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COVID-19 ‘long haulers’ have lingering health problems

Physicians say some patients discharged from hospitals after COVID-19 have developed heart and kidney problems, suffered lung damage and neurological issues such as blood clots and joint pain.

Dr. Heather Abraham, an assistant professor of internal medicine at Wayne State University School of Medicine, opened a COVID-19 continuing care clinic in late July at the University Health Center at DMC Detroit Receiving Hospital.

Abraham has been treating 10 patients who tested positive for COVID-19 and are having lingering health problems after being diagnosed in March, April and May.

“They still have shortness of breath and other things” such as fatigue and symptoms similar to post-traumatic stress disorder,” Abraham said. “Mostly people had asthma, COPD, heart failure, stroke” and are complaining they are not well. Doctors like Abraham say they are most worried about COVID-19 survivors who have existing chronic diseases. Those with diabetes, kidney disease, heart disease, chronic obstructive pulmonary disease, obesity, cancer or mental illness are likely to develop additional health problems.

Since coronavirus swept into the U.S. earlier this year and Michigan in March, COVID-19 has killed more than 6,300 Michiganders with 84,000 testing positive. As of Aug. 12, the U.S. had the most deaths in the world at 165,000 and positive cases at 5.2 million. Worldwide, 745,000 have died with 20.4 million testing positive.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases and member of the White House Coronavirus Task Force, said post-viral COVID-19 syndrome is fast becoming a patient care problem.

“Brain fog, fatigue and difficulty in concentrating,” said Fauci at a recent International AIDS Conference describing the new COVID-19 associated symptoms. “So this is something we really need to seriously look at.”

There are no FDA-approved treatments for post-viral syndrome, but experts say patients suffering from it after a bout of COVID-19 can develop a severe illness that may take weeks to overcome.

A June JAMA paper showed that 87% of COVID patients in Italy who recovered still have at least one persistent symptom, particularly fatigue and dyspnea, or labored breathing. Of 179 eligible patients, 44% were observed to have worsened quality of life.

These so-called “coronavirus long-haulers” have symptoms that include fatigue, difficulty breathing, chest pain and joint pain, the JAMA paper said.

Nationally, a growing number of patients on social media groups like Facebook’s “Long COVID Support Group” have freewheeling discussions about their lingering symptoms.

They share and discuss mild problems that include continued loss of taste or smell to more serious ones such as irregular heart beats, unusual chest pressure or pain, shortness of breath, extreme fatigue, memory or cognitive difficulties or recurring fevers.

“I took a massive sudden turn for the worse at lunchtime today . I had bad heart pain and palpitations, chest pain, back pain, dizziness, I just couldn’t breathe. I was so scared I called 911,” one Facebook post described. “They were looking for signs of sepsis but were happy I didn’t have any but advised about a possible readmission (to a COVID-19 ICU). This isn’t a place you want to be and I’ve been in no hurry to go back (after 17 weeks).”

Specialty doctors also say people who required intensive care are also at increased risk for mental health issues like post-traumatic stress disorder, anxiety and depression. Cancer patients who contracted COVID-19 also may have delayed treatment, leading to worsening conditions.

People with chronic health conditions such as heart disease and diabetes were hospitalized six times more often than otherwise healthy individuals infected with the coronavirus during the first four months of the pandemic, and they died 12 times more often, according to a new report published by the Centers for Disease Control and Prevention.

Research also is underway at the University of Michigan and other university-based academic medical centers on the impact of COVID-19 on health, employment, quality of life and access to care. UM is conducting a survey about how COVID-19 is affecting survivors.

“We know that the pandemic is much more than just an illness,” said lead investigator Nancy Fleischer, associate professor of epidemiology at the UM School of Public Health, in a statement. “It has caused a massive economic shift as well, and so we’re also asking about things that happened in terms of not just the people diagnosed with COVID-19, but also their families, and if they have experienced job loss, had problems paying rent or had a harder time feeding their families.

Fleischer said the UM survey is asking survivors a number of questions, including how COVID-19 has affected their well-being and what health problems they are encountering.

“We don’t know how many people and how long they will be affected. We are still in the middle of the COVID-19 pandemic,” Fleischer said.

The additional costs to patients in dollars and in reduced quality of life is hard to calculate, said Edward Norton, a health economist in the University of Michigan’s School of Public Health.

Besides health care costs of the acute COVID-19 treatment, Norton said people who develop long-term chronic illnesses related to COVID-19 will generate additional health care costs.

“Very often when someone leaves the hospital they get additional, post-acute care. If they are elderly, they may go to a nursing home for rehabilitation,” Norton said. “COVID-19 disrupts the post acute care they normally would get and could exacerbate their current condition.”

Norton said employed workers with long-term issues could experience decreased productivity and job performance. They might have to take time off and could possibly lose their jobs.

“There are a lot of domino effects. People won’t pay as much toward income taxes and that could affect the entire system. They could lose health insurance and go on Medicaid or get unemployment insurance,” he said.

Dr. Aditya Pandey, a neurosurgeon at the University of Michigan, said doctors and hospitals are preparing for a possible second wave of COVID-19 later this fall.

“We have to be prepped. Each health system needs to look at what they need. In April and May we saw a 30 percent decrease in patients coming in for stroke. We know strokes didn’t stop. They either died at home or their condition worsened and they risked becoming permanently disabled,” he said.

Some COVID-19 ‘long haulers’ have lingering health problems after recovery” originally appeared in Crain’s Detroit Business.



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