As the COVID-19 pandemic has progressed, it has become clear that many survivors — even those who had mild cases — continue to manage a variety of health problems long after the initial infection should have resolved.
In a new study from Washington University School of Medicine in St. Louis, researchers found that COVID-19 survivors — including those not sick enough to be hospitalized — have an increased risk of death in the six months following diagnosis with the virus.
The researchers also have catalogued the numerous diseases associated with COVID-19, providing a big-picture overview of the long-term complications of COVID-19 and revealing the massive burden this disease is likely to place on the world’s population in the coming years.
In the study, the team analyzed data from more than 87,000 COVID-19 patients and nearly 5 million control patients in a federal database.
They found that up to six months after diagnosis, the risk of death following even a mild case of COVID-19 is not trivial and increases with disease severity.
They showed that, after surviving the initial infection (beyond the first 30 days of illness), COVID-19 survivors had an almost 60% increased risk of death over the following six months compared with the general population.
The researchers identified newly diagnosed major health issues that persisted in COVID-19 patients over at least six months and that affected nearly every organ and regulatory system in the body, including:
Respiratory system: persistent cough, shortness of breath and low oxygen levels in the blood.
Nervous system: stroke, headaches, memory problems and problems with senses of taste and smell.
Mental health: anxiety, depression, sleep problems and substance abuse.
Metabolism: new onset of diabetes, obesity and high cholesterol.
Cardiovascular system: acute coronary disease, heart failure, heart palpitations and irregular heart rhythms.
Gastrointestinal system: constipation, diarrhea and acid reflux.
Kidney: acute kidney injury and chronic kidney disease that can, in severe cases, require dialysis.
Coagulation regulation: blood clots in the legs and lungs.
Skin: rash and hair loss.
Musculoskeletal system: joint pain and muscle weakness.
General health: malaise, fatigue and anemia.
While no survivor suffered from all of these problems, many developed a cluster of several issues that have a significant impact on health and quality of life.
The team says compared with flu, COVID-19 showed a remarkably higher burden of disease, both in the magnitude of risk and the breadth of organ system involvement.
Long COVID-19 is more than a typical postviral syndrome. The size of the risk of disease and death and the extent of organ system involvement is far higher than what we see with other respiratory viruses, such as influenza.
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The study is published in Nature. One author of the study is Ziyad Al-Aly, MD.
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