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| Patient Mike Camilleri works with physical therapist Beth Hughes in St. Louis on March 1. A mild covid-19 case set off a chain reaction that left Camilleri with dangerous blood pressure spikes, a heartbeat that raced with slight exertion and episodes of intense chest pain (Angie Wang/AP) |
A recent study has unveiled that numerous long-lasting
symptoms associated with long COVID persist even after two years, highlighting
the continued impact of the virus on people's health. The research sheds new
light on the true toll of the virus, revealing that even individuals who had
mild cases of COVID-19 remain at an increased risk for various health issues
such as lung problems, fatigue, diabetes, and other conditions commonly linked
to long COVID.
The study, which was published in the journal Nature Medicine
on Monday, is significant for being one of the first to comprehensively
document the extent to which a range of post-effects can persist beyond the
initial months or year following a COVID infection. The research delves into
the lingering consequences that individuals can face as part of the often
debilitating syndrome known as long COVID.
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| Hundreds of cots on the National Mall in Washington on May 12 represent the millions of people suffering from post-infectious disease complications. (Sarah Silbiger/Bloomberg News) |
The findings from the study emphasize that patients who
experienced more severe COVID cases requiring hospitalization are particularly
susceptible to enduring health problems and even death two years after their
initial infection. However, even individuals with milder or moderate cases of COVID
are not exempt from consequences when compared to those who never contracted
the virus, as they still face a heightened risk of developing numerous medical
conditions covered in the analysis.
The study highlights an ongoing burden faced by millions of
individuals in the United States and the healthcare system at large. This is
notable given that the federal government officially ended the coronavirus
public health emergency a few months ago and the World Health Organization
declared the pandemic no longer an international public health emergency.
Ziyad Al-Aly, the senior author of the study and a clinical
epidemiologist at Washington University School of Medicine, explained that many
people might think they've recovered from COVID and are fine, but the study
reveals that the virus continues to impact their bodies, leading to enduring
health issues even years later.
The concept of long COVID remains complex and multifaceted,
with different studies defining it based on various symptoms and timeframes.
Notably, some medical professionals still don't fully acknowledge the
seriousness of patients' complaints regarding long COVID. The new study
differentiates itself by using a two-year timeframe and exploring a broader range
of symptoms and conditions.
Various estimates exist regarding the prevalence of long COVID's
significant aftereffects. One analysis, based on a collaboration between The
Washington Post and electronic health records company Epic, suggested that
around 7 percent of nearly 5 million COVID patients in the United States sought
care for long COVID symptoms within six months of their initial illness. This
equated to approximately 15 million individuals with symptoms typical of long COVID
among the roughly 200 million known COVID cases in the country at that time.
The study draws its data from electronic medical records from
VA databases containing records of almost 139,000 military veterans diagnosed
with COVID in the early stages of the pandemic, between March 2020 and the end
of the same year. They were compared with a group of nearly 6 million veterans
who were not confirmed to have contracted COVID during that period. Both groups
were monitored every six months for up to two years, investigating whether those
who had COVID exhibited higher rates of about 80 conditions associated with
long COVID. Hospitalizations and deaths were also examined.
Among COVID survivors who had been hospitalized, there was a
heightened risk of death, subsequent hospitalization, and a majority of the
medical conditions studied two years after infection. These conditions included
cardiovascular issues, blood clotting problems, diabetes, gastrointestinal
troubles, and kidney disorders. Notably, the study's findings suggest that the virus
itself contributed to the heightened risk of persistent medical problems, as
the survivors and uninfected individuals had similar health statuses at the
outset.
For those COVID survivors with milder cases, their long-term
risks were reduced but not eliminated. Six months after testing positive, their
likelihood of death was comparable to that of uninfected individuals. While
their elevated risk had mostly dissipated by then for two-thirds of the
conditions examined, they still faced higher odds of medical problems related
to specific organ systems, such as cardiovascular, gastrointestinal, and blood
clotting issues, along with diabetes, fatigue, and lung problems, even after
two years.
The study has been praised for capturing the experiences
narrated by patients, who report varied and debilitating impacts on different
systems, leading to diminished quality of life and disruptions in work and
school. Patients have described ongoing challenges, such as becoming fatigued
after walking short distances.
Despite some positive aspects of the study, such as
indicating that some individuals with milder COVID cases tend to have fewer
lasting effects over time, Eric Topol, director of the Scripps Research
Translational Institute, pointed out that the data doesn't offer much optimism.
He remarked that the findings essentially extend the patterns observed at the
one-year mark.
The study acknowledges that the COVID survivors included in
the analysis might not entirely represent the demographic most prone to
developing long COVID. Since the study focuses on veterans, the cohort is older
than the general population, and it largely consists of men, unlike the broader
group of long COVID patients in which women constitute the majority.
The study's limitations are apparent in its timeline, as it
only examines patients infected in 2020, a period before COVID vaccines were
widely accessible and before antiviral treatments like Paxlovid were developed.
This also means that the participants were exposed to the virus without any pre-existing
immune defenses from previous COVID infections.
Looking forward, the study's authors are actively engaged in
continuing their research and are planning to conduct three-year and even
five-year analyses to further understand the long-term effects of COVID.
Immunologist Akiko Iwasaki from Yale School of Medicine noted that while the
future remains uncertain, the emergence of the Omicron variant and its
associated long COVID symptoms might align with the study's findings, as the
variant is still fundamentally a version of the same virus.
This study contributes to a growing body of research
demonstrating that viral outbreaks can lead to enduring aftereffects. The study
was funded by the Department of Veterans Affairs and was conducted
independently of the $1.2 billion long-COVID initiative known as RECOVER
initiated by the National Institutes of Health.
As the US has witnessed over 1 million COVID-related deaths
and the WHO has reported more than 103 million confirmed COVID cases in the
country, the study underscores the importance of understanding the lasting
consequences of the virus, even as it has been somewhat overshadowed by other
pressing pandemic-related concerns.
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