COVID-19 – The Consequences

COVID-19 isn’t “just the flu.”

“This [virus] is behaving differently [than any other known virus].”

We still have so much to learn. While we do know that the majority of the deaths are in our seniors, we know that long-term health consequences do not have an age limit. We do know it can take months for some people to recover; there are enough of them to have a name: “Long Haulers.” We learned recently that there is a strong chance of cardiac issues amongst people who have recovered from COVID-19.  We know that there can be organ damage, including lung damage and brain damage.

What we don’t know is what we don’t yet know. And THAT is what scares me the most.

There are long-term consequences of this virus that we know about and more that could take years to develop. Here are some things to consider about what a virus can do to you:


Chicken pox is a virus. Lots of people have had it, and probably don’t think about it much once the initial illness has passed. But it stays in your body and lives there forever, and maybe when you’re older, you have debilitatingly painful outbreaks of shingles. You don’t just get over this virus in a few weeks, never to have another health effect. We know this because it’s been around for years, and has been studied medically for years.

Herpes is also a virus. And once someone has it, it stays in your body and lives there forever, and anytime they get a little run down or stressed-out they’re going to have an outbreak. Maybe every time you have a big event coming up (school pictures, job interview, big date) you’re going to get a cold sore. For the rest of your life. You don’t just get over it in a few weeks. We know this because it’s been around for years, and been studied medically for years.

HIV is a virus. It attacks the immune system, and makes the carrier far more vulnerable to other illnesses. It has a list of symptoms and negative health impacts that goes on and on. It was decades before viable treatments were developed that allowed people to live with a reasonable quality of life. Once you have it, it lives in your body forever and there is no cure. Over time, that takes a toll on the body, putting people living with HIV at greater risk for health conditions such as cardiovascular disease, kidney disease, diabetes, bone disease, liver disease, cognitive disorders, and some types of cancer. We know this because it has been around for years, and had been studied medically for years.

Now with COVID-19, we have a novel virus that spreads rapidly and easily. The full spectrum of symptoms and health effects is only just beginning to be cataloged, much less understood.

So far, the symptoms include:

  • Fever
  • Fatigue
  • Coughing
  • Pneumonia
  • Chills/Trembling
  • Acute respiratory distress
  • Lung damage (potentially permanent)
  • Loss of taste (a neurological symptom)
  • Sore throat
  • Headaches
  • Difficulty breathing
  • Mental confusion
  • Diarrhea
  • Nausea or vomiting
  • Loss of appetite
  • Strokes have also been reported in some people who have COVID-19 (even in the relatively young)
  • Swollen eyes
  • Blood clots
  • Seizures
  • Liver damage
  • Kidney damage
  • Rash
  • COVID toes (weird, right?)

People testing positive for COVID-19 have been documented to be sick even after 60 days. Many people are sick for weeks, get better, and then experience a rapid and sudden flare up and get sick all over again. A man in Seattle was hospitalized for 62 days, and while well enough to be released, still has a long road of recovery ahead of him. Not to mention a $1.1 million medical bill.

Then there is MIS-C. Multisystem inflammatory syndrome in children is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extra tired. While rare, it has caused deaths.

This disease has not been around for years. It has basically been 6 months. No one knows yet the long-term health effects, or how it may present itself years down the road for people who have been exposed. We literally *do not know* what we do not know.

For those in our society who suggest that people being cautious are cowards, for people who refuse to take even the simplest of precautions to protect themselves and those around them, I want to ask, without hyperbole and in all sincerity:

How dare you?

How dare you risk the lives of others so cavalierly?

How dare you decide for others that they should welcome exposure as “getting it over with,” when literally no one knows who will be the lucky “mild symptoms” case, and who may fall ill and die. Because while we know that some people are more susceptible to suffering a more serious case, we also know that 20- and 30-year-olds have died, marathon runners and fitness nuts have died, children and infants have died.

