Many post-Covid patients face new medical problems

Hundreds of thousands of Americans have sought medical attention for post-Covid health conditions that had not been diagnosed before becoming infected with the coronavirus, according to the largest study to date on the long-term symptoms of Covid-19 patients.

The study, which tracks the health insurance records of nearly 2 million people in the United States who contracted the coronavirus last year, found that a month or more after their infection, nearly a quarter – 23% – of them sought medical treatment for new conditions.

Those affected were of all ages, including children.

The most common new health problems were pain, especially in the nerves and muscles; breathing difficulties; high cholesterol; discomfort and fatigue; and high blood pressure.

Other problems were bowel symptoms, migraines, skin problems, heart abnormalities, sleep disturbances, and mental disorders such as anxiety and depression.

According to the study, health problems after infection with the virus were common, even in people who had not gotten sick at all.

While almost half of patients hospitalized for Covid-19 experienced subsequent medical problems, 27% of people who had mild or moderate symptoms and 19% of people who said they were asymptomatic also experienced medical problems.

“What surprised us was the large percentage of asymptomatic patients they’re in that long Covid category, ”said Robin Gelburd, president of FAIR Health, a nonprofit that conducted the study based on what it claims is the world’s largest claims database. country’s private health insurance.

More than half of the 1,959,982 patients whose charts were evaluated showed no symptoms of their Covid infection.

40% had symptoms but did not require hospitalization, including 1% whose only symptom was loss of taste or smell; only 5% were hospitalized.

Gelburd said it’s important to highlight the fact that asymptomatic people can show symptoms post-Covid, so patients and doctors know they should consider the possibility that certain health issues may in fact be. consequences of the coronavirus.

“There are people who may not even know they had Covid,” he said, “but if they continue to have some of these conditions that are unusual for your health history, it may be of interest to the healthcare professional with whom he works to do more research. “

The report, which will be published on the organization’s website Tuesday morning, analyzed the records of people diagnosed with Covid-19 between February and December 2020, with follow-up until February 2021.

It found that 454,477 people visited health care providers for symptoms 30 days or more after their infection.

FAIR Health said the scan was reviewed by an independent academic reviewer, but not formally peer reviewed.

“The strength of this study really is its size and its ability to examine the full range of disease severity in a variety of age groups,” said Dr. Helen Chu, associate professor of medicine and infectious diseases at the College. of Medicine at the University of Washington, which was not involved in the report.

“It’s a study difficult to do with so much data“.

The report “shows that the long Covid can affect almost all organ systems“said Dr. Ziyad Al-Aly, chief of the research and development department of the health care system of St. Louis VA, who was not involved in the new study.

“Some of these manifestations are chronic illnesses that will last a lifetime and will mark forever to certain individuals and families, ”added Dr Al-Aly, author of a large study published in April on persistent symptoms in Covid patients in the health system of the Department of Veterans Affairs.

In the new study, the most common problem that patients saw a doctor for was pain – including nerve inflammation and associated nerve and muscle pain – reported by more than 5% of patients or nearly 100,000 people, with more than a fifth of those reporting post-Covid problems.

3.5% of post-Covid patients have experienced breathing difficulties, including shortness of breath.

Almost 3% of patients sought treatment for symptoms associated with diagnostic codes of malaise and fatigue, a very broad category that could include problems such as brain fog and exhaustion that gets worse after physical or mental activity – effects that have been reported by many people with long-term Covid.

Otros problemas nuevos para los pacientes, especialmente los adultos de entre 40 y 50 años, fueron el colesterol alto, diagnosticado en el 3% de todos los pacientes post-Covid, y la presión arterial alta, diagnosticada en el 2.4%, según The report. Dr Al-Aly said these health conditions, which have not been commonly seen as sequelae of the virus, show “increasingly clearly that post-Covid or long-term Covid has metabolic signature marked by disorders of the metabolic machinery ”.

Relatively few deaths – 594 – occurred 30 days or more after Covid, and the majority occurred in people who had been hospitalized for their coronavirus infection, according to the report.

The study, like many others using electronic records, only addressed certain aspects of the post-Covid landscape.

He did not specify when the patients’ symptoms appeared or how long the problems persisted, and he did not assess exactly when, after infection, patients sought medical help, only that it was 30 days or more.

The database only included people with private health insurance or Medicare Advantage, not those who were not insured or covered by Parts A, B and D of Medicare, Medicaid or other health programs. government.

Dr Chu said people without insurance or whose income is low enough to qualify for Medicaid are often “more likely to have worst results “, the results may therefore underestimate the prevalence of some post-Covid health problems or may not represent the whole picture.

Additionally, electronic records diagnostic codes are “as good as documented by the provider who saw the patient,” said Dr Chu, co-author of a smaller study on post-Covid symptoms in patients. Washington academics.

For example, neurological or cognitive problems, like brain fog, go unreported because doctors cannot find an appropriate diagnostic code or because patients do not seek medical help for that specific problem, FAIR Health noted.

It is also possible that some people classified as asymptomatic infected with Covid-19 have developed symptoms after testing positive.

And some people who were first diagnosed with a medical problem such as high blood pressure or high cholesterol after Covid may have had these problems before but have never sought or received treatment.

Another limitation of the study is that people who had Covid-19 were not compared to those who did not, so it is not clear whether post-Covid symptom rates were higher than in a more general population.

The study by Dr Al-Aly, who made such a comparison, found that between one and six months after being infected with the coronavirus, patients who had Covid had a 60% higher risk of death and a 20% higher likelihood of needing outpatient medical care. care only for people who had not been infected.

The FAIR Health report excluded patients with certain pre-existing serious or chronic conditions, such as cancer, kidney disease, HIV infection, liver disease, and stroke because the researchers said that it would be difficult to separate their past health from post-Covid symptoms. .

The report did not explore links between patients’ other pre-existing conditions and their likelihood of developing post-Covid symptoms.

However, it is claimed that people with intellectual disability or Alzheimer’s disease or dementia they were at increased risk of dying 30 days or more after infection.

Overall, experts say, the report’s findings underscore the widespread and varied nature of post-Covid symptoms.

“People with prolonged Covid need multidisciplinary care,” said Dr Al-Aly, “and our health systems must adapt to this reality and develop the capacity to manage these patients”.

Pam Belluck is a health and science writer whose honors include sharing a Pulitzer Prize and the Nellie Bly Prize for Best Featured Story. She is the author of Island Practice, a book about an unusual doctor. @PamBelluck