The Impact of Long COVID: A Phenomena Taking the World by Storm
Large numbers of patients who have been infected with SARS-CoV-2 continue to experience a constellation of symptoms for weeks and months past the time that they have recovered from the initial stages of COVID-19 infection (Collins, 2021). Since early May, 2020, increasing attention has been paid to the lived experiences of patients with COVID-19 symptoms whose symptoms persist for four or more weeks. According to the Office for National Statistics (ONS), an estimated 186,000 people currently have COVID-19 symptoms 5–12 weeks or longer after acute infection (Gorna et al., 2021). Often referred to as “Long COVID”, these symptoms, which can include fatigue, shortness of breath, sleep disorders, fevers, “brain fog”, gastrointestinal symptoms, anxiety, and depression, can persist for months and can range from mild to incapacitating (Gorna et al., 2021). In some cases, new symptoms arise well after the time of infection or evolve over time.
Recent studies have shown that 10-35% of COVID-19 patients will develop persistent, long-term symptoms (Logue et al., 2021; Rubin, 2020). The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems (Mayo Clinic, 2021).
Older people and people with many serious medical conditions are at the greatest risk for experiencing persistent COVID-19 symptoms, but even young, otherwise healthy people can be impacted for weeks to months after the initial infection. Some of the most common symptoms that linger include:
Shortness of breath
Other long-term symptoms may include:
Muscle pain or headache
Fast or pounding heartbeat
Loss of smell or taste
Memory, concentration or sleep problems
COVID-19 has been classified as a disease that primarily affects the lungs, but it can damage many other organs in the body as well, including the heart, lungs, and brain. This may increase the risk of long-term health problems.
Blood Clots and Blood Vessel Problems
COVID-19 can also make blood cells more likely to clump and form clots. Although large clots can cause heart attacks and strokes, much of the heart damage caused by COVID-19 is believed to stem from very small clots that block tiny blood vessels (capillaries) in the heart muscle.
Other parts of the body affected by blood clots include the lungs, legs, liver and kidneys. COVID-19 can also weaken blood vessels and cause them to leak, which contributes to potentially long-lasting problems with the liver and kidneys.
Problems with Mood and Fatigue
People who have severe symptoms of COVID-19 often have to be treated in a hospital's intensive care unit, with mechanical assistance such as ventilators to breathe. Simply surviving this experience can make a person more likely to later develop post-traumatic stress syndrome, depression and anxiety.
It is difficult to predict long-term outcomes from the new COVID-19 virus, but scientists are looking at the long-term effects seen in related viruses, such as the virus that causes severe acute respiratory syndrome (SARS).
Many people who have recovered from SARS have gone on to develop chronic fatigue syndrome, a complex disorder characterized by extreme fatigue that worsens with physical or mental activity, but doesn't improve with rest. The same may be true for people who have had COVID-19.
Long-Term Effects Remain Unknown
Much is still unknown about how COVID-19 will affect people over time. However, researchers recommend that doctors closely monitor people who have had COVID-19 to see how their organs are functioning after recovery. Many large medical centers are opening specialized clinics to provide care for people who have persistent symptoms or related illnesses after they recover from COVID-19.
Research has shown that 1 in 3 long-COVID patients develop Dysautonomia and 1 in 5 develop an AutoImmune Disease (Dani et al., 2021). The most common form of Dysautonomia diagnosed in long-COVID patients is postural tachycardia syndrome (PoTS). It is estimated that there are between 1-3 million PoTS patients in the US. The influx of long-COVID has nearly doubled that number in less than a year. As a comparison, congestive heart failure (CHF) costs 39 billion with an estimated 6 million patients in the US averaging about $6,500 per person per year. Chronic obstructive pulmonary disease (COPD) costs 36 billion annually with an estimated 16 Million patients in the US averaging $2,250 per person per year. Considering the average of the above costs per person, we get $4,375. At an estimate of 1-3 million PoTS patients in the US, the annual cost is between 4.375 to 13.125 billion. COVID LONG HAULERS JUST DOUBLED THAT COST to between 8.750 to 26.250 billion annually.
It is estimated that 25% of PoTS patients are unable to work. Furthermore, it is estimated that 33% of CHF patients and 24% of COPD patients are unable to work. Given these estimations, 154,320 to 540,122 patients are anticipated to be unable to return to the workforce due to Dysautonomia triggered by COVID-19.
Aila Health is a virtual health platform that delivers personalized healthcare to autoimmune patients. We provide remote patient monitoring coupled with virtual and live engagement for people living with complex chronic diseases. We incorporate social determinants of health, environmental, genetic, medical history and digital phenotype data to create a complete picture of patient health to help providers deliver personalized care at scale.
Assaf, G., Davis, H., & McCorkell, L. An analysis of the prolonged COVID-19 symptoms survey by Patient-Led Research Team. Patient Led Research, 2020.
Collins, F. S. (2021, February 23). NIH launches new initiative to study “Long COVID”. National Institutes of Health. https://www.nih.gov
Dani, M., Dirksen, A., Taraborrelli, P., Torocastro, M., Panagopoulos, D., Sutton, R., & Lim, P. B. (2021). Autonomic dysfunction in ‘long COVID’: Rationale, physiology and management strategies. Clinical Medicine, 21(1), e63.
Gorna, R., MacDermott, N., Rayner, C., O’Hara, M., Evans, S., Agyen, L., ... & Hastie, C. (2021). Long COVID guidelines need to reflect lived experience. The Lancet, 397(10273), 455-457.
Logue, J. K., Franko, N. M., McCulloch, D. J., McDonald, D., Magedson, A., Wolf, C. R., & Chu, H. Y. (2021). Sequelae in adults at 6 months after COVID-19 infection. JAMA Network Open, 4(2), e210830-e210830.
Mayo Clinic. (2021). COVID-19 (coronavirus): Long-term effects. Mayo Clinic. https://www.mayoclinic.org
Rubin, R. (2020). As their numbers grow, COVID-19 “long haulers” stump experts. JAMA, 324(14), 1381-1383.