How dare you behave as though you know more than medical experts, when those same experts acknowledge that there is so much we don’t yet know, but with what we DO know, are smart enough to be scared of how easily this is spread, and recommend baseline precautions such as:

  • Frequent hand-washing
  • Physical distancing
  • Reduced social/public contact or interaction
  • Mask wearing
  • Covering your cough or sneeze
  • Avoiding touching your face
  • Sanitizing frequently touched surfaces

The more things we can all do to mitigate our risk of exposure, the better off we all are, in my opinion. Not only does it flatten the curve and allow health care providers to maintain levels of service that aren’t immediately and catastrophically overwhelmed; it also reduces unnecessary suffering and deaths, and buys time for the scientific community to study the virus in order to come to a more full understanding of the breadth of its impacts in both the short and long term.

I reject the notion that it’s “just a virus” and we’ll all get it eventually. What a careless, lazy, heartless stance.


The above message is not my words. They have been shared with many versions. Some attribute this to Dr. Fauci, but Snopes says the original author is probably a woman named Amy Wright. (Good last name!)

 


Suggested reading

As I become aware of additional long-term consequences I will add them here.

MULTIPLE ORGANS

Scientists Uncover Long Term Effects of COVID-19, Virus Attacks Vital Organs: https://www.nbcsandiego.com/news/local/scientists-uncover-long-term-effects-of-covid-19-virus-attacks-vital-organs/2358577/

HEART & CIRCULATION

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19). In a new study report in the prestigious JAMA, 100 patients, recently recovered from COVID-19, were given a Cardiac MRI. 53 were male. The median age was 49; ages ranged from 45-53. “Cardiac magnetic resonance imaging revealed cardiac involvement in 78 patients (78%) and ongoing myocardial inflammation in 60 patients (60%), which was independent of preexisting conditions, severity and overall course of the acute illness, and the time from the original diagnosis.” “These findings indicate the need for the ongoing investigation of the long-term cardiovascular consequences of COVID-19.”  https://jamanetwork.com/journals/jamacardiology/fullarticle/2768916

Queensland Health: Health impacts of COVID-19. “As we learn more about the virus (COVID-19) every single day, we’re learning that for a reasonable number of people, they don’t recover, they’ll have long-term consequences from the disease…” Our Chief Health Officer Dr Jeannette Young, explains some of the potential long term health impacts of COVID-19.
https://www.facebook.com/QLDHealth/videos/924795394695626

Journal series gives in-depth look at COVID-19’s impact on the heart.
The Journal of the American College of Cardiology ranks among the top cardiovascular journals in the world for its scientific impact. Today (10/19) they made the news, reporting that a quarter of hospitalized patients have myocardial injury. Researchers said that the long-term risk of serious illness for survivors of severe cases of COVID-19 remain uncertain, but early observations are concerning. “It is plausible to assume that COVID-19 survivors will be more vulnerable to long-term cardiac morbidity,” https://www.eurekalert.org/pub_releases/2020-10/acoc-jsg101520.php

Ohio State study: 30% of student athletes have heart damage linked to COVID-19: New research suggests COVID-19 may leave lingering heart damage.
https://www.fox26houston.com/news/ohio-state-study-30-of-student-athletes-have-heart-damage-linked-to-covid-19

COVID-19 Triggering Recurrent Clots in Arm:
Researchers have reported the first case of COVID-19 causing dangerous, recurring blood clots in a patient’s arm. The report offers new insight into how the damage of inflammation caused by COVID-19 can linger.
https://www.webmd.com/lung/news/20210519/first-case-of-covid-19-triggering-recurrent-clots-in-arm

LUNG

Lifelong Lung Damage: The Serious COVID-19 Complication That Can Hit People in Their 20s: https://www.healthline.com/health-news/lifelong-lung-damage-the-serious-covid-19-complication-that-can-hit-people-in-their-20s

BRAIN

How Covid-19 can damage the brain: https://www.bbc.com/future/article/20200622-the-long-term-effects-of-covid-19-infection

COVID-19 could hide in your brain and reactivate down the road:
https://www.wsbtv.com/news/local/new-study-shows-coronavirus-could-hide-your-brain-reactivate-down-road/KGK5DCZUYBHS3LKGEXR2QY5BEE/?
https://news.gsu.edu/2021/01/19/study-finds-covid-19-attack-on-brain-not-lungs-triggers-severe-disease-in-mice/

How COVID-19 Attacks The Brain And May Cause Lasting Damage:
https://www.npr.org/sections/health-shots/2021/01/05/953705563/how-covid-19-attacks-the-brain-and-may-cause-lasting-damage

