Prolonged COVID-19 patients face persistent and worrying health risks, study finds

Not only can the health effects of COVID-19 last for months, but appear to increase the risk of death and chronic health problems, even in people who were never sick enough to be hospitalized, a new study finds.

In the study, published this Thursday in the scientific journal Nature, Researchers analyzed the medical records of more than 73,000 people in the United States whose coronavirus infections did not require hospitalization. Between one and six months after being infected, these patients had a significantly higher risk of death (60% higher) than people who had not been infected with the virus.

Research, based on patient records in the health system of the Department of Veterans Affairs, also found that out-of-hospital COVID-19 survivors were 20% more likely to need ambulatory care during those six months than people who had not contracted the coronavirus.

Virus survivors have experienced a wide range of long-term medical problems that they have never had before, not only lung problems due to the respiratory effects of the virus, but symptoms that can affect virtually any organ system or part of the body, neurological, cardiovascular or gastrointestinal. They were also at higher risk for mental health problems, such as anxiety and sleep disturbances. “We found it all,” said study author Dr. Ziyad Al-Aly, head of research and development VA St. Louis Health Care System.

“It’s obvious that recovering from the disease does not mean recovering from the after-effects it may have caused. This is observed in many patients who, after overcoming the disease, are left with a sequelae profile for a long time and may even have a greater possibility of suffering from certain complications or of dying. SARS-CoV-2 is an extremely intelligent and capable microorganism. You have to be extremely careful to achieve the end goal that we have to have in front of him and which is not to be infected, ”he said. Amos García Rojas, president of the Spanish Vaccination Association and advisor of the vaccination plan in Spain.

American researchers have discovered that some of the post-illness medical problems patients, such as diabetes, kidney disease, and some heart problems can develop into chronic illnesses that they would need treatment for the rest of their lives.

“People have continuous respiratory illness, continuous headaches, this, that and the next,” he said in dialogue with The New York Times the doctor Laurie Jacobs, president of internal medicine of the Hackensack University Medical Center, who did not participate in the study. “And we still don’t understand the underlying cause or why it becomes chronic in some cases and disabling in others. In some areas people have improved, but it varies a lot. “

Jacobs assured that his clinic looked at the wide range of symptoms in the study. But say that the risk of death among the patients in the study was considerably higher than I expected. “I was really surprised by the number,” he said.

Thinks that the study is the largest to date by evaluating such a full range of health problems. Outpatient COVID-19 survivors in the study tested positive for the virus from March 1, 2020 through November. Researchers compared their risk of death and other characteristics with data from nearly 5 million patients in the Veterans System who did not have COVID-19 and they were not hospitalized during this period.

“It is a problem that arises every day. Each time we find more surprises about what happens to those who have been infected with the virus. Keep in mind that in many people the infection is massive, for example in the coloring of fabrics. There, the amount of virus that affects the lungs or the heart is really massive. It does not surprise me that among these people there is a higher mortality, even months after being infected, because a large part of these tissues are still affected ”, he stressed in dialogue with Infobae Ernesto Resnik, Argentine scientist, molecular-cell biologist and biotechnologist specializing in monoclonal antibodies.

Between one and six months after suffering a relatively mild or moderate infection, 1,672 of 73,345 patients, or about 2.3%, died, the study reported. It does not say what caused the deaths or anything specific about the conditions of these patients.

Researchers they also couldn’t tell if people had any underlying health issues what if your new symptoms were the direct effects of their coronavirus infection, the corollary effects of the drugs they were taking to treat some of the symptoms, the stress of other pandemic-related issues or other influences. Experts said the study’s results reflected a cascade of problems due not only to the virus itself, but also the medical system’s struggle to cope with the disease and its long-term effects.

“We have hundreds of thousands of people with an unrecognized syndrome and we’re trying to find out more about the immune response and how the virus modifies that response and how the immune response can include all organ systems in the body ”, the doctor warned Eleftherios Mylonakis, head of infectious diseases of the Warren Alpert School of Medicine and the Brown University Lifespan Hospitals, who also did not participate in the study. “The health care system is not designed to cope with something like this.

For the specialist, in many cases, “People with new symptoms who have never been seriously ill from the viral infection are entering a confused and balkanized medical world, where they seek help from primary care physicians and are then referred to various specialists who are attempting to treat conditions that fall within their particular area of ​​expertise. This helps explain why the study found that survivors of the disease had about one and a half times more outpatient visits per month than patients in the general VA population. “

Research has shown that COVID-19 survivors they were also more likely to take a variety of medications for their new health problems, including the opioidsthat the doctor Al-ally said it was worrying because it might herald another wave of opioid addiction issues to come.

Al-ally and his co-authors Yan Xie and Benjamin Bowe, both Washington University in Saint-Louis, too analyzed the records of 13,654 patients hospitalized for their initial coronavirus infection. As expected, found that the sickest patients, those who needed intensive care, had the highest risk of long-term complications, followed by those who have been hospitalized in ordinary wards, followed by patients who have never been hospitalized.

However, at least some of the people who have never been hospitalized have experienced virtually all categories of symptoms, from chest pain to shortness of breath, diabetes and muscle weakness.

“I would interpret this as saying: “The virus is everywhere” “, said the expert. “Even though you stayed home and recovered in quotes in three or four days. Yes this is very important because this segment is really the bulk of COVID-19 patients. Most people, when they contract the disease, are not hospitalized, ”he continued.

For hospitalized people, their experiences involved a significantly higher risk of long-term health complications than people hospitalized for seasonal influenza, the study found. They had more likely to develop or have persistent symptoms in a wide range of categories beyond respiratory manifestations of coronavirus: metabolic neurological, cognitive, psychological, cardiovascular, gastrointestinal problems, anemia and blood clotting, as well as fatigue and malaise.

Mylonakis and other experts noted that the understanding of the virus and the state of medical treatment are changing rapidly, And these advances are already translating into improvement for some patients. In addition, some people with long-term coronavirus have improved over time, either on their own or with the help of treatment.

Even like that, Al-ally concluded: “What we will be faced with over the next few years, maybe even decades, is the long-term health effect of the pandemic. We have been caught off guard for COVID-19. Let’s not let go of the ball for too long “.

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