When COVID-19 first appeared, doctors knew only that some patients survived and some died. There is growing recognition that many people who survive the coronavirus may experience long-lasting complications. These so-called long-haulers feel really bad after COVID-19 for many months (JAMA, online Oct. 5, 2020). This “long COVID” appears to affect a lot more people than originally believed (The Lancet, Jan. 8, 2021). Now doctors think they have a clue to who might suffer.
How Common Is Long COVID?
Even after recovering from COVID-19 infections, a substantial proportion of people report symptoms that last for many months. Some suffer neurological problems such as headaches, trouble concentrating, tinnitus or loss of the sense of smell. A number of studies clarify how often people feel bad after COVID-19 “recovery.” Doctors conducted one of these investigations in Wuhan, an early focus of infection. We describe their findings below. In addition, we discuss the results of two reports on long-lasting COVID symptoms, one from Britain and one from the VA in the US.
Lingering COVID-19 Symptoms in Britain:
British researchers tracked nearly 48,000 COVID patients who were discharged from hospitals there (medRxiv, Jan. 15, 2021). About 30% were re-admitted over the next several weeks and 12.3% died. People experienced serious breathing problems, heart attacks, heart failure, arrhythmias, strokes diabetes and chronic kidney disease.
Some US Veterans Also Feel Bad After COVID-19:
A similar study followed more than 2,000 veterans diagnosed with COVID-19 and discharged from 132 VA hospitals (JAMA, Jan. 19, 2021). Within two months of discharge, 27% of these patients came back to the hospital or died. Post-COVID syndrome, as doctors now term these complications, deserves more attention.
Research from Wuhan:
With less than two years of experience with SARS-CoV-2 and its resulting infection, COVID-19, we don’t yet know much about long term consequences. A study of patients in Wuhan, the Chinese city hit earliest in the pandemic, is sobering.
The research, published in The Lancet (Jan. 8, 2021), followed up on more than 1,700 individuals discharged from hospitals between January and May of last year. All had been hospitalized with COVID-19.
Approximately six months after hospital discharge, more than 60% reported fatigue or muscle weakness. About a quarter were still having trouble sleeping, and nearly that many reported anxiety or depression. Those who had been most severely ill when hospitalized were more likely to have breathing problems.
Long-Haulers Feel Bad After COVID-19:
Long-haulers report symptoms such as fatigue, chest pain, trouble breathing and joint pain that last for months. Although older people are more likely to have difficulty snapping back after an infection, a significant proportion of younger people also report symptoms that linger.
Even people who were not hospitalized may experience some of these long-term health consequences. Some survivors, including previously healthy young athletes, have evidence of damage to the heart muscle. In one study of 55 patients three months after hospital discharge, 70% had imaging abnormalities suggestive of lung fibrosis.
Neurological and Psychological Reactions to COVID-19:
There are also quite a few people who suffer mood swings and brain fog months after the initial illness. In addition, long-haulers may be vulnerable to isolation, loneliness, depression and anxiety. After all, no one expects them to continue to suffer. British researchers report that approximately 10% of patients feel very bad after COVID-19 (JAMA, online Sept. 23, 2020).
No one yet knows how long these symptoms may persist. However, with millions of people recovering from COVID-19, the world needs thoughtful comprehensive studies that can guide programs of care.
Who Might Feel Bad After Recovering from COVID?
Now scientists suggest that a technique identifying damage to small nerve fibers can predict who may be susceptible to long COVID. These small fibers can be detected in the cornea, or outer transparent layer of the eye (British Journal of Ophthalmology, July 26, 2021). The researchers report that people with neurological symptoms following COVID-19 infection have significant small-fiber nerve damage apparent in the cornea. The amount of damage correlates to the severity of the symptoms. The study included 30 healthy individuals and 40 who had recovered from COVID. Approximately half of the latter had lingering symptoms. However, all of those who had experienced a coronavirus infection had elevated levels of immune system cells on their corneas.
Should People with Long COVID Get Vaccinated?
Q. I had COVID in December. Although I got over the pneumonia, I still have brain fog. In addition, I feel very weak and get tired easily. My right hand shakes. I had none of these problems prior to catching COVID.
Is it dangerous to get the vaccination after you have already had COVID? My doctor says it is safe once three months have gone by, but I am still nervous. Any information you have would be appreciated.
A. According to the CDC,
“Yes, you should be vaccinated regardless of whether you already had COVID-19…If you were treated for COVID-19 with monoclonal antibodies or convalescent plasma, you should wait 90 days before getting a COVID-19 vaccine.”
We have heard from some experts that the vaccine might even help overcome some of the symptoms of post-COVID syndrome (PCS).
“As more people get vaccinated, a surprise discovery has been that the vaccines seem to provide relief for some patients with what’s being called ‘long COVID’ (when symptoms linger for weeks or even months)…As many as 30 to 40 percent of those who get the vaccine have reported improvements to their symptoms.”
To learn more about PCS and ways to treat this mysterious condition, you may want to listen to our podcast, Show 1254: “Combating the Long-Term Effects of Post-COVID Syndrome.” It is under the podcast tab at www.PeoplesPharmacy.com.
You may also wish to listen to our interview with social epidemiologist Dr. Margot Gage Witvliet, who describes what it is like to feel bad after COVID-19 six months later. We also discuss long-lasting COVID-19 symptoms with Dr. Michael Saag. Both interviews are included in our Show 1230.
Show 1230: What Happens When COVID Symptoms Don’t Go Away
Even young healthy people may have trouble when COVID symptoms don’t go away for weeks or months. Find out what it’s like.
There is also more information about vaccines in Show 1247: What You Need to Know About COVID-19 Vaccines and Variants.