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COVID-19 Long-Haulers: Here’s What We Know

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November 30, 2020

Did you know that months after being infected with COVID-19, there are people who are still living with symptoms? In the United States, we’ve started calling them “long haulers” and in the UK, they refer to this as “Long COVID.” The fact that there is a term for this should tell you that it’s happening often, and everywhere. 

The World Health Organization (WHO) states that most people who contract the virus will recover in two to six weeks, but for some, the illness comes back or lingers for months. Will they ever get well? We won’t know for a while, but it might be time to stop focusing on mortality rates and start paying attention to how COVID-19 might impact our long-term health. 

COVID Long-Haulers Are Common

Imagine being sick for several weeks and, suddenly, the symptoms start to improve. Your terrible cough gets better, you can breathe easier, and your fever has broken. Inside, you’re relieved to be beating this disease and start looking forward to feeling more like your normal self. 

For some, that will happen, but reports and research are showing a startling trend—some people have been sick for more than nine months. They don’t feel like themselves, suffer from ongoing bouts of fatigue, their cough comes and goes, and they struggle to concentrate on anything. 

The worst part is that doctors have too often dismissed this as depression or even a little PTSD after surviving a major illness. After all, if your COVID test comes back negative, it must mean that you’ve recovered, right? Unfortunately, that’s not true for many people. 

Published studies (see here, here, and here, for example) show that between 50% and 80% of patients experience persistent symptoms three months after the onset of COVID-19, despite tests no longer detecting the virus in their bodies. 

Here are some of the most common long hauler symptoms:

  • Fatigue
  • Headaches
  • Body aches
  • Shortness of breath
  • Difficult concentrating
  • Inability to exercise
  • Difficulty sleeping
  • Hair loss

This article by Harvard Health digs into the types of people who are most likely to become long haulers, other medical conditions they may develop, and the potential reasons why COVID can cause so much damage to the body. 

Kids Are Long Haulers Too

There has been a lot of debate surrounding whether to send kids back to school for in-person classes. The argument has been that children are less likely to contract COVID-19, and when they are infected, their symptoms are less severe. Meanwhile, research has shown that kids may be just as likely as adults to spread the virus. 

It’s important to note that children can be long haulers too, with some living with symptoms for months. One serious condition that they may develop is a multisystem inflammatory syndrome, or MIS-C, which causes inflammation in the heart, lungs, digestive system, and brains. There have been more than 1,000 confirmed cases since October 2020 and at least 20 children have died from it. 

A study showed that 14.8% of kids who developed MIS-C after COVID-19 also reported new neurological symptoms including muscle weakness, impaired reflexes, and headaches, among others. 

Heart Damage

One of the most common, lingering effects of COVID-19 is heart damage—even among those who were asymptomatic, experienced mild symptoms, or were in their 30s. One paper found that 78% of recovered patients showed abnormalities in the heart and 60% had ongoing myocardial inflammation. 

Additionally, a three-part journal series in the Journal of the American College of Cardiology found that nearly a quarter of people hospitalized with COVID-19 developed myocardial injury (injury to the heart tissue) and some even developed blood clots, arrhythmias, and thromboembolic disease. 

While it’s possible that the damage could heal itself, it may also lead to heart failure in some patients. We’re seeing healthcare facilities dedicated to this issue now, too. The Cedars-Sinai Smidt Heart Institute, for example, has launched an entire clinic to treat heart damage in COVID-19 survivors.

Chronic Fatigue

Many “recovered” COVID-19 patients report chronic fatigue as one of the most common aftereffects of infection. According to Sharon Dunn, the dean of LSU Health Shreveport’s School of Allied Health Professionals, “Something they’re talking about now are the long haulers, those people who might have had a limited impact while they had COVID,” she said. “But they have this persistent level of fatigue well beyond a few weeks of being positive with COVID.”

Dunn, who is also the president of the American Physical Therapy Association, believes that physical therapy can gradually help these people get back to normal. “The things that physical therapists can help with are graded exercise programs, to their tolerance, to hopefully get them back to a level of performance so that they don’t feel chronic fatigue,” she explained.

Neurological Concerns and Mental Illness

There is growing evidence that COVID-19 can cause lasting neurological damage. One study has shown that the virus can get into nerve cells and the brain. Does that happen routinely or only with severe cases? We don’t quite know yet, but it’s something researchers are watching closely. 

In another study published in Neurology, COVID-19 patients at four New York City hospitals were monitored after being diagnosed with brain and other nerve-related medical conditions. Again, what is known is evolving, but based on these U.S.-based studies and early reports from Asia and Europe, it is believed that the virus frequently causes neurological injuries. 

Some have theorized that this is the result of lung impairment preventing adequate levels of oxygen from reaching the brain. New research has also shown that COVID-19 causes a spike in proteins and causes an inflammatory response that disrupts the blood-brain barrier, potentially raising the risk of neurological damage. 

Most recently, there have been increasing numbers of reports that appear to link COVID-19 and developing mental health issues. According to a new study, one in five people who survived the virus are diagnosed with a mental illness within three months of testing positive. Of course, researchers will need to dig deeper to understand the underlying reasons for this. 

It’s Not Just About Mortality Rates

When it comes to COVID-19, it’s not just about surviving. It’s important that we learn more about the long-term effects this virus can have on our bodies and quality of life. We need to listen to the people who have been battling this novel coronavirus for months in order to better understand their experience, and how we can be better protected. In the meantime, let’s work together to keep everyone safe.

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