Most COVID-19 patients have neurological symptoms:
80% of those patients hospitalized with COVID-19 had neurological manifestations including encephalopathy (49%), coma (17%), and stroke (6%). Presence of clinically captured neurologic signs and/or syndromes was associated with increased risk of in-hospital death. https://www.news-medical.net/news/20210517/Most-COVID-19-patients-have-neurological-symptoms.aspx

REPRODUCTIVE

From a peer-reviewed medical article that had been published in J Endocrinol Invest. 2020 Jul 13 : 1–9: “… great attention should be directed towards the possible long-term outcomes of the disease. Despite being a trivial matter for patients in intensive care units (ICUs), erectile dysfunction (ED) is a likely consequence of COVID-19 for survivors, and considering the high transmissibility of the infection and the higher contagion rates among elderly men, a worrying phenomenon for a large part of affected patients.” 

Their conclusion? “COVID-19 survivors might develop sexual and reproductive health issues. Andrological assessment and tailored treatments should be considered in the follow-up. … In conclusion, there is quite enough reason to suspect that male sexual and reproductive health could be affected in the survivors, by the sequelae of the COVID-19, both in the short and long terms Erectile function, as a surrogate marker of cardiovascular/pulmonary health, could also become extremely valuable as a quick and inexpensive first-line assessment of the pulmonary and cardiovascular complications for COVID-19 survivors.”

 That report can be viewed here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355084/

Additional connections of Erectile Dysfunction and COVID-19:

PSYCHIATRIC CONDITIONS AND DISORDERS

New studies connect COVID-19 with mental health issues.  At least three new studies published in the past few days indicate that COVID-19 may be linked to several psychiatric conditions and disorders. Mental health issues including anxiety disorders, insomnia, dementia, and PTSD are appearing in 20% of patients 14 to 90 days after a COVID-19 diagnosis.

One of these studies also found that people who had a mental health diagnosis in the year before COVID were about 65% more like to receive a diagnosis of COVID, even accounting for known risk factors such as age, sex, race, and underlying physical conditions.

A number of articles have been published on this topic, including BBC, https://www.bbc.com/news/health-54874010 and Psychiatry Advisor, https://www.psychiatryadvisor.com/home/topics/general-psychiatry/covid-19-patients-with-longer-hospital-stays-may-have-better-psychiatric-outcomes/

The actual studies can be found at The Lancet – Psychiatry, https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30462-4/fulltext and also at https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30462-4/fulltext, as well as one in The Lancet – Healthy Longevity, https://www.thelancet.com/journals/lanhl/article/PIIS2666-7568(20)30020-9/fulltext.

SLOW RECOVERY – LONG HAULERS

Long Haulers: It can take months for some people to recover. Those who struggle with no sign of recovery are called “long-haulers.” Here’s the story of several long-haulers: https://www.theatlantic.com/health/archive/2020/06/covid-19-coronavirus-longterm-symptoms-months/612679/

I can’t shake Covid-19: Warnings from young survivors still suffering: https://www.cnn.com/2020/07/18/health/long-term-effects-young-people-covid-wellness/index.html

Puzzling, often debilitating after effects plaguing COVID-19 “Long Haulers:”
https://www.cbsnews.com/news/covid-long-haulers-60-minutes-2020-11-22/

Doctors Begin to Crack Covid’s Mysterious Long-Term Effects. Severe fatigue, memory lapses, heart problems affect patients who weren’t that badly hit initially; ‘It’s been so long’ https://www.wsj.com/articles/doctors-begin-to-crack-covids-mysterious-long-term-effects-11604252961?

