Six at-risk groups, maybe more

Clear as mud, right? It’s easy to understand why even the experts aren’t sure who might be more likely to develop long COVID.

There are, however, some well-informed theories about who’s most at risk:

1) Those who’ve had repeat COVID infections, regardless of severity.

If you’ve survived COVID unscathed, the odds aren’t necessarily in your favor next time around. A preprint of a study published earlier this month on ResearchSquare found that risk of long COVID, hospitalization, and death increased with each COVID reinfection, Azola says.

• regardless of severity（无论其严重程度如何）

• unscathed: not harmed or injured

• in one's favor: to one's credit or advantage（对某人有利）

• next, first, second, etc. time around/roung

2) Those who had a high viral load during their COVID infection.

A recent study found that those who had higher viral loads during their acute COVID infection—regardless of severity of symptoms—were more likely to develop long COVID. Treatments like COVID antiviral Paxlovid may eventually reduce long COVID in this at-risk population by squashing their viral loads, Azola says.

• antiviral [a./n.]: an antiviral medicine or drug

• in this at-risk population（这一高危人群）

• squashing their viral loads（抑制病毒载量）

3) Those who harbor dormant Epstein-Barr Virus.

（那些有潜伏人类疱疹病毒第四型的人。）

Epstein-Barr Virus (EBV) is one of the most common human viruses. Many are infected during childhood and don’t know it, according to the U.S. Centers for Disease Control and Prevention. The virus can cause mononucleosis and, according to some researchers, Chronic Fatigue Syndrome—which, similar to long COVID, includes symptoms like fatigue, concentration problems, and headaches. The aforementioned study found that some long COVID patients were more likely to have levels of reactivated EBV circulating.

（根据一些研究人员的说法，这种病毒可以引起单核细胞增多症，以及慢性疲劳综合症。慢性疲劳综合症与冠状病毒疾病类似，包括疲劳、注意力不集中和头痛等症状。上述研究发现，一些长期冠状病毒疾病患者更有可能有重新激活的 EBV 循环水平。（

4) Those who have autoimmune antibodies circulating.

（自身免疫性抗体循环）

The aforementioned study also found that those with auto-antibodies circulating were at higher risk. Only 6% of long COVID patients with auto-antibodies had been diagnosed with an autoimmune condition before COVID, researchers wrote. “They seem to have an increased number of antibodies in their blood, but we don’t know why or how,” Azola says.

5) Those who had neurological symptoms during their COVID infection.

（神经系统症状）

Dr. Panagis Galiatsatos—an assistant professor at Johns Hopkins’ Division of Pulmonary & Critical Care Medicine who treats long-COVID patients—hypothesizes that a subset of “long haulers” who experience fatigue and shortness of breath have brains that misinterpret subclinical inflammation or remaining virus. Their neurons, damaged by COVID, signal for the body to produce sensations that encourage them to seek more sleep and oxygen. In his clinical experience, long COVID patients who fit into this bucket often experienced neurological symptoms—like loss of taste or smell and bad headaches—during their acute COVID infection.

（经历过疲劳和呼吸困难的 “长途运输者” 中，有一部分人的大脑会误解亚临床炎症（低度炎症 low - grade inflammation, LGI）或残留病毒。他们的神经元被冠状病毒疾病损坏，向身体发出信号，使身体产生感觉，促使他们寻求更多的睡眠和氧气。根据他的临床经验，长期冠状病毒疾病的病人在急性冠状病毒疾病感染期间经常会出现神经症状，比如味觉或嗅觉丧失和剧烈头痛。）

6) Those who haven’t been vaccinated.

There is conflicting data about how much vaccination reduces one’s risk of long COVID. “Some studies say a lot, some say 10%, but the overarching message is that vaccines decrease the risk of long COVID,” Azola says.

• the overarching message: 主要信息

Unfortunately, most long COVID risk factors are out of our control and, perhaps, even our ability to know if they apply to us. The things in our control, Azola says: vaccination, masking, and social distancing.

Individuals should weigh their risks not only of coming down with severe COVID, but of developing long COVID, Azola says—especially as new variants continue to evolve and cause reinfection.

（阿佐拉说，人们不仅要权衡患上严重冠状病毒疾病的风险，还要权衡患上长期冠状病毒疾病的风险ーー尤其是在新的变异体不断进化并导致再感染的情况下。）

Long COVID “can happen to anyone, independent of severe disease,” she says. “It can be disabling. The thought of ‘COVID is over,’ or that we need to put our masks away, is a completely unfair assessment. We still need to be diligent.”

它可能会让人丧失行动能力。

我们仍需努力。