Whether a patient recovers at home or needs care in an intensive care unit, COVID-19 may affect their future health — possibly in drastic ways.
A recovery can take as a little as two weeks or as long as a matter of months.
One patient has been in recovery for more than three months and has had severe headaches, memory loss, language issues, and had to undergo treatment for a brain injury. Patients who have experienced symptoms for months are being called “ long haulers.”
The illness goes beyond respiratory symptoms, affecting other organs such as the heart, said Dr. Mafuzur Rahman, vice chair of medicine, director of hospital medicine and clinical assistant professor at SUNY Downstate.
“Every day it surprises us,” he said this week during a segment of “On Point,” a radio show produced by WBUR-FM in Boston.
“The majority of patients discharged from the hospital after time on the ventilator do not walk out as healthy persons,” said Dr. Charles Lerner, an infectious disease specialist from San Antonio and member of the Texas Medical Association COVID-19 Task Force.
Dr. Lerner said patients with asymptomatic coronavirus disease seem not to have a pathological condition resulting from their infection. However, there have been no studies of this.
There is very little peer-reviewed published literature on what patients experience after surviving COVID-19. What is available are a few, yet unpublished articles with small numbers of patients. These must be regarded as anecdotes rather than data. Most of these reports on individual complications suggest that 10 to 20% of patients experience each complication.
“CT scans following recovery in some patients with symptomatic infection suggest chronic lung damage (scarring). Long-term effects of this damage are not known with certainty but would probably make subsequent episodes of pneumonia worse,” Dr. Lerner said.
There have been constant reports throughout the pandemic on the deaths and positive cases of COVID-19 as it has spread worldwide, but not about the recovery process.
“Currently, there is no uniform method for reporting recoveries across the United States,” Douglas Donovan, a spokesman for Johns Hopkins University, which is one of the few institutions that has been tracking recoveries, told CNN in April.
Dr. Lerner said patients who are in an intensive care unit experience the most complications, some of which are permanent.
Here are five effects Dr. Lerner is aware of.
1. Psychological trauma akin to post-traumatic stress syndrome, inability to concentrate, poor memory and depression as well as muscle atrophy are associated with prolonged time on a ventilator. There is usually significant weight loss while in the ICU. The muscle atrophy requires rehabilitation therapy, which may happen in a rehabilitation hospital. Psychiatric care may be necessary. Up to 30% of ICU patients experience these complications.
2. Loss of taste and smell can persist for months and in some patients seem to be permanent.
3. Inflammation of the heart occurs in up to 20% of patients.
4. Blood clots resulting in stroke can leave permanent neurologic damage, as well as send emboli to other areas. Broadway actor Nick Cordero had a leg amputated because of this complication.
5. Kidney failure requiring dialysis has been reported in some patients. This apparently is permanent. It is more likely to occur in patients who have underlying kidney problems.
“Patients with pre-existing medical problems that are not severe enough to cause them functional limitation may be pushed into functional limitation by the added complications from COVID-19 infection, Lerner said. “For example, someone with mild heart disease plus the myocarditis (heart inflammation) from the infection may be pushed into congestive heart failure.”
“Patients with mild kidney failure that they may have not been aware of may require dialysis for life,” he added.