The Long Term Effects of COVID-19

Respiratory infections can damage lungs

“Viral respiratory infections can lead to anything from a simple cough that lasts for a few weeks or months to full-blown chronic wheezing or asthma,” Martin said.

He added that when a respiratory infection is severe, recovery can be prolonged with a general increase in shortness of breath — even after lung function returns to normal.

Also, patients with COVID-19 who developed ARDS, a potentially life threatening lung injury that could require treatment in an intensive care unit (ICU), have a greater risk of long-term health issues.

Who is most at risk?

Not everyone who beats COVID-19 has the same risk of experiencing long-term consequences from the SARS-CoV-2 infection.

Those most at risk are “people 65 years and older, people who live in a nursing home or long-term care facility, people with chronic lung, heart, kidney and liver disease,” said Dr. Gary Weinstein, pulmonologist/critical care medicine specialist at Texas Health Presbyterian Hospital Dallas (Texas Health Dallas). Additionally, he said others who could be at risk are those with compromised immune systems and people with morbid obesity or diabetes.

Weinstein added that there are particular health issues that patients with severe COVID-19 illness may face.

He said some patients will need to recover from pneumonia or acute ARDS and that many may require oxygen. Additionally, depending on the duration of the illness, many will be severely debilitated, deconditioned, weak, and could require aggressive rehabilitation.

“Finally, when patients have lung failure, they frequently have failure or dysfunction of their other organs, such as the kidney, heart, and brain,” emphasized Weinstein. However, “Patients with mild symptoms will recover faster and be less likely to need oxygen but will likely have weakness and fatigue.”

Post-intensive care syndrome

While placement in a hospital’s ICU can be lifesaving for patients with severe illness, it can also come with significant health consequences.

Generally, people requiring intensive care are at increased risk for mental health issues like post-traumatic stress disorder (PTSD), anxiety, and depression when they’re released from treatment, according to Weill Cornell Medicine in New York City. They may also have significant cognitive impairment and limited physical ability.

“Post-intensive care syndrome (PICS) is used to describe patients who have survived a severe critical illness, along with the intensive care required to survive. Patients can have some combination of physical impairment, cognitive impairment, and psychiatric impairment,” explained Weinstein. “Physical impairments that can occur include weakness and malnutrition. Cognitive impairment can include decreased memory, decreased attention, and decreased mental sharpness or ability to solve problems.”

COVID-19 might affect the brain stem

“Some of the data that we’re getting now from the China studies, one study that was just publishedTrusted Source in JAMA Neurology showed that 36.4 percent of patients had neurologic issues,” said Dr. Sheri Dewan, neurosurgeon at Northwestern Medicine Central DuPage Hospital in Winfield, Illinois. “One of the review articles that came out at the end of February discussed the possibility of virus traveling into the olfactory neurons, through the olfactory bulb, and into the brain.”

Dewan said one theory was that COVID-19 can affect the medulla oblongata (the brain stem), which controls our cardiorespiratory system. “So in that way, it’s not only related to the lungs, where the patients can’t breathe properly, but also the medullary neurons that control our breathing are also affected. This is one of the first articles pointing that out.”

But she emphasized that there isn’t enough data available to know what the long-term consequences of this could be. Dewan said it might be helpful to look at what is known about the damage to this area.

“It’s really difficult to say right now without data, however, patients that have stroke in the medulla, take the virus out of it and look at damage to the medulla — some of those patients will actually end up needing long-term tracheostomies to breathe,” she explained. “But we don’t know with the data that’s coming out, and some of the data from China is not necessarily comprehensive, but time will tell what the long-term effects will be.”

The bottom line

COVID-19 can be a severe illness, especially in people over 60 years of age or those with chronic diseases like diabetes and cardiovascular issues.

Impaired lung function from SARS-CoV-2 infection can negatively affect other organs like the heart, kidneys, and brain, with significant health impacts that may last after getting over the infection.

Experts say that being placed in a hospital’s intensive care unit can result in post-intensive care syndrome, which includes diminished physical abilities and cognitive impairment. Also, the coronavirus could infect a part of the brain involved in breathing and circulation with, so far, unknown consequences.

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