Long-term consequences of COVID-19

After more than a year of COVID 19, physicians have now been able to gain a lot of experience with the accompanying symptoms of this disease.

Only now one of the most serious consequences is coming to light, namely the long-term health consequences of the disease: Long Covid.

In a webinar, AAN and GAAPP President Tonya A. Winders, and Dr. Purvi Parikh (Clinical Assistant Professor of Medicine NYU Langone School of Medicine & Director, Allergy and Asthma Association, Murray Hill) highlighted this very issue of the long-term effects of COVID-19.

What are „Long-Haulers“?

The name was given to patients that have in theory recovered from the worst impact of COVID-19 and have tested negative – yet – they still have symptoms.
There seems to be no consistent reason for this.
10% of COVID-19 patients become „Long-Haulers“.

It can affect anyone:
Young, old, otherwise healthy people, people with other conditions, those who were hospitalized, patients who had very mild symptoms
“Long Haulers” have not been taken seriously enough. There is an urgent need for dedicated research.

Long-term health consequences of COVID-19

People cannot work or function as they normally would.
Long-term consequences remain largely unclear – 6 months later 75% still experience at least one Symptom.
A certain picture is emerging – according to one study – 50% are unable to work full time, 88% have cognitive problems/memory loss.

Persisting symptoms are:

  • Coughing
  • Ongoing, sometimes debilitating fatigue
  • Body aches
  • Joint pain
  • Shortness of breath
  • Loss of taste and smell — even if this didn’t happen during the height of illness
  • Difficulty sleeping
  • Headaches
  • Brain fog

COVID-19 and the brain

Patients suffer from a variety of symptoms due to effects on the brain:
– Confusion (including loss of smell or taste or life-threatening strokes)
– Patients in their 30s and 40s could experience possible life-threatening neurological changes due to strokes or hyperactive blood clotting
– Patients are also having peripheral nerve issues, such as Guillain Barré syndrome, which can lead to paralysis and respiratory failure.

Most confusing symptom: Brain fog!

Most confusing symptoms Long-Haulers report are being unusually forgetful and confused, or not even being able to concentrate enough to watch TV.

This can happen to people who have been in the ICU for a while, but it is relatively rare. It happens, however, in many patients who have not been in the hospital.

Some people have reported feeling better for a few days or even weeks and then relapse. For others, it is the case that they simply do not feel like themselves.

COVID-19 and the lungs

Post COVID-19 lungs:
Dense scarring in the lungs of most post COVID patients have been seen.
This occurs in nearly 100% of symptomatic patients and 70-80% in asymptomatic patients.

Theories

1. A common theory about long COVID is that the virus may remain in the body in a small form.
2. Another theory is that the immune system continues to overreact even though the infection has passed.

Studies

Study results from China

Six months after hospitalization from COVID-19 most patients experienced at least one symptom.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext

Symptoms:
Fatigue or muscle weakness, Sleep difficulties, anxiety or depression.
In more severely ill patients: Increased risk of pulmonary diffusion abnormality, atigue or muscle weakness. anxiety or depression (symptoms are consistent with SARS survivors)

Manifestations beyond the pulmonary system:
Risk of anxiety or depression as an important psychological complication and impaired pulmonary diffusion capacities were higher in patients with more severe illness.

Organ manifestations beyond the pulmonary system:
Renal dysfunctions observed, newly diagnosed diabetes, venous thromboembolic diseases, Cardiovascular events (heart), cerebrovascular events (stroke),persistent kidney impairment could lead to kidney injury or the need for dialysis.

Study results from UK

– 1/3 of COVID-19 patients end up back in the hospital within 5 months
– One in 8 dies from complications of the disease
– Development of heart problems, diabetes, chronic liver and kidney disease
– Higher risk of secondary diseases in various organs in people younger than 70 years of age

Since young and old people are at increased risk for other diseases, we need to continue to monitor COVID-19 patients over time.

Questions that remain

“Why one person and not the other?”
“Why do some seniors with COVID-19 die and others survive?”
“Why do some young people have severe problems – need a lung transplant and others seem to make a full recovery?”

Source:

https://allergyasthmanetwork.org/news/covid-long-haul/