Many people insist that more than 99% of the people who catch COVID-19 recover. They maintain that it’s just not that big a deal, even though more than 100 million people have caught the coronavirus in the US and more than one million have died. Those downplaying the infection have not considered that a lot of people experience post-COVID symptoms. The number of people who could suffer long-term consequences of post-COVID syndrome (PCS) is staggering.
Post-COVID Symptoms in Young People:
Most Americans are trying to put COVID in the rear view mirror. At this point, the rate of infections is low around the country, although epidemiologists expect increases during the winter. But even past COVID infections are causing trouble.
A study published in JAMA Network Open shows that children and teens who had COVID are 50 percent more likely than their peers to develop type 2 diabetes (JAMA Network Open, Oct. 14, 2024). Investigators compared the health records of 600,000 young people between January 2020 and December 2022. Approximately half had COVID during that time; the other half had colds, flu or another respiratory infection.
The absolute risk of diabetes is low, under 1 percent for people between 10 and 19 years old. However, youngsters have many years ahead of them in which diabetes may offer additional health challenges. We hope that this increased risk of metabolic disruption due to COVID-19 but not other upper respiratory tract infections will inspire studies on the cellular-level causes of type-2 diabetes.
Cardiovascular Consequences of COVID:
There is news of another disconcerting long-term consequence of infection with SARS-CoV-2. Researchers analyzed data from the UK Biobank (Arteriosclerosis, Thrombosis, and Vascular Biology, Oct. 9, 2024). Over 10,000 people had confirmed cases of COVID-19. They were compared to more than 200,000 control patients.
Those individuals who had a COVID infection were two times more likely to experience a major adverse cardiac event. That means a heart attack, a stroke or death. In fact, people who had been hospitalized with more severe cases of COVID were almost four times more likely to experience cardiovascular complications. People with type A and B blood were more susceptible than those with type O blood.
Perhaps most alarming, the risk persisted for at least three years. The consequences of a COVID infection increased the cardiovascular risk almost as much as well-established risk factors such as diabetes or peripheral artery disease. These results may encourage cardiologists to consider infection as an important risk factor for heart disease.
What Is the Incidence of Long COVID?
No one really knows how many people will develop post-COVID symptoms. It could take months or even years to fully assess the consequences of the coronavirus. That said, estimates range from 10% to 30% of COVID-19 patients may develop this thing called Long-COVID. Such patients are often referred to as “long haulers.”
An article in JAMA Network Open (Feb. 19, 2021) describes Long COVID this way:
“Many individuals experience persistent symptoms and a decline in health-related quality of life (HRQoL) after coronavirus disease 2019 (COVID-19) illness.”
The researchers wanted to know how long the symptoms last and how many people are affected:
“In this cohort of individuals with COVID-19 who were followed up for as long as 9 months after illness, approximately 30% reported persistent symptoms. A unique aspect of our cohort is the high proportion of outpatients with mild disease. Persistent symptoms were reported by one-third of outpatients in our study, consistent with a previously reported study, in which 36% of outpatients had not returned to baseline health by 14 to 21 days following infection. However, this has not been previously described 9 months after infection.”
Another study from the UK published in the BMJ (Aug. 11, 2020) suggests that:
“Approximately 10% of people experience prolonged illness after covid-19.”
Whether the true incidence of post-COVID syndrome is 30%, 10% or 1%, the consequences could be disastrous. Given that we will soon surpass 30 million people with COVID in this country, 10% would represent 3 million people with post-COVID symptoms. Even people who had mild cases with few complications can become long haulers.
What Are Post-COVID Symptoms?
The CDC describes the most common long-term symptoms of COVID-19 infection as (Nov. 13, 2020):
“The most commonly reported long-term symptoms include:
• Fatigue
• Shortness of breath
• Cough
• Joint pain
• Chest pain
“Other reported long-term symptoms include:
• Difficulty with thinking and concentration (sometimes referred to as “brain fog”)
• Depression
• Muscle pain
• Headache
• Intermittent fever
• Fast-beating or pounding heart (also known as heart palpitations)
“More serious long-term complications appear to be less common but have been reported. These have been noted to affect different organ systems in the body. These include:
• Cardiovascular: inflammation of the heart muscle
• Respiratory: lung function abnormalities
• Renal: acute kidney injury
• Dermatologic: rash, hair loss
• Neurological: smell and taste problems, sleep issues, difficulty with concentration, memory problems
• Psychiatric: depression, anxiety, changes in mood
“The long-term significance of these effects is not yet known.”
People who may have only experienced mild symptoms during the initial infection sometimes find that months later they are still suffering fatigue, shortness of breath, rapid heart rate, brain fog, headache and muscle pain.
What About POTS?
Another complication of post-COVID syndrome may be POTS (postural orthostatic tachycardia syndrome). In this condition, people may experience palpitations or lightheadedness as well as severe fatigue. When they stand, their heart rate may soar and they may become dizzy or faint.
Researchers at the University of Toledo have identified five inflammatory markers that suggest that POTS may have an auto-immune origin (Journal of Clinical Medicine, Feb. 6, 2021). Investigators in the UK are intrigued by reports that some long-COVID sufferers may have reduced symptoms after vaccination. They hypothesize that the shot may reset the immune system in some as yet undetermined way.
Final Words:
You can learn more about Long-COVID by listening to our podcast with two health professionals who themselves are long haulers. Here is a link to Show # 1230: What Happens When COVID Symptoms Don’t Go Away. In addition, you may be interested in Show 1254: Combating the Long-Term Effects of Post-COVID Syndrome.
If you have suffered from post-COVID symptoms, please share your experience in the comment section below. If you believe that COVID-19 is no big deal, how do you respond to people who are long haulers? Remember, many of these people did not experience severe illness when they first caught COVID-19. But now they are suffering.