Attributes and predictors of long COVID. A study that included over 4,000 COVID patients found that 13.3 percent reported having symptoms lasting more than 28 days, 4.5 percent had symptoms for more than eight weeks, and 2.3 percent had symptoms more than 12 weeks. Long COVID, or Post-Acute Sequelae of SARS-CoV-2 infection (PASC), was more likely with older patients, patients with higher body mass indices, and females. Experiencing more than five symptoms during the first week of illness was also strongly associated with long COVID. https://www.nature.com/articles/s41591-021-01292-y

Long Hauler’ Study Shows Covid Can Kill Months After Infection. “We are starting to see a little bit beneath that iceberg, and it’s really alarming.” “One of the largest studies of Covid-19 “long haulers” has proved what many doctors suspected: Not only are many patients suffering a raft of health problems six months after infection, they’re also at significantly greater risk of dying.” “Survivors had a 59% increased risk of dying within six months after contracting the SARS-CoV-2 virus … The excess mortality translates into about 8 extra deaths per 1,000 patients — worsening the pandemic’s hidden toll amid growing recognition that many patients require readmission, and some die, weeks after the viral infection abates.”
https://www.bloomberg.com/news/articles/2021-04-22/-long-hauler-study-shows-covid-can-kill-months-after-infection. The full study, “High-dimensional characterization of post-acute sequalae of COVID-19,” can be found at https://www.nature.com/articles/s41586-021-03553-9

Why Impact of ‘Long Covid’ Could Outlast the Pandemic. “Millions of people who have gotten Covid-19 and survived are finding that a full recovery can be frustratingly elusive. Weeks and months after seemingly recovering from even a mild case, many patients confront a wide range of health problems. As researchers try to measure the durability and depth of what’s being called “long Covid,” a burgeoning number of specialized post–acute Covid clinics are opening to handle the patients. The scale of the pandemic means that Covid’s disabling effects — as well as economic pain and drain on health resources — could persist well after the contagion ends.”
https://www.bloomberg.com/news/articles/2021-04-13/why-impact-of-long-covid-could-outlast-the-pandemic-quicktake

Sixty-Day Outcomes Among Patients Hospitalized With COVID-19. “Nearly 1 in 3 patients died during hospitalization or within 60 days of discharge. For most patients who survived, ongoing morbidity, including the inability to return to normal activities, physical and emotional symptoms, and financial loss, was common. These data confirm that the toll of COVID-19 extends well beyond hospitalization.”
https://www.acpjournals.org/doi/10.7326/M20-5661

HAIR LOSS

COVID-19 Related Hair Loss: Telogen effluvium as a consequence of COVID-19 infection. Believed to be temporary, there are increased reports about patients losing their hair two to three months after being infected with COVID-19. https://consultqd.clevelandclinic.org/covid-19-related-hair-loss/

DIABETES

New-Onset Diabetes in Covid-19. There is a bidirectional relationship between Covid-19 and diabetes. On the one hand, diabetes is associated with an increased risk of severe Covid-19. On the other hand, new-onset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and hyperosmolarity for which exceptionally high doses of insulin are warranted, have been observed in patients with Covid-19. https://www.nejm.org/doi/full/10.1056/NEJMc2018688

Can COVID-19 Cause Diabetes? Recent research suggests a COVID-19 infection may cause the sudden onset of insulin-dependent diabetes with significant insulin resistance, even in previously healthy young adults, who were asymptomatic. There’s been an uptick in autoimmune diabetes since the pandemic started. Sanjoy Dutta, vice president of research for JDRF (formerly the Juvenile Diabetes Research Foundation), said, “I don’t think this is type 1 or type 2 diabetes. I think it should be called new onset or sudden onset insulin-dependent diabetes.” https://www.webmd.com/lung/news/20200903/can-covid-19-cause-diabetes#2

Doctors probe whether COVID-19 is causing diabetes
. Many experts are convinced that COVID-19 can trigger the onset of diabetes – even in some adults and children who do not have the traditional risk factors. “We have more questions than answers right now,” said Dr. Robert Eckel, president of medicine and science at the American Diabetes Association. “We could be dealing with an entirely new form of diabetes.” Researchers at Imperial College in London and several hospitals there found that cases of type 1 diabetes among children nearly doubled to 30 during late March to early June – as the pandemic ragedIn the United States, Children’s Hospital Los Angeles said the percentage of newly diagnosed type 2 patients who arrived in diabetic ketoacidosis, a potentially fatal buildup of acid in the blood, has nearly doubled for March through August compared to the same period in 2018 and 2019. https://www.reuters.com/article/health-coronavirus-diabetes-insight/doctors-probe-whether-covid-19-is-causing-diabetes-idINKBN2741D6

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