A COVID-19 “long-hauler” is a person who experiences persisting symptoms of COVID-19 long after the infection is defeated. In addition to shortness of breath, long-haulers report extreme fatigue, tachycardia (a racing heart), gastrointestinal issues, low-grade fever, muscle and joint pains, and cognitive complications such as memory loss and brain fog that interferewith everyday tasks.
– National Institutes of Health Director's Blog and the American Association of Retired Persons
For some, these symptoms can last weeks. For others, the syndrome can drag on for months. An Italian study published in JAMA found 87 percent of hospitalized COVID-19 patients had at least one symptom continue two months after the onset of the disease. And, it's not just critically ill patients who are feeling the lingering effects of COVID-19. In the CDC report that looked at recovery rates for people with mild illness, 1 in 5 young and healthy adults reported prolonged problems.
Sean Smith, M.D., an assistant professor of physical medicine and rehabilitation at the University of Michigan Medical School, says …
“Now, we're also seeing more outpatients (people who were never admitted to the hospital) who are able to walk, but they need oxygen long term to help relieve shortness of breath. And even with oxygen therapy they still get winded very easily, can't climb stairs like they used to, that sort of thing.”
(Rachel Nania. “When Coronavirus Symptoms Refuse to Go Away.” AARP. September 04, 2020.)
Other viral illnesses can also result in chronic symptoms, including SARS and RSV (respiratory syncytial virus). But what is different is that the lasting symptoms seem to be more common and more magnified with COVID.
David Putrino, a neuroscientist and a rehabilitation specialist at Mount Sinai Hospital has cared for many long-haulers, mostly women whose average is age is 44. Most were formerly fit and healthy. They are very different from the typical portrait of a COVID-19 patient – an elderly person with preexisting health problems. Putrino says …
“It’s scary because in the states that are surging, we have all these young people going out thinking they’re invincible, and this could easily knock them out for months. And for some, months of illness could turn into years of disability.”
(Ed Yong. “Long-Haulers Are Redefining COVID-19.” The Atlantic. August 19, 2020.)
Putrino thinks that many long-haulers have symptoms that resemble dysautonomia. This is an umbrella term for disorders that disturb the autonomic nervous system, which controls bodily functions such as breathing, heart rate, blood pressure, and digestion.
More than 90 percent of long-haulers whom Putrino has worked with also have “post-exertional malaise,” in which even mild bouts of physical or mental exertion can trigger a severe physiological crash.
Of course, our initial understanding of COVID-19 early formed around the idea that it kills a few and is “mild” for the rest. That belief was circulated before the new coronavirus even had a name, and, instead of shifting in the light of fresh data, it remained. Now, it appears that no matter the exact diagnosis, the COVID-19 pandemic will almost certainly create a substantial wave of chronically disabled people.
ABC News in an article titled “Doctors working to crack the mystery of 'long haul' COVID-19 sufferers,” reported …
“In a multi-state survey report from the CDC, 35% of patients who tested positive for COVID-19 with symptoms had not returned to their usual state of health when interviewed two to three weeks after testing. Experts don't yet know the exact percentage of people who are likely to suffer these long-term effects, or how long the symptoms last.
“And, according to a survey conducted by the British Medical Association (BMA) and reported in the BMJ, one-third of the 3,729 doctors surveyed have treated patients with long-term COVID-19 symptoms, including chronic fatigue and loss of the sense of smell.”
(Dr. Alexis E. Carrington and Dr. Jay Bhatt. “Doctors working to crack the mystery of 'long haul' COVID-19 sufferers. ABC News. September 09, 2020.)
We must get the pandemic under control, but also we must not ignore the long-term impact of Covid-19. Even when the threat of severe illness and death is in the past, some people with Covid-19 will remain seriously incapacitated. We must figure out why and try to fix it. The long-haulers deserve our utmost attention.
"The important thing to note is that statistically, long haulers may be charted as folks who have recovered from the illness – but in reality, their life is forever changed and they will likely never be the same.”
– Dr. Sunny Jha, anesthesiologist caring for COVID-19 patients in a special hospital in Los Angeles
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