COVID-19 isn’t simply a disease in which a person either recovers or dies. There is a subset of cases in which varied health problems persist after a typical recovery timetable.
The Healthier Oklahoma Coalition on Tuesday dedicated a portion of its weekly virtual news conference to the subject of what is commonly referred to as long-haul syndrome, or long COVID, or long-haulers. The majority of people do recover as outpatients, but not all.
“It’s important to remember that COVID’s a serious infection that doesn’t just involve the respiratory tract and the lungs, but all of the major internal organs: heart, kidneys, pancreas, major blood vessels,” said Dr. Stan Schwartz. “You’ve heard that people get strokes during COVID, even young people that have no risk of getting strokes.”
Schwartz holds a fellowship from the Infectious Diseases Society of America. He said the virus either circulates and attacks organs — it’s been found in organs other than the lungs — or the virus causes an inflammatory reaction in which the body begins to destroy itself in those inflamed areas.
He said most experts agree that a person who is significantly sick but doesn’t necessarily need hospitalization on average can take a full month for “a so-called normal recovery.” About 10% of people who have “recognized but not highly severe infections” don’t resolve their symptoms by that month and have some degree of impairment afterward, he said.
Severely sick people are expected to take longer, he said, but some stay ill much longer than anticipated based on their infection’s acuteness.
“We don’t know how long this is going to go on because COVID’s only been around in the United States for a bit over a year,” Schwartz said.
Healthier Oklahoma Coalition is a group of health care professional organizations throughout the state. Schwartz also is a Fellow of the American College of Physicians.
Schwartz listed off typical long-haul symptoms: Shortness of breath; persistent discomfort in the chest and cough; alteration or loss of smell and taste; a “brain fog” or memory impairment that makes it more difficult to think; psychological symptoms such as anxiety; or symptoms characteristic of post-traumatic stress disorder.
There can be permanent damage to lungs after COVID-19. Kidney damage has led to dialysis treatments, he said, and attacks to the pancreas have resulted in new onset diabetes or a worsening of the condition.
Some people who are very sick or in intensive care lose tremendous bone and muscle mass, which lead to persistent fatigue and loss of endurance that can last for months, he said.
There also are cases of people who have multiple symptoms for which doctors can’t find specific organ damage, he said.
“In a way these people resemble folks that have chronic fatigue syndrome — something I’ve been interested in for years — another long-term syndrome that can go on months or years after certain infections,” Schwartz said.
Schwartz said that about one-third of people whose infection is significant enough to be sick will have some involvement of the heart, such as mild inflammation.
He said anyone who has had a serious COVID infection and will perform high-intensity activities or partake in sports should undergo a cardiology evaluation before resuming.
“I think it’s really important to distinguish between the kind of damage you can get to the internal organs from COVID, and the persistent symptoms that some people get who never really had that bad of a condition,” Schwartz said. “It’s going to be something we’re going to be seeing a lot of I think, considering the millions of people who have had COVID in this country.
“I think we’ll see quite a few folks with these long-haul symptoms, we’ll be learning a whole lot about it as we go along.”
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