemma

WITH more than 200 identified symptoms— from lingering coughs and fatigue to ear numbness and the feeling that “the brain is on fire” — long-term COVID is undoubtedly not one but multiple conditions, experts say.

True long-term COVID, many argue, is best defined as a chronic fatigue syndrome-like condition that develops after infection with COVID, similar to other post-viral syndromes that can occur after infection with herpes, Lyme disease, and Ebola, among others.

Other post-COVID complications such as organ damage should not be defined as long-term COVID and would fit better under the larger umbrella category of PASC, experts say. Also known as post-acute consequences of COVID-19the term is used to encompass a wide range of consequences of COVID, from chronic fatigue-like symptoms and the aftermath heart disease to permanent lung damage to strange new symptoms such as urinary incontinence, itching and skin lesions.

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Signs of aging can overlap with a long illness of COVID-19, or so it seems. These often include back and neck pain, osteoarthritis, chronic obstructive pulmonary disease and dementia, among others. according to the World Health Organizationnear fatigue.

Officially diagnosed or not, it is estimated that almost 60% of the world’s population is infected with COVID, according to Institute for Health Metrics and Evaluation at the University of Washington. Now that most of the world’s citizens have experienced the virus, it’s difficult to determine what new symptoms and conditions the virus has caused or contributed to, said Dr. Nir Goldstein, a pulmonologist at National Jewish Health in Denver who directs the long-term hospital clinic..

“From a clinical perspective, it becomes challenging to temporally define causality,” he told za Wealth.

Time as an indicator

Symptoms of aging usually appear gradually, said Dr. Panagis Galiatsatos, an assistant professor in the Johns Hopkins Division of Pulmonary and Critical Care Medicine who sees long-term COVID patients. Wealth. Not so with the long COVID.

“There really is a big difference between ‘Before I felt like this’ and ‘After I felt like this,'” he said regarding the lingering symptoms of COVID after a COVID infection. “I don’t think too many people confuse their symptoms with aging.”

“Many patients will tell you they feel like they’ve aged after COVID,” he added.

At Azola, there are many elderly patients who have been less active in the last two years due to pandemic restrictions, and now complain that exercise is exhausting. Reduced activity during the pandemic — not the virus — could be to blame for at least some of their symptoms, she said.

“The elderly population experiences a combination of reduced activity during years of isolation and then deconditioning,” she said.

“Most respond well to more physical approaches to activity progression” or physical therapy, she said.

For now, it doesn’t matter what’s causing your symptoms, experts say, since no treatments have been approved specifically for long-term COVID. Doctors treat the symptoms, regardless of the cause.

Ultimately, the cause of symptoms could matter if the exact mechanisms behind long-lasting COVID are determined and treatments are developed, Goldstein said.

“But at this point, practically, it’s not,” he said.

This story was originally published on Fortune.com

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