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, researchers reported Thursday in the journal Nature. The excess mortality translates into about 8 extra deaths per 1,000 patients -- worsening the coronavirus pandemic’s hidden toll amid growing recognition that many patients require readmission, and some die, weeks after the viral infection abates.
“When we are looking at the acute phase, we’re only pretty much looking at the tip of the iceberg,” said Ziyad Al-Aly, chief of the research and development service at the St. Louis VA Medical Center in Missouri, who led the study. “We’re starting to see a little bit beneath that iceberg, and it’s really alarming.”
Al-Aly and his colleagues documented the cascade of debilitating effects that plague survivors months after diagnosis, from blood clots, stroke, diabetes and breathing difficulties to heart, liver and kidney damage, depression, anxiety and memory loss. They also found the risk of complications was far higher than with the flu.
Globally, more than 143 million people have tested positive for Covid-19, and more than 3 million have died from the disease. Some studies indicate about 10% of patients may become so-called long haulers.
Al-Aly and colleagues used the U.S. Department of Veterans Affairs national health-care databases -- the largest nationally integrated health-care delivery system in the U.S. -- to examine diagnoses, medication use and laboratory test results from 73,435 non-hospitalized and 13,654 hospitalized patients up to six months after they had recovered from an acute case of Covid-19.
Covid survivors were more likely to require assistance for additional medical problems than almost 5 million users of the Veterans Health Administration system who didn’t have Covid-19 and weren’t hospitalized. These included:
- respiratory conditions
- nervous system disorders
- mental health problems
- metabolic and cardiovascular disorders
- malaise
- fatigue
- musculo-skeletal pain
- anemia
Individuals experiencing long-term symptoms also showed an increased use of various medications, including antidepressants and drugs to treat anxiety and pain.
“We worry about potential spikes in suicide or potential spikes in overdose of opioids,” Al-Aly said in a Zoom interview.
Covid-19 patients who survived hospitalization were found to have a 51% increased risk of dying compared with 13,997 influenza patients who also had been hospitalized.
Al-Aly, who is also an assistant professor of medicine at the Washington University School of Medicine, said he hoped the research would provide a roadmap to inform health-system planning and care strategies to mitigate chronic ill health among Covid-19 survivors, especially in the U.S.
“Let’s not act surprised two years down the road, when people start committing suicide,” he said. “We did not do very well preparing and dealing with Covid. Let’s not make that mistake a second time.”
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