Q: I've been hearing that there are long-term complications of COVID-19. Is that true?
A: Yes, it is true. There is still much that is not known about this disease and, since it is still only about a year old, that's especially true about the long-term consequences. The initial assumption was that a certain percentage of people got very sick from COVID-19 and a smaller percentage of people died from it, but that the majority of people who caught it would have a mild viral illness (or no symptoms at all) and fully recover.
Now doctors are beginning to see more and more people who either have long, slow recoveries, sometimes lasting weeks, or who appear to recover, but then begin developing longer-term symptoms. There are still a lot of questions about these cases, their relationship to COVID-19 and whether they are truly lifelong effects or just prolonged symptoms that will eventually go away.
It's important to realize that the patients who are having these longer-term symptoms do not have to have had a severe case of COVID-19. It would be expected that those with serious illness would have a longer recovery, but the U.S. Centers for Disease Control and Prevention reports, "Even people who are not hospitalized and who have mild illness can experience persistent or late symptoms."
Some of the most commonly reported long-term symptoms are very similar to the usual symptoms associated with COVID-19, such as fatigue, cough and aches and pains.
However, some people have more serious long- term complications that are related to actual organ damage, such as:
> Cardiovascular: inflammation of the heart muscle.
> Respiratory: lung function abnormalities.
> Renal: acute kidney injury.
> Dermatologic: rash, hair loss.
> Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems.
> Psychiatric: depression, anxiety, changes in mood.
Patients with these apparent long-term problems have come to be called "long haulers." It is not clear how common this condition is, but one study reported by the CDC interviewed COVID-19 patients two to three weeks after their illness. At that point, 35% of those interviewed reported that they had not yet returned to their usual state of health, including 20% of previously healthy patients in the 18- to 34-year-old age range. These patients do not remain contagious, but it is still unclear what is causing these problems.
Testing on some patients has shown heart muscle damage, damage to the air sacs (alveoli) in the lungs and even strokes. COVID-19 is known to increase the risk of blood clots, and some think this might be a part of the problem. However, there is currently no consensus on the cause. At this point, there is no cure for COVID-19 or its long-term effects, and there is no specific treatment for this condition other than to treat the symptoms.
So this is one more reason to not ignore the risks to everyone's health posed by this pandemic. Even a mild case of COVID-19 can lead to prolonged symptoms and possibly even permanent damage to your body. The only way to prevent these complications is to not get COVID-19 in the first place. The news on a vaccine remains promising, but there is still much we can do by following the same precautions we've been discussing for months now: Wear a mask or facial covering, keep your "socializing from a distance" to at least 6 feet from people outside your household, and keep up the good hygiene habits like handwashing. Also avoid being around crowds, and especially anyone who is sick. If you are sick, stay home. Further information can be found at bit.ly/covid-long.
Paul M. Hendricks, M.D., is the Hamilton County health officer and a member of the Chattanooga-Hamilton County Medical Society.