Long Term Consequences of COVID-19 Infection

One reason a substantial fraction of U.S.-ians claim to not be worried about COVID-19 might be that too many people believe if you don’t die, you’ll get over it. Yes, there might even be a couple weeks of hell, but you’ll recover. Unfortunately, that doesn’t always seem to be the case. It’s hard right now to know exactly what fraction of cases have significant long-term effects, but there seem to be enough individual cases to suggest that the number is non-negligible. Consider this from Ebola virus expert Peter Piot, who contracted COVID-19 (boldface mine):

Virologist Peter Piot, director of the London School of Hygiene & Tropical Medicine, fell ill with COVID-19 in mid-March. He spent a week in a hospital and has been recovering at his home in London since. Climbing a flight of stairs still leaves him breathless…

I could only whisper for weeks; even now, my voice loses power in the evening. But I always had that question going around in my head: How will I be when I get out of this?

One week after I was discharged, I became increasingly short of breath. I had to go to the hospital again, but fortunately, I could be treated on an outpatient basis. I turned out to have an organizing pneumonia-induced lung disease, caused by a so-called cytokine storm. It’s a result of your immune defense going into overdrive. Many people do not die from the tissue damage caused by the virus, but from the exaggerated response of their immune system, which doesn’t know what to do with the virus. I’m still under treatment for that, with high doses of corticosteroids that slow down the immune system. If I had had that storm along with the symptoms of the viral outbreak in my body, I wouldn’t have survived. I had atrial fibrillation, with my heart rate going up to 170 beats per minute; that also needs to be controlled with therapy, particularly to prevent blood clotting events, including stroke. This is an underestimated ability of the virus: It can probably affect all the organs in our body.

Many people think COVID-19 kills 1% of patients, and the rest get away with some flulike symptoms. But the story gets more complicated. Many people will be left with chronic kidney and heart problems. Even their neural system is disrupted. There will be hundreds of thousands of people worldwide, possibly more, who will need treatments such as renal dialysis for the rest of their lives. The more we learn about the coronavirus, the more questions arise. We are learning while we are sailing. That’s why I get so annoyed by the many commentators on the sidelines who, without much insight, criticize the scientists and policymakers trying hard to get the epidemic under control. That’s very unfair.

There are other cases, but, like I said, I haven’t really seen any good summary of long-term outcomes.

It’s those long-term outcomes that scare me. I assume, at some point, I’ll get COVID-19, since the Trump administration really doesn’t care if we get sick. If I just have a couple of hellish weeks, and no long-term effects, I’ll consider myself lucky. But, as Piot noted, we should assume that a fraction of COVID-19 survivors will be crippled, but too many people don’t seem to realize this. That’s why the U.S.’s de facto herd immunity strategy is so galling: so many people will be disabled over the long-term who otherwise wouldn’t be.

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