What Doctors Know So Far About The Long-term Effects Of COVID-19
📍WORRISOME—Over 91% of #COVID19 patients in South Korea survey report suffering from residual effects after recovery. #longhaulers— Eric Feigl-Ding (@DrEricDing) September 29, 2020
Fatigue (26.2%), inability to focus (24.6%), brain/mental problems, & loss of taste/smell, among many symptoms. #longcovid https://t.co/Mqr1nkKDkw pic.twitter.com/ADkIhLomXE
As of Tuesday, more than 72,000 people in Utah have contracted COVID-19. Most of them — about three quarters — are considered recovered. But as the pandemic wears on, many reports are emerging about the wide range of lasting consequences they may face from the disease.
A recent survey of nearly 1,000 coronavirus patients in South Korea found that over 91% reported lingering effects after they were considered recovered — including fatigue, inability to focus and loss of taste and smell. Other survivors have reported irregular heart rhythms, joint pain and difficulty breathing.
“The magnitude, severity and duration of COVID-19 suggests we will see a wave of longer-term health consequences emerge in survivors,” Melbourne-based medical researcher Elizabeth Hartland said in The Guardian. “These will be many and varied; immunological, haematological, gastrointestinal and neurological.”
But she said doctors still don’t know how many of those symptoms will translate into chronic health issues in the future and patients are often left wondering how long their symptoms will persist.
Here’s a look at what is known so far:
The coronavirus is primarily a respiratory illness, and affects the lungs most directly. It causes them to inflame and sometimes fill with fluid.
Dr. Panagis Galiatsatos, a lung disease expert at Johns Hopkins Medical Center, wrote the virus can cause pneumonia and, in the most severe cases, acute respiratory distress syndrome — a form of lung failure.
He said COVID-19-induced pneumonia tends to affect both lungs, filling them with fluid and making it harder for patients to breathe. While the pneumonia does not usually leave lasting symptoms, if it progresses, acute respiratory distress syndrome can set in and scar the lungs, Galiatsatos said.
Those impacts can contribute to the shortness of breath, dizziness and extreme fatigue many patients report feeling.
“It's hard to describe how brutal the fatigue can be,” Maneesh Juneja, who has reported 174 days of lingering symptoms, said in a tweet. “This is not normal tiredness, this is like a wave of complete exhaustion that envelopes your body & brain.”
Doctors are beginning to find evidence that the body’s immune response to the virus can damage the heart and cardiovascular system.
According to Dr. Kevin Shah, a cardiologist at the University of Utah, that can lead to complications such as irregular heart rhythms, heart failure and strokes.
Shah said those complications tend to show up in people who had severe cases of the disease — patients who are older or who have chronic medical conditions — but also in younger patients who are obese. According to the Centers for Disease Control and Prevention, severe heart damage has also occurred in young, healthy people, but is rare.
The CDC noted heart damage might also help to explain other frequently reported long-term symptoms, such as chest pain.
Shah said he’s also seen that COVID-19 has led to indirect effects to heart health in that it’s caused people to avoid or delay seeking medical care.
“What we're finding is many patients come to the hospital with a delayed presentation of their acute cardiovascular problems,” he said. “And for a lot of these conditions, time matters and delaying seeking medical care can have a dramatic consequence.”
It's hard to describe how brutal the fatigue can be during #LongCovid, especially when family and friends say stuff like "Yeah, I also feel a bit tired now and then too"— #DigitalHealth Futurist 👨💻 (@ManeeshJuneja) September 29, 2020
This is not normal tiredness, this is like a wave of complete exhaustion that envelopes your body & brain
The virus can also impact other parts of the body, including the brain and kidneys.
Dr. Galiatsatos said severe cases of COVID-19 can result in sepsis, which can spread throughout the bloodstream and damage tissue everywhere it goes.
In a recent Washington Post op-ed, doctors William Li and Andrew von Eschenbach wrote about a July study in the New England Journal of Medicine that found the coronavirus could also infect and inflict serious damage to the vascular endothelium — a layer of cells that line the blood vessels of vital organs, including the brain, kidneys, heart and lungs. They said patients also have a much higher likelihood of experiencing clots in these blood vessels.
When the virus impacts the brain, it can lead to strokes, seizures and Guillain-Barre syndrome — a condition that causes temporary paralysis — even in young people, according to staff at the Mayo Clinic. It may also increase the risk of developing Parkinson's disease and Alzheimer's disease.
Much To Learn
Dr. Shah from the University of Utah said it’s still too early to determine who's going to face long-term problems from the virus and what kinds of complications they might see. He said the University of Utah is beginning a study to track patients’ recovery to better understand those implications, as are organizations around the world, including the CDC.
As their understanding of the virus evolves, health professionals continue to stress the best strategies for preventing COVID-19 infection in the first place are to wear a mask in public, stay at least six feet away from other people, wash hands frequently and avoid crowds and confined spaces.