I got COVID (the OG version) in September 2020. Six days later, my senses of smell and taste were back, and I was over everything but the fatigue. The fatigue dragged on and on, and I started to get scared. Was I turning into a case of “Long COVID”?
My doctor is unusually thorough, so she did bloodwork for everything, including mononucleosis (an infection with the Epstein-Barr virus, which I had a severe case of in high school).
There are generally two tests for mono, one that is referred to colloquially (at least where I live) as “mono spot,” which is a simple positive or negative test. She did that one, but she also did a titer test to measure the actual presence of the virus in my blood. For reasons that are not understood (yet), my mono spot turned up negative. My titer test, however, revealed the presence of mono in my blood at a level more than twice as high as necessary for a diagnosis. If my memory serves, it was 43 when the usual threshold for a diagnosis is 20.
I did what one normally does for mono. I stayed in bed as much as humanly possible, slept and slept and slept, and I fully recovered in eleven weeks.
If someone you love believes themselves to be suffering from “Long COVID,” try to get a doctor to test them for Epstein-Barr virus, and make sure you get both types of tests. Let them know you will be asking about specific numbers, and you want them to do the sort of test that returns those numbers.
Here is a study that discusses “Long COVID” in terms of re-activated Epstein Barr virus. Bear in mind that not everyone who gets mono in high school or college is aware of it — the symptoms, especially in milder cases, can mimic depression, which is also quite common in that age cohort.
I think “Long COVID” is psychological for many people, but Epstein-Barr infections should absolutely be ruled out before that possibility is explored in any individual case, and I hope my experience has helped some of you know what questions to ask your doctor.