Craig A. Spencer, director of Global Health in Emergency Medicine at New York-Presbyterian/Columbia University Medical Center, opens up about the post Covid syndromes. He worked during the Ebola time at Guinea and fell ill to the same disease and was fortunately recovered in 2014. Dr. Spencer now fights against Covid-19 in Columbia University Medical Center, New York.
Many people who’ve had Covid-19, the disease caused by the novel corona virus, continue to experience complications long after their initial illness, and those in the medical field still couldn’t make out why.
“As a doctor who treated hundreds of covid-19 patients in New York and sees them frequently in the emergency room, I know how this virus touched nearly every organ system, and how many still haven’t recovered months after their initial illness. But in a sense, I’m also a long-hauler myself”, he said.
So what research do we have for Covid-19? So much of what we know about long-haulers is actually from long-haulers themselves. Groups such as Body Politic led the first detailed patient surveys and have set up expansive support groups. We don’t know for sure, but multiple studies have suggested approximately 10 percent of people experience prolonged illness after Covid-19, many of which leading to death. These are the most prominent among them:
Lasting heart issues
A study from Rome showed the overwhelming majority of hospitalized patients still struggled with symptoms 60 days out. Fatigue, difficulty breathing, joint pain and chest pain persisted in many. About 87 percent still had at least one symptom, and 55 percent had three or more.
Covid-19 has been associated with many long-term cardiac problems, including inflammation of the heart muscle (myocarditis) or the sac around the heart (pericarditis), as well as abnormal heart rhythms. Some may develop cardiomyopathy, a disease of the heart muscle that prevents the heart from pumping effectively.
A lot of college and professional athletes have been found to have myocarditis, even after a mild bout of Covid-19, which has led some leagues and players themselves to call off their season.
Respiratory and kidney problems
Unsurprisingly, given that it’s primarily a respiratory virus, emerging data indicate that many patients must deal with lung damage and ‘experience persistent respiratory symptoms months after their initial illness’.
Like SARS and MERS (where 30 percent had persistent lung abnormalities after their acute illness), breathlessness and cough are commonly reported long after recovery from covid-19. Many also have fibrosis (scarring), bronchiectasis (damage to bronchial tubes) and pulmonary vascular disease.
But we also know that patients who have been on ventilators and who are given pulmonary rehabilitation early on have better and faster resolution of underlying damage and symptoms. Those of us working on the Covid-19 front lines saw how this disease caused kidney injury or failure in so many patients admitted to our hospitals.
The neurologic system seems to have the most diverse aftereffects of Covid infection, such as persistent headaches, anosmia (loss of smell), long-term disability from stroke and some relatively rare conditions – among them encephalitis, cranial neuropathies and even myasthenia gravis (a neuromuscular disorder causing weakness).
There are also many case reports of Covid-19 patients with Guillain-Barré syndrome, an autoimmune illness that causes altered sensation and motor function, primarily in the legs and arms. This was something we also saw with infections from the Zika virus a few years ago.
And there have been loads of studies about anosmia related to covid-19. In many, this was reported in 30 to 60 percent of Covid cases. Thankfully, most episodes resolved in two to three weeks, but for some, symptoms persist beyond that.
In addition to the neurologic impact, the mental health manifestations of long-Covid can be profound. According to a report in STAT, “1 in 3 patients recovering could experience neurological or psychological aftereffects of their infections.”
The mental health toll of this pandemic has been hard on everyone. But for long-haulers, the extra stress of being sick and not knowing if or when you’ll feel better is an added burden. Support groups are helping many, but we need more resources. Still, the exact after effects of Covid-19 infection is unknown to the medical field, the best way to stay healthy is taking all the precautions not to be infected.