Since the Centers for Disease Control and Prevention confirmed the first case of the novel coronavirus back in January, scientists, doctors, and researchers have closely studied more than 5 million cases to learn as much as possible about the virus.
From potential treatments and vaccines to rapid testing and ICU availability, our nation- and the world as whole- has experienced a steep COVID-19 learning curve. One factor in particular is still a mystery being unraveled: the long-term effects of the coronavirus, even after recovery.
More and more patients are now being dubbed “long-haulers” because they are still experiencing symptoms up to five months after recovering from COVID-19. The majority of people with the coronavirus recover in one to two weeks. A smaller fraction of patients with severe symptoms may take up to four weeks to fully recover. But long-haulers are much different.
As Janice Johnston, medical director of Redirect Health in Scottsdale, Arizona, explained, “It’s not really clear just yet who is most at risk of having these lingering symptoms, but it does seem to impact those considered to be high-risk and those with more severe symptoms.”
Shortness of breathing, tightness of the chest, and coughing are the most common lingering symptoms observed in long-haulers. These are also the symptoms most prevalent during the acute phase of coronavirus infection.
As one long-hauler, Kristin Smith, explained, “I can’t take a deep breath without the reminder of COVID, as it feels like there are paper bags crinkling in my chest.”
It’s often the patients who were ventilated that suffer the most intense breathing difficulties after COVID-19 recovery. “Their lung function and overall muscle mass take a long time to recover, often needing multiple medications, inhalers, oxygen and physical therapy to gain back strength,” Johnston explained.
Many long-haulers also face overwhelming fatigue as they attempt to return to their daily routine. It’s not simply physical fatigue, either. The collective physical, emotional, and cognitive work required to recover from a serious illness takes its toll on the body, especially in the form of exhaustion.
“For example, patients who are recently discharged from a serious COVID-related illness may have trouble walking up and down stairs because their muscles are not back to full strength,” said Aluko Hope, co-director of Montefiore Health System’s COVID Recovery Engagement Clinic in the Bronx, New York. “This means a simple task like answering a phone call or picking up the mail during the day could push this patient to their physical limits.”
Strain on the Heart
An MRI study performed in Germany recently suggested that even mild COVID-19 infections make the body vulnerable to long-term heart damage. Lead researcher Valentina Puntmann found that 78% of COVID-19 patients in his study showed structural changes in their hearts.
In addition, 76% had evidence of a biomarker signaling cardiac injury usually seen after a heart attack. A full 60% of patients in the study showed signs of inflammation in the heart.
“The fact that 78% of ‘recovered’ [patients] had evidence of ongoing heart involvement means that the heart is involved in a majority of patients, even if COVID-19 illness does not scream out with the classical heart symptoms,” Puntmann explained.
Overall, Kristin Smith wraps up what so many long-haulers are experiencing months after “recovering” from COVID-19. “Comparing myself to how I felt in March, I am overall better. But not recovered,” she said. “I’m terrified that I’ll be this way for the rest of my life. I feel like I’m caught somewhere between death and recovery.”